Ventricular ablation

I was just informed that I need a ventricular ablation for severe PVC's. I am an afib patient who had an atrial ablation almost 2 years ago and this past July had a Mini-maze surgical ablation. At four months post op I have not had afib so they are confident that the afib is gone. However, the pvc's have worsened since the surgery to the point that I am having severe fatigue, light headedness, fainting spells (briefly) and occasional labored breathing. I had a month long halter that showed my pvc's ranging from every 6th to 7th beat at it's best...to every other beat at it's worst. So it is severe enough to be addressed with an ablation according to my doctors. My research shows that its not as successful as atrial ablations and carries more significant risks. But, doing nothing can lead to ventricular fibrillation which can be fatal. So, I am asking if anyone has had a ventricular ablation and if so, what was it like, how did it turn out, etc. Any details you can share would be greatly appreciated. Thank you!

In skilled hands, PVC and VT ablation has high success rate. Natale's group in Austin do 400 of these a year. There are scattered centers around the US that do a decent volume of these. It is more difficult to do than AF so you do want to make sure the EP has the skills and volume. A couple of other top centers are UPenn and Brigham and Women's. Most places that do mini-maze do not have the RF ablation skills required.

thanks for the info, do you know of any places in Florida that would be considered high volume?

Hello cbarnhill10
Do you by an chance take Taurine? I ask, because after my second ablation, I was in a similar situation as you. I had severe PVC's and it was suggested that I may have to have a ventricular ablation too. As a last resort, I carefully looked at all my supplements and realised that in some folk, Taurine can cause PVC's. I stopped taking it and within a few days, so did my PVC's - I still had a few, but within 'normal' limits.
I thought I would just mention this to you, in case you do take Taurine.
I wish you all the best
Spekkles

You might also up your magnesium intake, ramping up slowly to bowel tolerance. The combination of mag & taurine has been useful for arrhythmias of all kinds.

George

No I do not take it. That would have been great if it were that simple! lol I am only on metoprolol 50 mg 3x per day. Stopped the eliquis after the mini maze after they excised the left atrial appendage. Thanks for the info though.

Do you really need to still be on Metropolol? The symptoms you report are not uncommon side effects.

What is your blood pressure? What is your heart rate? Check these and let us know.

Sam

I checked CCF (Pinski and company) several months ago and they only do 10 VT ablations a year split about evenly between the 3 EP's. I did not check central Florida hospital and they are probably worth checking If I have to take a guess, I think Berman at Augusta would be the highest volume EP in your region. If I was on the east coast and it was my heart, I would go with Upenn or Stevenson at Brigham's.

Thanks for the info. Just curious, how do you find out how many each place has done? I ask the office of the doctor and they are clueless. They say you have to come in and consult with the Dr and ask him then...which kind of defeats the purpose! I don't want to consult with anyone if they don't do a lot of ventricular ablations! lol

You can request info from CCF directly via their website. Most EP departments will be glad to help if you are a patient doing first pass screening to short list centers. I would avoid those with attitude. I ran into that for Scripps Memorial and I told the director I won't bother him any more, in preparation for father-in-law if he was to be suitable, he wasn't. Upenn post their annual ablation volume on their website and many top VT ablation specialists were trained by Marchlinski and Natale, in that order. Even within VT ablation, there is a range of complexity. For example epicardial ablation requiring the most skill. So if you find someone that does epicardial VT ablation frequently, you know you have somebody elite in the field. Some info can be gleaned from VT clinical trials as only centers that do a sufficient volume are allowed to recruit subjects.

Dr Natale did my PVC ablation in 2001. It was an 11 hour procedure but successful!
It was life changing
Alice