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Afib and svt's

Posted by Sandy 
Afib and svt's
September 30, 2017 12:36AM
I had my first cryo ablation less than a year ago. I'm 57. I still feel out of breath at times and feel odd beats when laying down. My svt has started up again and an ER Dr put me on diltiazem. I'm worried about doing an ablation for this due to it being in different part of the heart. Anyone have this issue? If so what was your solution. I'm scared of the unknown and can't find much on this.Maybe not looking in the right places. Comments,suggestions or any info. welcomed.
Re: Afib and svt's
October 02, 2017 07:24PM
Welcome Sandy,

A CRYO ablation can work okay for some straight forward basic Paroxysmal AFIB (PAF) cases who do not yet have Non-Pulmonary Vein (Non-PV) triggers, well beyond the PV-Antrum area around the four pulmonary veins that is the only area CRYO Balloon ablation catheters are designed to address.

The problem is that many paroxysmal AFIB cases, especially those PAF fibbers who have had longer term AFIB and those who have had even one episode that has last over 20 hours duration before self converting back to NSR ... and essentially ALL persistent and Long Standing Persistent AFIB cases ... very much often do have anywhere from several to dozens of real-time-detected Non-PV triggers throughout both the LA and RA and, as noted above well away from the four pulmonary veins osmium area.

So its quite possible you could be having recurrence too of your AFIB in addition to these runs of SVT. I assume the SVT has been formally documented by 12 lead ECG?? If so, do you have the most common form of SVT called AVNRT (Atrio-Ventricular Nodal Re-entry Tachycardia)?

This most common form of SVT is also a known precursor to eventual AFIB and the two atrial arrhythmia's are certainly closely related, though not often appearing at they same time. Usually, SVT appears well before AFIB first raises its head in a given person, but not always, and at times some people will even have a mix of AFIB, A-Flutter and occasional SVT runs as well.

An ablation for confirmed SVNRT is often the best way to get rid of it, but since it is such a strong canary in the coal mine indicating near certain AFIB if not already, then in the future, many experienced EPs with often consider doing a full AFIB ablation and then ablate the SVT circuit in the RA too on the way out of the overall AFIB ablation to try to kill two birds with one stone in what is hoped they might be a 'one and done process'.

We can discuss more about this when my wife and I get back from Phoenix to our place in Sedona after I had a complete vitrectomy eye surgery in my right eye this morning. I'm not reading too well at the moment, and have a large patch over my right eye for the next few days at least and it will be a period of time before my right vision fully clears up again I am told.

Perhaps next week will be better. If you wish to discuss your options over the phone, which work best for me at the moment, send me your cell number and time zone and Ill try to catch up with you next week during day time hours.

Be well,
Re: Afib and svt's
October 03, 2017 02:22AM
I hope you heal quickly and all is well. Thank you for your reply. I have formulated some questions and gleaned a little more knowledge. Not sure how.my EP will respond to my inquire, he is a little arrogant. Oh well that's aother story. I would like to know my options and more about the non pv triggers. When you feel well,we can talk then. Again thank you for your response
Best regards
Re: Afib and svt's
October 03, 2017 09:18AM
Check your private message box at top right of this forum window I sent you a note requesting your cell

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