SA Node Modification

Something's fishy here

by AgentX86 - 2022-10-20 21:53:37

You said that you had an AV node ablation, which implies a pacemaker. Yet you still have heart rates in the 30s at times.  There's something wrong here. You have SVTs (if it was VT, you'd have an ICD), yet you've had an AV node ablation. The two don't go together.

 Your doctor also wants to do an "SA node modification" which is (or at least was very recently) an experimental alternative to an AV node ablation.  Once you've had the latter, the former makes no sense. The SA node no longer means anything.

There is some (a lot) of confusion somewhere here.

Further clarification needed

by Gemita - 2022-10-21 05:42:19

I agree, your post doesn’t make a great deal of sense POTSgirl?  Perhaps you have misunderstood what type of ablation you have had?  

Did you perhaps have a regular pulmonary vein isolation (PVI) ablation to try to treat any atrial tachy arrhythmias?  A PVI ablation is usually tried first because an AV node ablation is so final and effectively blocks all electrical signals from the upper chambers of the heart (the atria) from passing through the AV node to the lower chambers of our heart (the ventricles and main pumping chambers).  This would then require an immediate pacemaker since we would become pacemaker dependent.  But of course you do not yet have a pacemaker so it would seem you haven't had an AV Node ablation?

An AV node ablation is usually a last resort when all other treatment options for an atrial tachy arrhythmia have been tried and have failed.  By blocking electrical signals at the AV Node, it effectively stops fast atrial arrhythmias from passing through to push our ventricles too fast.  This would bring immediate symptom relief for most of us.  It won't however stop our "atrial" tachy arrhythmias which would still continue to fibrillate, flutter in the atria but you shouldn't feel this so much any more.  By blocking the irregular, fast arrhythmias in the atria and pacing the heart steadily with a pacemaker, symptom relief can be achieved.

I would go back and ask your doctors to explain the type of ablation you have had and what they intend to do next?  I would take someone with you for support.  After any type of ablation we can expect increases in heart rhythm disturbances while our hearts are healing.  

Perhaps you could clarify your post in due course, so that we can try to support you.  Vasovagal syncope may not always be helped by a pacemaker since a sudden fall in blood pressure can also cause syncope and a fall in blood pressure cannot unfortunately be controlled by a pacemaker, as can a fall in heart rate

Second opinion

by Rch - 2022-10-21 20:45:27

Hi

I would suggest you talk to your PCP to be referred to another EP for a second opinion. Also, try to get some insight from a Neurologist's prospective to address the issue outside of ablations and pacemakers! My personal opinion about some of the EPs is that if you only have a hammer everything looks like a nail! 

Hammers and nails

by AgentX86 - 2022-10-22 00:01:59

You sure hit that on right on the head. 🥴

I was having periods of light-headedness one day a month, all day, like clockwork. My cardiologist and EP kept looking for a source and gave up.  I finally had a grand mal siezure and it became clear that we were looking in the wrong direction. No one can explain the monthly thing but a neurologist (I collect "ists") and two more pills a day and I'm good.

I apologize

by POTSgirl - 2022-10-24 06:16:38

Today is the morning of my procedure. I'm not sure the correct term for the ablation I had a month ago. All I know is I was awake for the entire thing and it was painful. I had a vasovagal episode on the table, fainted and he immediately stopped. I have been thoroughly tested by a neurologist and considered "clean bill of health" in the neurologist department. He said the SA Node modification could potentially make my fainting worse. We don't know what is causing the syncope-- high heart rate or the sudden plummet. During the tilt table test, my heart rate got to 160, I fainted, and had a heart rate of 30 with no pulse felt. My blood pressure seems to stay the same. I am on the max doses of propanolol, midodrine and ivabradine. This is the one doctor I trust that is fully invested in my well being.