Anyone out there with Idiopathic Left Ventricular Tachycardia?

[angelinax2]

Anyone out there with Idiopathic/Fascicular Left Ventricular Tachycardia?  I also have Inappropriate Sinus Tach. What I have is apparently very rare and I have not been able to find anyone else who has what I have.  I am on a desperate search to share my experience with someone else who has the same thing.  I am a 37 year old female who underwent a linear v tach ablation in 12/06.  In the 2 months since the ablation, I have not had any further V Tach, but now I am left with frequent PAC's and rare PVC's.  It's discouraging and a nuisance.  I was not made aware prior to the procedure that post ablation one could end up with other arrhythmia problems.  Even on Toprol I was having 40-60/day.  I took myself off the Toprol, and the frequency has slightly increased, but it was important for me to be off meds so I could evaluate the efficacy of my ablation.  Even if this ectopy remains, but the V Tach never comes back, I will consider the ablation a success.  PAC's & PVC's are not life threatening.  But, I live in hope, still, that they will go away.  They interrupt my daily life and are a constant reminder that my heart is not normal. Anyone out there with this, please write me back.  It helps me so much to communicate about what has happened to me and I know I could help someone else (I am a critical care cardiac nurse).

[Momto3]

In 2003, I had two ablations, one for RVOT and the other for LVOT.  I was mult-focal so I knew I might need more than one procedure.  After the first procedure, I continued to have thousands of pvcs/day. and the doctor thought it would be a good idea to try and ablate another foci.  After the 2nd procedure (LVOT), I experienced pvcs for about 8 weeks...One night (Christmas Eve), I was in bigeminy for 6 hours and that was about 7 weeks after the 2nd procedure.  

Since that time, I get occasional pvcs, different patterns, some nsvt, but nothing like before.

The doctor told me it could take 6 months or so for things to settle down. Maybe you are just experiencing the after effects of having your heart tampered with.  Wishing you the best!
Connie

[angelinax2]

Connie,
Thank you so much for sharing your story with me.  It gives me hope that I still have the chance for things to get better.  I don't expect to ever be completely free of PAC's/PVC's- but I don't want to be having as many as a do. I will give it 6 months with no meds and see what happens. I was under the assumption that when you get an ablation, you become free from arrhythmia.  This is more than often, not necessarily the case.  Alot of people seem to have some residual arrhythmia. But as long as the arrhythmia is better, infrequent and not life threatening, than you can consider it a success. Before the procedure I wasn't like this and in some ways it makes me question if I ever should have gotten it done.  But, I have to remind myself that the reason I got this done was to get rid of the life threatening V Tach- and so far so good.  I'll wait and see. Do you have an underlying structural heart problem or was your arrhythmia simply an electrical problem? Can you explain LVOT?  Thanks so much! Talk to you soon!    

[Momto3]

You're welcome!  Oh yes, there is hope, don't give up.  LVOT is left ventricular outflow tachycardia.  I had my ablations for very frequent pvcs so I wasn't surprised when I had some residual ectopics.  Today, I get pvcs, but not in the tens of thousands per day.  Whew!

In my case, the persistent pvcs led to cardiomyopathy. My ejection fraction dropped from 55-60% to 40%.  I have mitral valve prolapse with 2-3+ (on scale of 1-4) mitral regurgitation. At first the doctors thought that the drop in EF was due to a deteriorating mitral valve. But, that proved untrue and it turned out to be the pvcs.  Because of the MR, the doctor was pretty assertive in getting the CM resolved.  Since the ablations, my EF has returned to normal.

I agree, I don't expect to ever be completely free of PVC's either, but in my case they are so much less frequent that I am not really bothered by them.  During the period right after the ablation, I think I was on beta blockers. Today, I only take them as needed for really bad days, mostly when I'm traveling.

Given your history of VT, I think the ablation was probably a very good idea : )

Do you have underlying structural heart problems?

[mariop]

I just had my ablation for left ventricle on Feb 16.  Unfortunately Doc wasn't able to reproduce problem.  He therefore guessed and made 23 burns.  It will take a month to really find out if he hit the right spot, or some of it.  He told me that if he hit it, then that is a permanent fix and I will have no PVCs or arrhythmia.

I have been getting a flurrie of PVCs since  the procedure but nothing vicious like I was getting prior to it.  I'm in limbo and do not know where it will go.  If it doesn't work to my satisfaction I will go for another ablation.

As a consequence of the ablation my darn HR is about 15 points higher and my BP is about 30 points higher.  Anyone have any ideas?  Is there a healing period? even though I do not feel any pain in the heart?

I wear an ICD incase of a non self terminating VTach.  Eventually I want to be ICD-free and drug-free.

[Momto3]

After my ablations, my HR was quite a bit higher than it had been in the past. I remember how weird that felt...Any activity would send it up 10-15 points. That settled down pretty quickly.

As for a change in BP - I always had a great bp (100-110/55-65.  After the ablations, I started getting higher readings.  Since then, I've been on BP medication. Fortunately, I am able to take a low dose and it keeps the bp in check.  I've often wondered what the relationship is between the ablations and the change in BP.  I thought maybe because my heart was actually beating better and stronger, the bp changed.  Not sure.

[angelinax2]

They could not induce my arrhythmia either during the procedure.  They ended up doing a linear ablation and burning the area where they thought the arrhythmia was coming from based on the EKG (9 burns).  Do you have an implanted cardiac defibrillator under your skin?  They have a new device out that you can wear as a vest and it defibrillates when needed.  It is a temporary external device.  It is called the Life Vest made by LifeCor.  Look it up on the internet.  I hope the linear ablation worked for you and you don't have to go back again.  

[mariop]

So, at what point in time can you say an ablation was successful, partially so, or an absolute failure.

Today I've been having erratic PVCs for about 10 hours.  I had my ablation on 2-16.  EP wasn't able to reproduce event so he used an old EKG to guess location.

Can I say this was a failure and ask for a repeat, or should I wait another couple weeks?  Can the burns themselves generate PVCs?

Angelina, my EP told me in very clear language that if the offending spot is successfully zapped, the fix is permanent and there will be no PVC from that spot.
I wonder if they just didn't miss a spot in your case.

[angelinax2]

The PVC's you are having are most probably directly from the site he ablated.  I had runs of V Tach for 2 weeks after my procedure which was absolutely coming from the site he worked on.  IT IS FROM SWELLING & IRRITATION. After 2 weeks, I had no more v tach.  But, boy, let me tell you, I was scared to death when I was getting more V Tach after the procedure. But, now, I am left with frequent PAC's (which come from the top of the heart)which I didn't have prior. I feel like during the study (to see if he could induce anything else) he probably damaged an area in the top part of my heart that is causing these frequent skipped beats.  I don't think he did anything inappropriate, but I think my heart happened to be sensitive to whatever was done in there. It's been 2 months, but I am still hopeful most of them will go away.  Everybody's body is different.  If they don't go away, I will learn how to deal with it emotionally and still enjoy my life. YOU NEED TO GIVE IT MORE TIME. THIS TYPE OF ECTOPY IS COMPLETELY EXPECTED FOR SEVERAL WEEKS AFTER AN ABLATION. Where did you get your procedure done? Mine was at The Hospital of the University of Pennsylvania. Do you have a permanent defibrillator? Do you have a structurally normal heart?

[angelinax2]

Hi! It's me again.  I didn't answer your question from a few days ago.  Yes, I have a structurally normal heart and just happen to have an electrical problem that came out of nowhere and slowly got worse over the last year.  Hope all is well. Talk to you soon.

[mariop]

Yes my heart is sound, but it's not much consolation considering the beatings I've taken from PVCs.

Yes I have a Medtronic ICD which has zapped me 6 times in a matter of ten minutes last May.

I had my ablation at West Penn Hosp in Pittsburgh.  My EP Dr Alpert graduated from U. Penn.  Very competent but not very talkative.  Office visits are barely 10 minutes.

Did you develop any problems relating to blood vessels in your head;  any irritation of your abdominal wall or diaphragm, irritation of arteries in the chest, and anything else you think I should know.


I appreciate your info, and momto3 too.

There's a site with some actual cases at www.pvcablation.com if you want to share your experience.

[angelinax2]

I have had no other problems except the PAC's/PVC's. My EP MD was Francis Marchlinski.  I bet your EP doctor will know him.  Thank god he spends a lot of time with me and answers all my questions. 10 minutes is ridiculous! I had to laugh when you said you were getting a "beating" from the PVC's.  I can relate. Try and have a wonderful day and I will too!    

[george799]

Yep i think i have the same or similar. Just undergone EP studies and it was unable to bring out the arrythmia. I have only has three events two after training on my road cycle and once due to alcohol