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New here... Ques about EPS study/possible ablation


Hummingbird
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Hello Everyone! :D

My name is Lauren. I am a 34-year-old female, diagnosed with Inappropriate Sinus Tachycardia (IST) and occasional episodes of PSVT. My IST occurs daily after getting out of bed and usually subsides within the first couple hours of rising. Along with IST, I have been experiencing episodes of PSVT which occur about once a month and only last about 5 minutes. I had a cardiologist follow-up appt a few days ago and told him that I want to try to get pregnant soon, but am concerned about the tachycardia being a problem. He stated that we can do an EPS study to rule out a re-entry pathway causing the PSVT. He thinks the IST is caused by my SA node being naturally set higher and I will probably have that all of my life. He states that naturally as a person ages the heart rate slows down. But, as far as the PSVT, he says this normally worsens during pregnancy and as one gets older. I want to rule out a re-entry pathway problem, but am VERY scared of having this procedure. Can someone please offer me some information and/or advice? Would it be a good idea to go ahead with the study before I try to get pregnant? Any info is VERY appreciated!!!

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What type of eps study is your cardio wanting to do? I have had most procedures and will be glad to share any info I have with you. As you will see from the posts on the board the diagnoses, treatments, and level of disability varies from individual to individual. Many people here have POTS but not all do. Some have MSA, MVP with dysautonomia, and a host of other related conditions that can contribute to dysautonomia. Some people find improvement in sxs after pregnancy some find pregnancy and childbirth make sxs much worse. So, there is A LOT of gray area with all of this stuff. Anyway, I am so glad you have decided to join us and hope we can help you find some answers.

Carmen

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:D THANK YOU so much for the responses! It is so nice not to feel like I am the ONLY one with these symptoms. This website has been a TREMENDOUS help. I am so glad I stumbled upon it.

Carmen: My doctor did not get very specific. He just stated that I have the option to do an electrophysiology study and possible cryoablation if any re-entry pathways are found. He would not touch the SA node, just ablate any irregularities. I kind-of want to have it done before I try and get pregnant just incase there is something he can fix. At the same time, I am not wanting to go through such an extensive procedure if it is not neccessary. I'm stuck in limbo trying to decide what to do. I noticed that you take Zebeta. I also take it. It has done wonders for me, but does tend to make me tired at times. Anyways, which procedures have you had, if you don't mind sharing!? Thanks in advance!!!

Jennifer: How did you deal with your symptoms during pregnancy? Were they serious? Thanks for your response!

April: Glad to hear that your pregnancies were uneventful as far as cardiac symptoms. What tests did you have to determine POTS?

Take care,

Lauren

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There have been a lot of discussions regarding the pros and cons of ablation so I would recommend searching under that term. Personally, I have not had ablation but I have had a femoral arterial run-off which is simiar to a heart cath. I actually have a permanent heart cath that was placed in the end of March that allows me to get daily iv treatments via my port-a-cath. Of course, I have had several echocardiograms, chest x-rays, and blood work including the ones that test for heart attack and high cholestrolol (sp?). So as far as cardiac procdures that I have had are as follows: port-a-cath placement, run-off on my leg, transesophageal echocardiogram (TEE)- that was awful, and again all the run of the mill echos, x-rays, bloodwork. I know I'm forgetting something but I just can't think of it right now. But the main thing is to make sure your cardiologist is knowledgeable about dysautonomia and what procedures are beneficial and which ones can cause more harm. You'll probably get a lot of different responses to your questions and I promise we aren't trying to confuse you! There is a lot to comprehend and everyone's experience is at least slightly different if not totally different.

Carmen

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Welcome Lauren!

I'm a Lauren too :rolleyes: . Welcome to the site! I hope you find help and support here.

I've never had an ablation, and never been pregnant, so I can't offer much help there. But, if you do a seach on the site, you should find some answers.

Coincedentally, I was bored and reading online last night and I came across a paper written about pregancy and POTS. The address is below:

http://www.blackwell-synergy.com/doi/abs/1...59.2005.50026.x

Hope that helps :(

- Lauren

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Welcome!

Before you have a EPS study please look into all the pros, and cons before doing it! Everyone if different, I am one that wishes I knew more before I had mine done, but many people it work great for. Just please look at all the options and talk to you doctor, plus look into the differnt form of abltions.

Good Luck with everything, and again Welcome glad you are here!

Amy

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Angela: Thank you! :)

Carmen: My cardiologist has never mentioned dysautonomia. The only reason I found out about it is because I was looking for answers to my crazy symptoms and found this website. I'm not FOR SURE that I have POTS, but I know that I have ALOT of the symptoms. In "real life" I have never met anyone with these symptoms... thank goodness for the web! I am currently undecided about the ablation and have put "trying to conceive" on hold. Due to my age, I can't put it on hold for much longer though. Anyways, thanks for your help. I will do a search for "ablation" :angry:

Lauren: Nice name! :) Thanks for the welcome and for the link! I am not able to look at the link for some reason. I will definitely try again later.

Amy: What do you wish you would have known before your ablation? Which part of your heart was ablated? Thank you for your post!

-Lauren

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Lauren, I had a sinus node ablation. What I wish I would have known (besides ablations not for POTS, but that was back in 1994) is the possibility that the sinus node ablation had the real possibility of causing bradycardia and that I would need a pacemaker. Sinus node ablations are not 100% accurate as far as finding the specific pathway. I might suggest that your docs rule out POTS--a tilt table test would seem to come before an ablation. Those are just me thoughts!

Lois

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Hi Lauren, don't have anything else to add, as I got my two great boys (14,11) before being diagnosed with POTS. I am very glad because I couldn't have babies the way my health is right now. Not to scare you off, just being honest! So, I'll stick to welcome you on this GREAT PLACE!!!

Corina :angry:

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Hi Lauren, welcome! I have had an EP study, they didn't find anything to ablate so just the study. I have episodes of PSVT as well, they were sure that I had AV node re-entrant tachycardia, but they couldn't trigger any specific areas to ablate during the study. You said your doctor stated that he would not go near your SA node so if he is just ablating the incorrect pathways found, it should not affect your usual rhythm or cause any bradycardia or need for a pacemaker. As I understand, it likely wouldn't rid you of the IST, but could eliminate the PSVT episodes that you experience.

It's hard to know what the best decision is when you are presented with these vague sort of options. Whatever you decide will be the right decision! I chose to have the EP study performed because my episodes were severe and they felt at the time that they could eliminate the problem. Meds weren't effective for me and I did not yet have the diagnosis of POTS. The doctors felt at the time that I had AVNRT and that it could be fairly easily fixed with ablation. Unfortunatly they were incorrect, but no damage done.

Good luck with your decision making! Oh, did you try the search bar at the top right corner of the page and look for old posts under ablation? Might give you a bit more info to work with. Laura

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lauren -

welcome! i'm sorry that you've been having a rough time but glad you found the forum...you'll find lots of info here to eat up all of your time reading online :)

others have given lots of good info & links regarding pros & cons of ablations, but as you mentioned that you haven't discussed dysautonomia or POTS with your doc, i would definitely bring it up with your doc when you're able. as others have alluded to, there is a BIG difference in hopes of relief via an ablation from tachycardia that is functional (OI/POTS) versus other types that may be structural. there is a lot more to it than my simple explanation, but one of the most significant differences between OI/POTS/dysautonomia related HR problems & other types is whether there is a difference when lying down/seated/standing.

i do hope you get some answers & relief soon! it's good to have you, hummingbird (i like your screenname!)

:) melissa

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