pvi

Hi everyone, just wondering if anyone has a similar problem, i have sick sinus syndrome. dual pacemaker. have had an ablation for atrial flutter which was a success ,but then got afib really bad, went for a pvi but a blood clot was dicovered in the left atrium,went back three months later, blood clot had dissolved and pvi was done 31st oct.2013 ,but seem to have more trouble more afib ,severe chest pain, even when in sinus rythym heart feels as if its going to bounce through my chest ,cardioligist says everythings okay, yhat im getting ectopic beats but its been over 4 months and i am still suffering, i take sotalol 120mg morning and afternoon ,160 mg at night ,doesnt seem to be doing anything.Any ideas, cheers Fender.....

4 Comments

H Fender

by IAN MC - 2014-03-08 07:03:34

I have SSS and also had an ablation for atrial flutter, which was successful like yours.

As your second PVI ablation has not worked and neither has the sotalol ; it seems to me that your best course of action is to firmly tell your cardiologist that everything is NOT okay as you have more afib !

He will then probably try different anti-arrythmic drugs , either instead of, or in combination with the sotalol ; or consider further ablations.

If you have no success, try a different cardiologist !


Best of luck

Ian

PVI

by golden_snitch - 2014-03-09 04:03:05

Hi Fender!

One usually says that it is not unusual to keep having afib episodes for at least up to 6 months after a PVI. That is also the reason why many PVI patients have to continue anticoagulation for 3-6 months. Also, I do know quite a lot of people who had lots of PVCs, palpitations and a higher heart rate after PVIs or other ablations for a couple of weeks or months. It's because the heart is irritated and sometimes a bit " huffy". In most patients these problems subside after a while. The success of a PVI cannot be evaluated four months afterwards, you need to wait at least 6 months. Remember that they have "burned" rings around the pulmonary veins, and the scar tissue needs a while to develop.

Also, I hope you were informed about this, PVIs are not always successful at first attempt. Many patients need two or three procedures, until they get better. Success rates after just one procedure are, I think, around 50-60%, while after two or three procedures they are at 70-80%.

What I would have done, if I were you, is to get a holter monitor, and not only for a day, but for 3-7 days. This should show what exactly is going on at the moment. At the clinic where I'm being seen, they do routine 7 day holters in every PVI patient. I think they do them 3 months later, then after 6 months again. They have a very strict follow-up protocol, and they do 4-5 PVI procedures every day. So, lots of experience there.

Have you tried other drugs than Sotalol? I would guess, yes, because usually the protocol is that you start with a betablocker, then take a class 1c antiarrhythmic agent (Flecainide, Propafenone), and if that doesn't work, you get a multi-channel-blocker like Sotalol or Amiodarone or Dronedarone.

Hope you get better soon!

Inga

Give It All Time To Heal

by scarheart - 2014-03-10 11:03:09

I have learned that any thing dealing with the heart takes time and patience. Had my ablation surgery August 2013 and Pacemaker 4 days later. Am currently on 120mg of Sotalol ,1in am and 1 in pm. Have tried most all other beta blockers but had a bad reaction. Have been on this medicine for about a month and a half and am happy to report that my rhythm has stayed in normal sinus since being placed on this drug. My energy is coming back and the pacemaker site is healing nicely.

My Dr. said that it would take at least 3 months on this medicine to feel the full effects. So far so good. Every now and again I get what they call, pre-beats and then I feel the stronger pump afterwards. At first I thought I was going to Fib out, but I never do. These pre-beats happen mostly after I have eaten a meal. Apparently we have nerves in our digestive tract that can effect our hearts..Like a direct line. Now when I eat I pay attention and sure enough that is when I will feel these extra beats. Nice to put all this in proper perspective.

Hang in there and give it all a whole lot of time.

Thanks

by fender - 2014-03-13 07:03:17

I would just like to thank you all for your replies,much appreciated ,all the best Fender.....

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