EP study, non-sucessful ablation attempt

For those that have done an EP study and not been able to get SVT to fire during, have you gone on to try meds to moderate condition, if so, what effects have accompanied that?

I get to go in for stress test on bike with echo at same time to see what my ASD might be doing.

Nothing lie having HR at 300bpm intermittently for 2.5 hours only to come out the same as you went in, well, except for the pain in groin

I’m 2 ablations into treating a fib and a flutter (1 right side, 1
Left side). I won’t know the level of success until I’m off meds (rate control and rhythm control) next month, 3 months after the right side ablation.

I can’t help you with the medical, physical aspects of SVT, but I’ve given a lot of thought to the emotional and mental aspects of recovering and getting back into it.

I look at this as a potential long process to get it right, but a necessary one. After finally qualifying in 2011, I was pretty amped to maintain and build fitness and speed, but that’s not in the cards. I’ve written off any real training until at least late 2013. Given that I’m 43, although I stress about missing a year or more, that’s the way it goes.

SVT is serious, so take the steps necessary to get it right. Use good doctors and make sure that you are confortable about the game plan.

Good luck.

thanks for the reply, SVT and A-fib are different animals. A teammate of mine just hung it up because of a-fib. I experienced a-fib once, in 1995 and can say without a doubt, that was way more debilitating as climbing a flight of stairs with that required rest stops along the way.

doc keeps saying it is not serious. no point in trying again either, as they could not trigger it. The worse that happens in my case is hr shoots up temporarily, power drops and breathing feel a bit short. doc said meds are probably not a good solution for me either, but i will ask again if they are good during periods when the svt is more frequent.

SVT is way easier than a-fib ablation. doc repeated said i would be able to be back to full training within 3-5 days, with the catheder insertion point healing being the limiting factor.

now, Wed stress test will help determine if they go back in to close the ASD or not.

annecdotally, i can blame it on 170 cranks, as in 2010 and 1012 tha tis what i used and in 2011, i had no episodes and was on 165s :slight_smile:

have to stay lighthearted about it only as it gets annoying at times. I skipped master nats because of this and that same weekend set a power PR over 20k locally

Jeff,

Curious about a couple things…& perhaps clarification would be helpful to the readers here…

  1. How’d you establish the diagnosis of SVT? And any more specific on the type?
  2. How bothersome/frequent/severe is the arrhythmia?
  3. Why exactly did your EP suggest NOT pursuing this further?
  4. Do you have a “real” ASD? With a documented shunt? Or a PFO? And do you have any breathing problems as a result?

I think it’d be very instructive to hear from serious endurance athletes who’ve pursued anti-arrhythmic therapy alone for SVT problems. I’ll bet there aren’t many good stories.

.

  1. via wearing the event monitor and recording several events. no delta waves to indicate WPW
  2. 2010, 4-5x/mo, 2011- 0, 2012, up to 4-5x per race/training day and as little as none in 2 weeks. ususally 20-90sec, as long as 6 min. does not require me to stop, but slow and vagal to reset has been fairly successful
  3. that is my determination, as the EP study could not get it to reproduce, how many times is one going to go in trying to induce it. The way he was talking about the stress test this wed upcoming, sounds like he expects they might see something there, unsure, will see
  4. yes, they saw it in '95 with that heart cath exam for my a-fib(possibly on echo too) and the last echo in Aug showed it is well. I am not sure how accurate that is, and rely on what they told me. my breathing problems are slight shortness of breath at low intensities, but i attribute some of that to exercise after eating, ie full stomach inhibiting diaphram/lungs from full expansion, i could be in outer space there. Doc said they is slight enlargening on one side. Not sure how they are going to do echo whilst on bike unit on wednesday, but doc felt since my HR recovers so quickly from exertion that I ought ot not get off equipment during testing.

What are your thoughts on how to proceed? I was hoping to get some singeing to alieve some of it :slight_smile:

it was listed as ostium secundum ASD on my health record

Thanks,

Jeff

My Co2 is on the higher side of normal, but not bad, I don’t think?

Anything jump out? all seems fairly normal

                                                       August  / December/Normal Range

Sodium 139 / 140 / 136-148 mmol/L
Potassium 4.4 / 3.9 / 3.5-5.1
Chloride 100 / 103 / 98-107
CO2 28 / 26 / 22-31/18-25(dec)
Glucose Non Fasting 75 / / 70-126 mg/dL
Glucose Fasting / 90 / 70-99
Bun 22 / 21 / 9-20
Creatine 1.1 / 1.1 / 0.7-1.3
Calcium 9.4 / 9.8 / 8.6-10.2
Anion Gap / 11 / 11-18

WBC 6.3/5.9/3.5-11
RBC 4.81 /4.9 /4.3-6.2
HGB 14.1/14.6/13.5-18 g/dL
HCT 42/43/39-54 %
MCV 88/88/80-100 fL
RDW 13/12.8/11.5-14.5 %
Platelet 193/216/150-450

Have had two ablations for my a-fib (and they found a-flutter in my right while they were in there burning the left for my first ablation). The docs had no trouble inducing the condition while I was under both times. Allowed them to find and zap the spots. Still have recurrences, but nothing more than annoyances. Second one was performed in July '11.

I do a pill-in-the-pocket flecanaide as needed if my symptoms flare up. But training has been basically non-existant since my first procedure. After repeated days of exercise it basically flares up for a few days so I have to limit any sort of exercise to sporadic times. Makes “training” impossible.

Good luck with your recovery! Remember, it is not uncommon to have symptoms during the healing process. Wait until after your “recovery” period and off the meds before you pass judgement on whether or not it worked.

there is no recovery as nothing was done, and there currently are no meds.

i havent done intervals since mid july, but power went up anyway on high tempo workouts

This was almost 20 years ago, so I’ll try to recall as much as possible. I was diagnosed with SVT, specifically Wolf Parkinson White, when I was 14 (1993). Used Tenormin (Atenolol) for maybe 18 months after initial EP study at Cedar Sinai. Lots of visits to the ER to have it converted since I continued to play waterpolo and swim with it. Episodes were triggered with exertion. Very depressed resting heart rate with the Tenormin. Definite effect on energy levels. Heart rate would go to 270bpm no problem and stick there with episodes, so sounds similar to yours. Not life threatening, but tiring until you get help.

Attempted ablation at UCSD with Dr Feld at the end of 1994 and beginning of 1995. The operation wasn’t successful, but it did change the characteristics of the pathway. Episodes would now occur without exertion, but heart rate only spiked at 180bpm and I could convert it with a double dosage of my normal medication. That was Tambocor (flecainide). Much better lifestyle with that medicine. Normal resting heart rate, no more ER visits. Stayed with flecainide until 2003.

Since I was leaving my mother’s health insurance, we tried ablation one more time in 2003. The SVT could not be activated during the procedure and I went off medication. No episodes of SVT since. Doctor seems to think my heart grew out of it. No other explanation.

Let me know if you have more specific questions. Eric

Normal!

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http://jcem.endojournals.org/content/83/8/2643.full

If this ia a possible cause or contributory factor to my SVT, what other options might one consider in treating hypothyroisim?

there is no recovery as nothing was done, and there currently are no meds.

i havent done intervals since mid july, but power went up anyway on high tempo workouts

My bad, mis-read that you had one.

i will add word "attempt to title, as you are correct in it being ,misleading
.

had a stress and bubble test yesterday, they didnt warn me about the bubble test in advance :frowning: i dislike IVs

the blizzard appearance in one atrium looked like a heavy snow storm on the other. how bad, i am unsure, they will let me know possibly friday. cardio guy will read test y and give results to my EP doc Friday.

O2 started at 99% before test and ended at 92% at ~vo2 max HR aka HR i see last 60sec in a 40k

Anyone have ventricular tachycardia and still training?

Anyone have ventricular tachycardia and still training?

Yes

Jeffp and I have traded a few pm’s about our procedures. I also have SVT diagnosed by event monitors catching episodes. “Classic” SVT is what the EP said. Failed ablation procedure in November and I won’t be going back. My episodes cost me 1-2min/hour under exertion and i have no episodes when sedentary. Train everyday and twice most days. Train hard, race harder. I just accept SVT for what it does and know what I need to do to stop it. STOP, vagals, and emergency meds if necessary.

didnt realize you had VT as well?? the sudden death version of things.

btw, i was back riding 2 days after procedure

didnt realize you had VT as well?? the sudden death version of things.

btw, i was back riding 2 days after procedure

Sorry, I do NOT have VT. I have the supra variety. I probably could have rode 3-4 days after, but my wife made me wait the full 10 after seeing all the blood from the catheter holes that wouldn’t clot. Two days is fantastic!

That bill I told you about…had $457 in pharmacy charges for the patches to help with the clotting. Ridiculous.

no clotting issues here.

i am not sure i want to see the bill

had to do a vo2 effort 5 days after as part of my follow up for ASD stress/echo/bubble tests

Resurrecting an old thread…

I’m in a similar situation though no attempt at an ablation procedure yet. I was (finally) diagnosed with SVT at age 38 after experiencing episodes since I was a kid. I typically have episodes while at rest though during periods when I’m more active. (There have been suggestions that dehydration may play a role) It is very common to trigger events when laying on my left side. The HR spikes generally last from 30 seconds to a couple of minutes and aren’t nearly as fast as they used to be, typically just north of 150 bpm, but that familiar feeling of an “inefficient heartbeat” is always there.

Anyway, my doc doesn’t seem too concerned with his biggest fear being that I may faint at an inopportune time. (He seems a bit cavalier about it in fact) He is unwilling to give me medication as my resting HR is too low, but suggests ablation as an option. From my perspective, if ‘it’s no bit deal’ (not his words) then why are we even discussing heart medication or a medical procedure involving my heart??

So that’s where I stand. I’m looking to get a second opinion from another cardio who deals more with athletes before I make a decision on the procedure. I guess I’m just looking to learn from other’s experiences and try to get a sense for the relative risks of not getting the procedure. I clearly need to find out more as I’m unsure which type of SVT I have