Pots & Ablations - Svt - Anyone Have An Ablation Pre Or Post-pots?

[iheartcats]

I had an ablation about 4 years ago. I did not have POTS at the time...and my HR got stuck one day at 250+ and had to be stopped in the ER. It was fast and steady and scary. Just was 'stuck.'

EP was pretty sure it was an electrical pathway issue so I had an ablation and didn't have this issue again.

But a couple years later I came down with POTS, finally diagnosed in Jan. 08. I think I'd had it since March/April 07, though.

Anyway, today just sitting I had the weird SVT rate for like 5 seconds (super fast steady fluttering beats) and it stopped.

I hope my pathway isn't back - I hope it was an anomaly - but I'm kinda freaked out. I know it's not really advisable to get an ablation with POTS. My EP says I had my ablation before POTS and it probably isn't connected in anyway, but now I won't have that option.

Has anyone had an issue like this?

[Maxine]

Hi----I just wanted to send you a HUG. I know how scary it is when your heart does weird stuff.

I haven't had the issue you had with the stuck heart rate (knock on wood), but have had those minutes where I had really fast flutters, then returns back to normal, and it does freak you out. I think mine comes from the OI issues, and acts up when my body is stressed.

I hope this is just a one time thing, and passes quickly.

I'll be keeping you in my thoughts and prayers Cat_Lady.

Maxine

[iheartcats]

Thank you so much (and what a pretty cat in your photo! I wish I could have multiple cats!).

I think it's hard on us because you always hear how bad things can go with the heart - and we put up with issues on a daily basis and are told they are normal and not to worry too much, etc.

I'm telling myself it was probably an OI thing...I know for normal healthy folk you can have a skipped beat, fluttering, fast rate for a bit, etc. It's just when you have had prior bad experiences just the littlest thing sets you off and you hope it doesn't lead to anything!

[MightyMouse]

There are folks who develop pots as a direct result of an ablation... I don't have the articles on my laptop, but I'm sure they are pretty readily available.

as for cats, I LOVE my babies. I have 3...

Moja (girl, kitten, left) and Wilbur (boy, almost 2, right)

and Abbi, age 20

Nina

[Maxine]

I must say that I can relate about having a really bad experience, and then being worried when something goes wrong after that.

In May of 2001 I was feeling a little better after a severe POTS crash, only I wasn't diagnosed yet, so I still didn't know what was wrong. I just felt a little better, so I went out by myself one day to pick up a piece of repaied jewelry at the mall. When I pick up the necklace I thought I felt faily good, so I thought I would treat myslef to a pretzel and lemonaid.

It was a perfect day outside, so I almost felt like I was getting away with something because I haven't felt well for months since I crashed hard in Dec. 2000.

I got my pretzel, and started to pick up my walking pace. All of a sudden it felt like my heart stopped, or dropped down into my gut--SOMETHING----------then it started beating so fast I thought this was it, I'm not going to make it. I got tunnel vision, and everything started to go gray. Then it was like everything rebooted, and went back to normal. I was very shakey, and drove myself to my parents who lived close to the mall. THEN THEY WEREN'T HOME! I panicked, because I just knew something was horribly wrong. I drove myself to the hospital where Dr. Grubb works. I happen to live only a half mile from where he works. Even though Dr. Grubb worked at the same hospital that I had been going to for ER visits when I was having previous tachycardia spells, and other POTS symptoms, no one knew what was wrong with me, and I never crossed paths with Dr. Grubb.

IT just so happened that this particular time there was a really smart female Doctor that thought outside the box, and she ordered a tilt table test. I saw Dr. Grubb soon after and was diagnosed with POTS. I never did find out what caused this episode, but had a few others---but not as bad. Dr. Grubb put in a cardiac loop recorder in 2005, but nothing other then PVCs, and PACs showed up, and a lot of sinus tachycardia. However my tachycardia was on the lower side due to being on betablockers. He just took it out on Dec. 10th.

I just think our bodies try to compensate, and our hearts do funny things when there's not enough blood up there to pump efficiently. It's definately something to bring up to the Doc though---

Maxine

[iheartcats]

I think kitties make everything better. Abbi looks fab. The spotted kids are beautiful. And that bundle? Now THAT is a bouquet I'd like to get.

Man, I hope the ablation didn't cause anything with POTS. The EP says it's too long after, so I hope...

[flop]

Hi Cat Lady,

there are different types of cardiac ablation depending on what electrical pathway they are attempting to modify/destroy. The normal electrical system of the heart has only one connection between the top (atria) and the bottom of the heart (ventricles) - this is called the atrio-ventricular node (AV node). A normal heart beat starts at the sino-atrial node (SA node), the electrical current flows through the top chambers causing them to contract/beat and then has to go through the carefully regulated AV node to get to the ventricles where a special conduction system makes the ventricles contract/beat to send blood round the body.

When you have a sinus tachycardia (like with POTS) the SA node is firing too fast and makes the heart race, but along the normal electrical pathways (like a car speeding on a highway).

Some people have one or more extra/abnormal electrical connections between the atria and the ventricles. This allows abnormal heart rhythms (SVTs) to happen.

When you have an SVT the electrical current often travels down the abnormal pathway and then back up the normal pathway, it can go round and round in a loop causing the heart to beat very quickly and in an abnormal way. (like a car speeding that cuts across the median to go the other way down a highway and keeps making u-turns going around in circles!) (that car doesn't manage to go very far and in the same way a heart in SVT doesn't pump blood as well as it should so you can feel really ill).

A cardiac ablation aimed at destroying an abnormal/accessory pathway is not risk-free but it is relatively safe and is not thought to cause POTS or make POTS worse.

A few years ago a study was done where they did ablations to modify the SA node in people who already had POTS. The thinking was that the ablation would slow down the sinus tachy and therefore reduce the symptoms of POTS. This was an experimental treatment and unfortunately the study showed that this sort of SA ablation made symptoms worse for most people and several people needed permanent pacemakers fitting. This sort of ablation is NOT advised.

Anyone with both POTS and SVT should have a discussion with an experienced electrophysiologist so that a treatment plan can be made. Having POTS is not a contra-indication to having an SVT ablated.

Sorry that is all a bit rambling, it is much easier to understand with diagrams!

Flop

[iheartcats]

Hi, Flop!

That made a lot of sense. My EP tries to explain things - I should have him hire you to draw up this chart and description. LOL

Yes, I had an SVT. I can tell the difference of the beat...my SVT stuff just felt wrong. And was very fast, instantly, not even standing. It really felt different. My POTS beat, while it can be fast and annoying, isn't the same.

So it makes more sense now how my EP is fairly sure they aren't interconnected. I guess I am just unlucky.