2nd ablation of sinus node

I just had a 2nd ablation of my sinus node last week. Every since then I have been in accelerated junctional rhythm. They raised my low setting on my pm to 90 to try to override it but when I get up or walk a little I feel like I am going to black out. I feel this pressure in my neck and then feel sick then everything starts going black. This is not livable. Has anyone else experienced this and is there anything I can do?

6 Comments

Ablations

by nat36 - 2012-09-26 04:09:36

I knew that you had sinus node ablations. I did not know you had four!
I was concerned about my phrenic nerve and superior vena cava syndrome(which I guess could still happen if I get more scar tissue) but no one suggested this as a possibility. He raised my sotalol up but it is not helping at all. I can't drive or do anything. I'm freaking out that this is permanent. Doctor says maybe it will go away but it seems to be getting worse instead of better.

Been there, done that

by golden_snitch - 2012-09-26 04:09:40

Hi! Have been dealing with this problem for years after several ablations, including four sinus node ablations. At first, raising the lower pm setting to 70bpm helped, but then the junctional rhythm got faster, and I started taking different meds. Took everything from simple betablockers to , Verapamil, Flecainide, Propafenone, Amiodarone, Dronedarone, Sotalol, and it all worked for a couple of months, but in the end all drugs failed to control that rhythm. So, in July my EP decided to go in again and try to ablate that junctional rhythm, but it didn't work out. Three weeks ago he went ahead and ablated the AV-node. I'm doing much better now, and do not need any drugs. However, I would not recommend this to you, unless you have tried several drugs. Maybe a little dosage of betablocker does the trick for you. AV-node ablation should be the last resort. It was my 8th ablation, and as I told you, I had tried all drugs available before I had it done.
Best wishes
Inga

P.S. The pressure in your neck comes from the atriums and ventricles beating out of sync. The atriums beat against closed valves, and so the blood backs up in the atriums and also the veins bringing blood from your body back to the heart. When blood coming back from your head backs up, it causes this pressure, and one can often also see the full veins in your neck and chest.

sotalol

by nat36 - 2012-09-27 02:09:39

I have tried pretty much every drug. I was on Sotalol before the ablation so I'm sure he is just leaving me on that since we've been through all the others. I go back on Monday and I am going to tell him the Sotalol is not working. Everyday just gets worse. I feel like I just exchanged one problem for another worse problem! Is there anything else that stops the junctional rhythm? Can this lead to heart failure or can it turn into ventricular tachycardia?

Sinus node ablation

by golden_snitch - 2012-09-27 03:09:23

I had superior vena cava syndrome, and needed open-heart to correct it. And now, about 12 years after the last sinus node modification, an EP study showed that there is activity in the sinus node area again; it just keeps recovering, but fortunately, it's not causing inappropriate tachycardia (yet). I have been told that one cannot ablate the whole sinus node, because it's not a clearly defined structure in the right atrium, but an area in which you always miss one arrhythmic spot or another.
Have you tried anything else than Sotalol? This is quite a strong drug to begin with. In my case, Propafenone (combined with a betablocker) did a good job for nearly two years.
Best wishes
Inga

Different arrhythmia now...

by golden_snitch - 2012-09-27 06:09:42

But you haven't tried all those drugs for the accelerated junctional rhythm, have you? I mean, from what you posted it sounds like you have the junctional rhythm problem only since last week, since your last ablation. That the drugs didn't work to treat a different arrhythmia does not necessarily mean that they don't help with the junctional rhythm. I'd go through them again, and start with a simple betablocker or Verapamil.
The junctional rhythm is benign, it won't cause any harm. Makes you feel aweful, but is not dangerous.
Best wishes
Inga

Doctor

by nat36 - 2012-10-03 02:10:44

Well I went back to the doctor Monday and the rhythm that I had the ablation for is back also!!! I am so discouraged. Now also the accelerated junctional is junctional tachycardia. Everything just keeps getting worse. Doctor said not to give up hope and that heart is still healing. He changed my medicine to Flecainide and Lopressor both twice a day and I have to go back to the doctor once a week for a while. He told me no driving and to just rest. I don't understand why everything is so much worse!!

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So, my advice is to go about your daily routine and forget that you have a pacemaker implanted in your body.