Is an AV node ablation final or can conductivity occur later on?

Obviously environmental stress is a trigger but I’m getting bouts of tachycardia. Longest was in the ER on and off for 24 hours without an EP or any cardiologist attending or willing to come down for a consultation and then the tachycardia converted and returned the following day for 4 hours.

It takes 5 months to see an EP, or 3 months going private..so I have to wait for private. I can’t advocate my health by getting to the root of my problem.

Since I am not in the states I called my California EP and he said I shouldn’t be getting tachycardia especially with my PM. I had my scheduled 8 month PM checkup Sunday and it’s functioning fine but I was told by the PM clinics’s EP to go to the ER for my 10/10 pain from walking from the elevator to the clinic. I took a nitro, pain went down to a 5 so I took a taxi home. A few hours later my hr was 130 and I couldn’t really talk because I was out of breath and having shooting pain from left neck to heart radiating down arm and back…so I called an ambulance back to the hospital.

My CA EP thinks my av node ablation has some conductivity issues. I asked how this was possible because the EP burned 18 seconds long at one time and told me he tried to get a “bundle of his” heartbeat by turning off temporarily my PM but didn’t even get a 20hr…so it was nuked .

We discussed that (you all know) AF ablations’s scar tissue causes a cage and prevents AF but conductivity can occur and touch ups are required. He said av node ablations less likely need a touchup and suggested another AV node ablation and to tweak my PM so it burst therapy at 110 and not 130. Anyways it’s only successfully paced terminated 68 out of 187 episodes (36.4%). I thought an AV node ablation was a permanent nuke job.

How can this be? The EP burned the cr#p of my av node. I was able to make an appointment next week with a regular cardiologist for insight on my 10/10 painful angina and shortness of breath and tachycardia since the pacemaker clinic interrogation didn’t record these episodes at all. It should record Ventricular tachycardia my EP said.

I had spent the month of November 2022 in the icu for my 190hr they couldn’t convert yet I never had this angina or shortness of breath.

Sounds like the ablation was incomplete. Just because he did a long burn doesn't mean it was in the right place.

I thought I was done with ablations.

However my EP in the states said an ekg can determine if the av node ablation held. How is that so?

Because if it held the only ventricular beats will coincide with pacer spikes.

Yup, an EKG has the timeline and depicts all the various electrical impulses in the wave form. If there's an extra one, and you don't have AF, and the only other source is the PM, then....there has been a 'progression'....God I'm beginning to dread that word as it relates to our disordered hearts. Sorry for this, Susan. I don't know how you do it...I really don't.

Obviously environmental stress is a trigger but I’m getting bouts of tachycardia. Longest was in the ER on and off for 24 hours without an EP or any cardiologist attending who was willing to come down for a consultation and then my tachycardia converted after 24 hours and I returned the following day to the clinic for 4 hours. The dr wanted to call an ambulance but my PM suddenly converted me so I went home.

It takes 5 months to see an EP, or 3 months going private..so I have to wait for private. I can’t advocate my health by getting to the root of my problem. I only hope to stay above ground until I can see an EP.

Since I am not in the states I called my California EP and he said I shouldn’t be getting tachycardia especially with my PM. I had my scheduled 8 month PM checkup Sunday and it’s functioning fine but I was told by the PM clinics’s EP to go to the ER for my 10/10 pain from walking from the elevator to the clinic. I took a nitro, pain went down to a 5 so I took a taxi home. A few hours later my hr was 130 and I couldn’t really talk because I was out of breath and having shooting pain from left neck to heart radiating down arm and back…so I called an ambulance back to the hospital.

My CA EP thinks my av node ablation has some conductivity issues. I asked how this was possible because the EP burned 18 seconds long at one time and told me he tried to get a “bundle of his” heartbeat by turning off temporarily my PM but didn’t even get a 20hr…so it was nuked .

What in the heck is the drug atropine? Is that used typically during an ablation? What is underlying rhythm?

[ibb.co]

We discussed that (you all know) AF ablations’s scar tissue causes a cage and prevents AF but conductivity can occur and touch ups are required. He said av node ablations less likely need a touchup and suggested another AV node ablation and to tweak my PM so it burst therapy at 110 and not 130. Anyways it’s only successfully paced terminated 68 out of 187 episodes (36.4%). I thought an AV node ablation was a permanent nuke job.

How can this be? The EP burned the cr#p of my av node. I was able to make an appointment next week with a regular cardiologist for insight on my 10/10 painful angina and shortness of breath and tachycardia since the pacemaker clinic interrogation didn’t record these episodes at all. It should record Ventricular tachycardia my EP said.

I had spent the month of November 2022 in the icu for my 190hr they couldn’t convert yet I never had this angina or shortness of breath.

Was it possibly adenosine and not atropine? Atropine is to counter a nerve gas or an anaphylaxis due to severe allergic response. It's what they jab into your thigh, or even into your heart muscle, to get you out of a quick death spiral. Adenosine is what they use to slow the heart down enough that the EKG shows a lot more discrete information.

You definitely need to have the angina and shortness of breath investigated. They may be unrelated to your arrhythmia issues.

You started two threads on this. I merged them into one thread but now your opening post is duplicated except one isn't the same as the other. We'll just have to live with this.

Yeah sorry about the duplication. I don’t know how that happened. I’m not feel well and apparently am impaired. I am a tough fighter but I feel defeated. First time for that.

Is atropine usually used during an ablation? If so, for what purpose?

Quote
gloaming
Was it possibly adenosine and not atropine? Atropine is to counter a nerve gas or an anaphylaxis due to severe allergic response. It's what they jab into your thigh, or even into your heart muscle, to get you out of a quick death spiral. Adenosine is what they use to slow the heart down enough that the EKG shows a lot more discrete information.

No it was Atropine according to my report I shared in this thread.
quick death spiral? Wow. Could the drug been iatrogenic error or it was a life saving move due to ablation complications or generally used in ablations?

I looked it up:
[www.ajconline.org].

“ Conventional electrical cardioversion failed to restore normal sinus rhythm (NSR) in 49 of 364 patients (13.5%) with persistent atrial fibrillation. After receiving up to 2 mg of atropine, 40 (81%) of these 49 “electrical-refractory” patients were successfully cardioverted to NSR by subsequent attempts of electrical cardioversion.”

Another link mentioned it’s used successfully during ablations
[onlinelibrary.wiley.com].

Nobody here has mentioned this drug was used during their ablations



Edited 1 time(s). Last edit at 02/01/2024 12:34PM by susan.d.

Quote
susan.d
Nobody here has mentioned this drug was used during their ablations

It was used during at least one of mine, not sure about the others. The anesthesiologist will sometimes use it because it reduces saliva production.

And that might be because they have a TEE in place? Do you know if it was, Susan?

The report didn’t say. I doubt it because he would had mentioned if my watchman was sealed. I only had two TEEs, the last that I know of was at my 6 month post watchman.

I think the anesthetist administers the atropine if there's a TEE, or some other tube, during anesthesia. I had a truly horrible first experience recovering from my first ablation due to an exceedingly dry throat and mouth. It was bloody awful. When it came time to meet the anesthetist for my second ablation, I mentioned this experience, at which the gentleman seemed most pleased to know it and offered to take some care not to over-medicate me on that account. Happily, Ablation The Second was a much happier experience....still is.

I know it's tough in your shoes, Susan. Considering all you have been through, and you appear to be getting clawed back all the time. It can't be a pleasant experience. Hang in there. The team is consulting about you, and they'll come up with a plan. We're all pulling for you here.

Currently in and out of tachycardia. No angina so I’m ignoring it. But it wears me out. When in tachycardia (117hr) my ekg doesn’t show a dipped p wave..it looks like sinus tachycardia.

Based on this Kardia 6 lead ekg, does it show my av node ablation failed due to conductivity issues?

[ibb.co]

No P waves, so no.