Heart Surgery/Procedure

Discussion in 'Fibromyalgia Main Forum' started by ABCDfamily, Aug 29, 2006.

  1. ABCDfamily

    ABCDfamily New Member

    I've just come from my cardiologist today who tells me a cardiac ablation is my best bet. I have SVT's (rapid heart rate) and I have grown allergic to the medication to help me. The other ones give terrible symptoms and my quality of life is important. The chances are 80/20 with 80 being a good success rate and 20 being the odds that it will not work. Has anyone heard of this before? I tried searching it and could not find anything here. I am doing lots of research on it currently but thought it would be helpful to get some feedback here.

    I have not been around to much lately so I do hope everyone is hanging in there.
  2. chickadee

    chickadee New Member

    and see if that doesn't explain the ablation procedure.

    My son (who is in his 40's)has this syndrome and doctor tried to do the ablation procedure on him but was not successful. He (son) finally got off all drugs and exercises quite regularly and seems to be doing quite well.

    He says he has just learned to live with it and it seems to work just to ignore it.

    Good Luck to you.

  3. ABCDfamily

    ABCDfamily New Member

    No way, these can not be ignored. I have CFS with Fibro too. That's like me telling everyone here to ignore their symptoms and it will go away. Give me a break, if it were so easy don't you think I would be ignoring it now?

    I appreciate your feedback but I am waking up in the middle of the night with my heart pounding, my chest in crushing pain. My cardio believes it's the SVT's that could be causing some of my symptoms other than just the stated here in this post. I'm curious as to what others are thinking and if this could be a possible theory?
  4. gumama

    gumama New Member

    I fully understand how scary this is.... My husband had a heart attack in 2004... we put a stint in.. but his heart rate was very high..... may I suggest if you haven't done this ..please ask your Dr about this before you consider the ablation procedure.

    The procedure itself is usually 80 to 85% successful... but before you do that.. ask your Dr to do an EVENT monitor for you... some patients wear it for a month, some a few days or a week.. in my husbands case he wore it only for a week... you are monitored by a group of Dr's.. and if they feel that your heart rate is to fast or your in danger they contact your Dr right away...... this is DIFFERENT than a 24 hour monitor..... you only wear one patch and not all the wires....

    If they still find that the STV's are causing a problem consider the medication Betapase... we were considering the surgery for my husband, but the Betapase did the trick.... it took us many months to get the Anxiety under control that my husband was experiencing because of this... he had been hospitalized several times because of the high pulse rate..

    I wish you well and hope that the two things mentioned above will help you determine if you should have the surgical procedure ...

    God Bless you


  5. JLH

    JLH New Member

    Yes, I have heard of this procedure. In fact, they came close to doing it on me.

    I have had heart rhythm problems for years. I've had the SVT, bradycardia (slow heart rate), atrail fib, etc.

    I was sent to a specialized cardiologist to check out the ablation, but he ended up putting in a dual chamber pacemaker. So far, it has solved my problems!!! I still take Loperssor, Rythmol, and Lanoxin for my heart.

    For the ablation, I know they stimulate your heart to do what it is doing wrong, then they take a little laser and burn the spot that is causing the trouble. I probably didn't explain it correctly, but I have worked with a couple people who had the procedure done and it was successful for them.

    Good luck, and I hope it solves your problems.

    jlh (Janet)
  6. JLH

    JLH New Member

    Heart Disease:
    Treating Arrhythmias with Ablation

    Ablation is used to treat abnormal heart rhythms. It can be performed both surgically and non-surgically. The type of ablation performed depends upon the type of arrhythmia and the presence of other heart disease.

    Non-surgical ablation, used for many types of arrhythmias, is performed in a special lab called the electrophysiology (EP) laboratory. During this non-surgical procedure a catheter is inserted into a specific area of the heart. A special machine directs energy through the catheter to small areas of the heart muscle that causes the abnormal heart rhythm. This energy "disconnects" the pathway of the abnormal rhythm. It can also be used to disconnect the electrical pathway between the upper chambers (atria) and the lower chambers (ventricles) of the heart.

    Surgical ablation procedures used for treating atrial fibrillation can be "minimally invasive" or traditional "open" surgery and may be combined with other surgical therapies such as bypass surgery, valve repair, or valve replacement. Surgical ablation procedures include:

    The Maze procedure. During this traditional open-heart surgical procedure, the surgeon makes small cuts in the heart to interrupt the conduction of abnormal impulses and to direct normal sinus impulses to travel to the atrioventricular node (AV node) as they normally should. When the heart heals, scar tissue forms and the abnormal electrical impulses are blocked from traveling through the heart.

    Minimally invasive surgical ablation. Unlike traditional heart surgery, there is no large chest wall incision and the heart is not stopped. These techniques utilize smaller incisions and endoscopes (small, lighted instruments that contain a camera).

    The modified Maze procedure. The surgeon uses a special catheter to deliver energy that creates controlled lesions on the heart and ultimately scar tissue. This scar tissue blocks the abnormal electrical impulses from being conducted through the heart and promotes the normal conduction of impulses through the proper pathway. One of four energy sources may be used to create the scars: radiofrequency, microwave, laser or cryothermy (cold temperatures). The modified Maze procedure involves a single incision in the left atrium.

    Why Do I Need Ablation Therapy?

    Doctors recommend ablation therapy to treat:

    Atrial fibrillation and atrial flutter
    AV Nodal reentry tachycardia (AVNRT)
    Accessory pathways
    Ventricular tachycardia
    In addition to re-establishing a normal heart rhythm in people with certain arrhythmias, ablation therapy can help control the heart rate in people with rapid arrhythmias, and reduce the risk of blood clots and strokes.

    How Should I Prepare for Ablation?

    The procedure preparation may vary, depending on whether you're having surgical or nonsurgical ablation. These are general guidelines; your doctor or nurse will give you specific instructions.

    To prepare for ablation, there are several steps you should take. Among them:

    Ask your doctor which medications you should stop taking and when to stop them. Your doctor may ask you to stop certain medications (such as those that control your heart rate or blood thinners including aspirin products) one to five days before your procedure. If you are diabetic, ask your doctor how you should adjust your diabetic medications.

    Do not eat or drink anything after midnight the evening before the procedure. If you must take medications, drink only with a small sip of water.

    When you come to the hospital, wear comfortable clothes. You will change into a hospital gown for the procedure. Leave all jewelry and valuables at home.

    What Can I Expect During Nonsurgical Catheter Ablation?

    During nonsurgical catheter ablation, the following things will occur:

    The procedure will take place in a special room called the EP (electrophysiology) lab. Before the test begins, a nurse will help you get ready. You will lie on a bed and the nurse will start an IV (intravenous) line. This is so the doctors and nurses can give you medications and fluids through your vein during the procedure. You will be given a medication through your IV to help you relax. Depending on the type of ablation you have, you may or may not be awake during your procedure. If you are awake, you will be asked to report any symptoms, answer questions or follow instructions given to you by your doctor. If you are uncomfortable or need anything, please let your nurse know.
    The nurse will connect you to several monitors.
    After you become drowsy, your groin area will be shaved and you neck, upper chest, arm and groin will be cleansed with an antiseptic solution. Sterile drapes will be placed to cover you from your neck to your feet.

    The doctor will numb the insertion site by injecting a medication. You will feel an initial burning sensation, and then it will become numb. Then, several catheters (special wires that can pace the heart and record its electrical activity) will be inserted through a small incision into a large blood vessel(s) and/or artery (in your groin, neck or arm) and advanced to your heart. If you are awake, it is important that you remain still and resist the temptation to raise your head to see what the doctor is doing while the catheters are being placed.

    After the catheters are in place, the doctor will look at the monitor to assess your heart's conduction system.
    Then, the doctor will perform the ablation procedure.
    During traditional ablation, the doctor will use a pacemaker-like device to send electrical impulses to the heart to increase your heart rate. You may feel your heart beating faster or stronger when the pacemaker delivers the impulses. If your arrhythmia occurs during the procedure, the nurse will ask you how you are feeling. It is very important to tell the doctor or nurse the symptoms you feel. The doctor will then move the catheters around your heart to see which area(s) your arrhythmia is coming from. Once the doctor finds the area of your arrhythmia, energy is applied. You may feel some discomfort or a burning sensation in your chest, but you must stay quiet, keep very still and avoid taking deep breaths. If you are feeling pain, ask your doctor or nurse to give you more medication.
    During pulmonary vein ablation (for atrial fibrillation), the doctor delivers energy through a catheter to the area of the atria that connects to the pulmonary vein (ostia), producing a circular scar. The scar will then block any impulses firing from within the pulmonary veins, thus preventing atrial fibrillation from occurring. The process is repeated to all four pulmonary veins. In some cases, ablation may also be performed to other parts of the heart such as the subclavian veins and coronary sinus. The catheter is a special "cool tip" catheter. Fluid circulates through the catheter to help control the intensity of the temperature.

    Once the ablation is complete, the electrophysiologist will use monitoring devices to observe the electrical signals in the heart to ensure that the abnormal heart rhythm was corrected.

    The procedure usually takes about four to eight hours, but may take longer.

    What Happens After Nonsurgical Catheter Ablation?

    After your non-surgical catheter ablation:

    The doctor will remove the catheters from your groin and apply pressure to the site to prevent bleeding. You will be on bed rest for one to six hours. Keep your legs as still as possible during this time to prevent bleeding.

    After your procedure, you may be admitted to the hospital. During your recovery, a special monitor, called telemetry, will be used to follow your heart rate and rhythm. Telemetry consists of a small box connected by wires to your chest with sticky electrode patches. The box allows your heart rhythm to be displayed on several monitors on the nursing unit. The nurses will be able to observe your heart rate and rhythm. In most cases, you will be able to go home the next day after the catheter ablation procedure but in some cases you may be able to go home the same day of the procedure.

    You and your family will receive the results of the procedure after the procedure. Your doctor will also discuss when you can resume activities and how often you will need to visit your doctor.

    Temporarily, many individuals experience heart palpitations on and off for a few weeks after the procedure. Sometimes you may also feel as if your abnormal heart rhythm is returning, but then it stops. These sensations are normal and you should not be alarmed. When these symptoms occur during your recovery, it is important to document them by calling your doctor or nurse as directed. Also call your doctor or nurse if you feel as if your abnormal heart rhythm has recurred.

    You may be required to take medications for a certain period of time after your procedure.

    If you have any other questions, please ask your doctor or nurse. Ask your health care provider how often you will need to go for follow-up appointments.

    How Should I Care for the Wound Site?

    You will have a small dressing on your wound. It may be removed the next day. Keep the area clean and dry.

    Call your doctor if you notice any redness, swelling or drainage at the incision site.

    What Can I Expect During Surgical Ablation?
    During the ablation, you can expect the following to take place:

    General anesthesia (the patient is asleep) or local anesthesia with sedation (the patient is awake but relaxed and pain-free) may be used, depending on the individual case.

    During minimally invasive surgery, the surgeon views the outer surface of the heart using an endoscope. Specialized instruments are used to locate the areas needing ablation and to create the lines of conduction block. Unlike traditional heart surgery, there is no large chest wall incision, and the heart is not stopped.

    The Maze procedure requires an incision along the sternum (breast bone). The incision may be traditional (about 6 to 8 inches long), or in some cases, minimally invasive (about 3 to 5 inches long). The heart is stopped during this procedure. A heart-lung machine oxygenates the blood and circulates it throughout the body during surgery.

    The modified Maze procedure involves using one of four different energy sources to create the lines of conduction block (radiofrequency, microwave, laser or cryothermy). The energy probe of choice is inserted, and under direct vision, used to create the lesion lines. As in the classic Maze procedure, these lesions create lines of conduction block that interrupt the abnormal impulses and restore the normal sinus rhythm. This procedure is used primarily in patients who have atrial fibrillation and other indications for surgery.

    What Happens After Surgical Ablation?

    If your ablation surgery was combined with valve, bypass or another surgical procedure, your post-procedure care may be different.

    After surgical ablation:

    The patient is usually transferred to an intensive care unit (ICU) for close monitoring for about one to two days after the surgery. When the patient's condition is stable, he or she is transferred to a regular nursing unit (called a telemetry unit).

    The monitoring during recovery includes heart, blood pressure, and blood oxygen monitoring and frequent checks of vital signs and other parameters, such as heart sounds.
    Most patients stay in the hospital about 5 to 7 days after the procedure, depending on their rate of recovery. Patients who had minimally invasive surgery may be able to go home 2 to 3 days after surgery. Your health care team will follow your progress and help you recover as quickly as possible.

    Full recovery from surgery takes about 6 to 8 weeks. Most patients are able to drive in about 3 to 8 weeks after surgery. Your health care team will provide specific guidelines for your recovery and return to work, including specific instructions on activity, incision care, and general health after the surgery.

    Many patients may experience skipped heartbeats or short episodes of atrial fibrillation during the first three months after the procedure. This is common due to inflammation (swelling) of the heart tissue and is treated with medications. After the heart has healed, these abnormal heartbeats should subside.

    A small number of patients require a pacemaker after surgery due to an underlying abnormal rhythm which previously was undetected.

    Medications after surgery may include:

    Anticoagulants (blood thinners), such as Coumadin, to prevent blood clots.
    Antiarrhythmic medication to control abnormal heartbeats.
    Diuretics to reduce fluid retention.
    Your doctor will monitor your recovery and determine when or if these medications can be discontinued.

    Next: Heart Transplant >
    View the full table of contents for the Heart Disease Guide.

    Reviewed by the doctors at The Cleveland Clinic Heart and Vascular Institute (2006).

    Edited by Cynthia Haines, MD, March 2006, WebMD.

    SOURCES: American Heart Association. Heart Rhythm Association.

    See WebMD.com for more info.

  7. kriket

    kriket New Member

    Hope everything goes ok with the decision that you decide to go with. I have a rapid heart rate and take toprol to keep the pulse rate down.

    I have never heard of cardiac ablation. Oh yea, by the way, NEVER NEVER NEVER ignore an irregularity of your heart.

    There is all kinds of advice here on this board, but sometimes you have to watch out for destructive advice. Let us all know what you decide and how things are going. Best Wishes.

    [This Message was Edited on 08/29/2006]
  8. chickadee

    chickadee New Member

    My response about my son having rapid heartbeats and just ignoring them was in no way intended to imply that you should just ignore yours.

    You should do exactly what you are doing. Investigate and make an informed decision with the help of your doctor on what is best for you.

    In my son's case, he spent more than 7 hours on the operating table and the doctor could not isolate the correct spot to do the ablation. He may have to let them try again but hasn't in about 4 years now.

    I was also trying to tell you that this condition is called Wolf, Parkinson, White Syndrome and that you could find information by looking that syndrom up on the computer.

    Please excuse me for trying to share an experience that I thought might point you in the right direction.
  9. kriket

    kriket New Member

    I apologize to you, cause I misunderstood you too. I clearly understand everything that you have just explained. Sorry I misunderstood you.

  10. kirschbaum26

    kirschbaum26 New Member

    Dear ABCDFamily:

    My 46 year old brother had this done 2 years ago. He did fine and the treatment worked for a while. He had the non-invasive procedure last time, and now need to have the more invasive type to scar (ablation is a actually a burning) the INSIDE of the heart wall. The first time it was done on the OUTSIDE of the heart wall. My brother had the atrial fibrillation. His heart beat would go past 250 for no reason. He is very fit, does triathalons and runs, and swims all the time. He is agreeing to the more complex surgery because he does not like to take the beta blockers, as they make him retain weight.

    Hope this helps a bit.

    I also have atrial fibrillation, but just found out about it. I am taking meds for it, and although it does not seem to bother me, I nearly had another procedure cancelled because my heartbeat was "abnormal".

  11. ABCDfamily

    ABCDfamily New Member

    I just wanted to Thank everyone for their feedback. All feedback is important and informative.

    I did want to add that I was on Beta blockers for close to 4 years and they did help. It was only recently that I had to come off of them due to the reaction I grew to the drug. It was terrible, it actually ended up making me worse. I believe I am going to have the ablation, it makes sense. I know there is a 20% risk that it will not work but 80% gives me hope.
  12. 1sweetie

    1sweetie New Member

    I know nothing of your condition or the procedure but I want to convey to you that we have missed you on the board and that I hope that this procedure will help you.

    I'm going to be positive and believe you will be in the 80% that will be cured. I know this has to be very scary.

    Please keep us informed.

  13. ABCDfamily

    ABCDfamily New Member

    Hi 1sweetie:

    Thank you so much, that was so nice to hear that it was noticed when I was not here :)

    I'm sure this will not cure all of my symptoms but it will hopefully (fingers crossed) get rid of the adrenaline rushes and SVT's. That would be improvement for sure. I'm nervouse about anyone going in and messing with my heart........yikes. I will walk through my fear and pray that I am part of the 80% I read the other post where 1chick (I think) son's went through this and they could not find his. I know this is a possibility but I'm willing to risk. If I don't I will now always wonder "what if" I'm not a "what if" kind of lady.

    I suffer from CFS/Fibro/Dysautonomia/SVT's or MVPS. The DR's are not really sure which one came first, CFS or Dysautonomia. I believe it's Dysautonomia because I was born with Mitral Valve Prolaspe, rapid heart rate (so my cardiologist believes) it was picked up after the birth of my daughter, 2nd child. Many years I went through this fight or flight thing that probably damaged my immune system which caused the CFS. So the theory is, let;s fix the SVT's (hopefully) which may improve the CFS but not cure it. I'm all about anything that can make me the even the slightest bit better.

    I hope everyone here is doing OK? I wish you and your family's all the best and Thank you for taking time out to read this :)
  14. ABCDfamily

    ABCDfamily New Member

    Please read post, labeled "Heartful Information on CFS" Curious as to everyone's thoughts here?
  15. pam_d

    pam_d New Member

    I know nothing about heart issues, but I'm going to be praying for you that this procedure works and alleviates your painful symptoms. It sounds like the symptoms you are experiencing are very scary...of course you need to take it seriously and find a solution. Do you think it would be worth getting a second opinion, or do you trust that your cardiologist knows his/her stuff? I'm glad others here could find info for you on this ablation procedure.

    Keep us posted...


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