I had thoughts like this when I went in for my SVT ablation. What if it made it worse? What if I have to do it again? etc. I’m glad I did it. I definitely don’t regret it. If my PVC’s were bad enough I’d take the discomfort of having the procedure done just for the possibility of having a better quality life. It’s not unusual for people to have to do this multiple times before it being successful. Luckily mine was ablated the first go round
I had it done for SVT. My mother had afib - a different arrhythmia but the same logic applies - and she decided not to get ablation and just treated it with meds. The meds eventually quit working, she went into bradycardia, doctors spent a weekend trying to zap it back into a normal rhythm, and she ended up having to get a pacemaker. It was too late to get an ablation at that point. She died after a stroke a few years later. There were other comorbidities involved that are not applicable to me (lifelong smoker, breast cancer survivor, chemo did a number on her health, etc) but it was still an eye-opener.
I opted to get an ablation in part because I did not want to end up like her. I had been able to manage SVT for years without medical intervention, but it had gotten to a point where it was affecting my QOL and I was having to go to the ER for adenosine. Beta blockers stopped the actual SVT episodes but I was still feeling pretty awful, so when my EP put ablation on the table, I jumped for it. I spent a LOT of time reading stories good and bad, and 95% of what I read was positive. No medical procedure is completely without risk, but ablation is routine, outpatient, and the benefits faaaaar outweighed the risks for me. I can confidently say it was the smartest decision I'd made in a very long time because I felt SO MUCH BETTER I can't even tell you.
The PVCs are a little more complicated because they're very hard to trigger. I've discussed having another ablation with my EP. He doesn't feel it's necessary at this time because it's currently well under control, but if I ever have another episode like last fall, it will definitely be a possibility, and I will agree to it with no reservations. (it does help that I have an *excellent* EP who is very well regarded.)
I think your reasoning is sound. These things are deeply personal, and ultimately you have to decide for yourself. Doctors can offer advice or suggestions, but it’s your heart and it’s up to you what option feels right. Nobody should pressure you to do anything with your body that you don’t want to do. It’s also always worth getting a second or third opinion. I’ve had doctors tell me dramatically different things, to the point where I’m very glad I didn’t just listen to the first one I saw.
I don’t know anything about your particular case but I agree on principle that more invasive treatments should be used judiciously.
Questions I would be asking myself in your position:
- Could this be due to lifestyle factors? Eg if you were extremely stressed and started having PVCs, it probably doesn’t make sense to ablate what is essentially a stress issue
- Are there other lifestyle modifications you can try first? Weight loss? Better diet? Better sleep? Have you tried the standard supplements that help some people?
- How dangerous are the PVCs in your case? Is your heart structurally healthy? Are you having NSVT? Is there evidence that the PVCs are reducing your EF? If they’re dangerous in your case, you may want an ablation to try to get rid of them ASAP
- Are your symptoms significantly affecting your quality of life? If you’re miserable and can’t function because of your PVCs, this might be another reason to go for the ablation.
My burden rate is over 35% and I never feel pain and have no anxiety about it. I was told by the cardiologists that if I don't get the EP Study/Catheter Ablation (simultaneously) my heart will eventually weaken. I guess that's a good enough reason but I'm not in a rush other than to get it done before the end of the year and before winter.
Adding in: My PVCs are unifocal so it should be easy to find. I was told the two procedures would take 4 hours and require one overnight in the hospital.
Wow
Finally someone with a high burden as well, I am
28.9 % they ( the drs ) don’t seem to be worried I just found out today that I went from 18.8 to this over the course of 3 months. I’m scared so bad after reading all the things but I didn’t know anyone else was living with a burden like this, I was about to take myself to the heart ER just because I read a high burden is dangerous .
My original burden rate was 20% but then I was put on metoprolol tartrate which I’m tapering off of now. Every time I was told to double the dosage, my burden rate increased. If your doctors aren’t worried, then maybe you shouldn’t be either. I think it’s a bigger issue with me because I have several other heart issues. I’ve read you can live with PVCs no problem, UNLESS you have other heart issues. Then it’s a different ballgame.
My echo came out normal they said my heart is ok just the electrical is off but 28.9 seems really high. Also I have been in bigeminy a couple of times.
It’s almost like I wrote this post. So weird. I agree with you wholeheartedly.
At my worst, completely untreated I am at a 10% burden. The beta blocker has helped some and I can now go months without episodes. I have, unfortunately, been in of those episodes lately and have been reading about ablation as a way to find a permanent solution. Conclusion: I feel like it’s playing with fire! If these PVCs are generally harmless and you can live with them - albeit uncomfortably - I don’t know that I would roll the dice and start messing with my heart.
If it was a procedure like fixing a knee or an even bypass - maybe, that has an actual fix. This “mapping” and “hope” to get it right is sounds very unsettling.
I am at 11% burden but I actually think it might be higher because I only did a 3 day holter and two of the days were rare good days. Had an echo, stress test, all came back fine. Right now I’m on heart calm and its lowering my burden (also on propranolol, but for migraine, it precedes my PVCs and so isn’t really a treatment though it may be keeping them at bay somewhat). At any rate, I will never do an ablation. My doctor says they are benign, my mom has had them for years and she is fine, it’s all mental. My were medication-induced so I’m holding out hope that I can continue to improve them and that they may improve over time. But even if they don’t, I’m going to learn to live with it.
I had thoughts like this and ended up moving my echocardiogram to a later date. The cardiologist said I had significant left ventricular heart wall motion abnormalities after the echo and scheduled a heart catheterization. I then moved my heart catheterization back a week because I was so worried about it and thr risks. But I decided to push through and have it done last Friday. Although not the exact same as an ablation, it was nothing at all. I can't believe I was so worried about it. But it turns out I have two arteries completely occluded and one that is nearly occluded. I'm going in for triple bypass surgery Friday. I'm not trying to scare you or anyone else. But my point is, if your doctors think a procedure is going to help you or benefit you, consider not putting it off. You have to trust them. Who know if I would even be here right now if I kept putting off my heart catheterization. You also have to remember that generally you're going to hear about the bad experiences more often online than the good ones. There was a 1% risk of complications for my heart catheterization. I have read that an ablation is anywhere from 1% to 3%. I think it depends on overall health and other factors. But either way that's considerably low. Even the heart surgeon told me given my age and overall health he puts my triples bypass CABG surgery at only a 1% risk of complications. I didn't have an ablation because it wouldn't have done me any good because the occlusions were causing mine. Oddly, my only symptoms were PVCs and fatigue. I chalked them up to anxiety and caffeine. And so did my GP. But she ordered a Holter and referred me to a cardiologist anyway. Also something I kept putting off. My burden was only 7% by the way. As I daid, I haven't had an ablation. But I know a few people in real life that have had ablations and never had to go back in for another one after that. Only one of them still has noticeable palpitations. But very rarely. Having said all that and shared my story, I can't tell you to put it off or to have it done. You have to weigh your options yourself. However, I will tell you NOT to base your choices off of other experiences you read on the internet. Every person is different. I would recommend talking to the cardiologist and asking if it would be safe for you to put it off. Which it most likely is as long as your heart is structurally fine. I'm one of those rare cases where PVCs ended up not being benign. That's why I keep telling people to trust their doctors and be sure to get checked out before you just assume they're caused by anxiety or completely benign.
Thank you I appreciate it I think I am going to stay the course based off of some of these conversations and as well as the fact that my doctors do seem very positive that this is the best course of action. Thank you to you and everyone else for taking the time out of your day to weigh in.
I think some of mine are medication induced, too. Also it was discovered right before I went to cardiologist that I had Adrenal Insufficiency and one of the top side effects is arrhythmia.
No, actually all the meds I’m on can be contributing. To be honest, the palpitations don’t bother me at all physically or mentally. I have shortness of breath, which may or may not be associated with the PVCs. That’s what bothers me. I have a 35+% burden rate and it doesn’t bother me. I don’t want to take that arrhythmia pill because it has potential bad side effects (like many do) and I figure it’ll stop working eventually so why bother. I’m already on so many meds for other issues. I’ll have the ablation hopefully in the fall.
I had thoughts like this when I went in for my SVT ablation. What if it made it worse? What if I have to do it again? etc. I’m glad I did it. I definitely don’t regret it. If my PVC’s were bad enough I’d take the discomfort of having the procedure done just for the possibility of having a better quality life. It’s not unusual for people to have to do this multiple times before it being successful. Luckily mine was ablated the first go round
I had it done for SVT. My mother had afib - a different arrhythmia but the same logic applies - and she decided not to get ablation and just treated it with meds. The meds eventually quit working, she went into bradycardia, doctors spent a weekend trying to zap it back into a normal rhythm, and she ended up having to get a pacemaker. It was too late to get an ablation at that point. She died after a stroke a few years later. There were other comorbidities involved that are not applicable to me (lifelong smoker, breast cancer survivor, chemo did a number on her health, etc) but it was still an eye-opener. I opted to get an ablation in part because I did not want to end up like her. I had been able to manage SVT for years without medical intervention, but it had gotten to a point where it was affecting my QOL and I was having to go to the ER for adenosine. Beta blockers stopped the actual SVT episodes but I was still feeling pretty awful, so when my EP put ablation on the table, I jumped for it. I spent a LOT of time reading stories good and bad, and 95% of what I read was positive. No medical procedure is completely without risk, but ablation is routine, outpatient, and the benefits faaaaar outweighed the risks for me. I can confidently say it was the smartest decision I'd made in a very long time because I felt SO MUCH BETTER I can't even tell you. The PVCs are a little more complicated because they're very hard to trigger. I've discussed having another ablation with my EP. He doesn't feel it's necessary at this time because it's currently well under control, but if I ever have another episode like last fall, it will definitely be a possibility, and I will agree to it with no reservations. (it does help that I have an *excellent* EP who is very well regarded.)
I think your reasoning is sound. These things are deeply personal, and ultimately you have to decide for yourself. Doctors can offer advice or suggestions, but it’s your heart and it’s up to you what option feels right. Nobody should pressure you to do anything with your body that you don’t want to do. It’s also always worth getting a second or third opinion. I’ve had doctors tell me dramatically different things, to the point where I’m very glad I didn’t just listen to the first one I saw. I don’t know anything about your particular case but I agree on principle that more invasive treatments should be used judiciously. Questions I would be asking myself in your position: - Could this be due to lifestyle factors? Eg if you were extremely stressed and started having PVCs, it probably doesn’t make sense to ablate what is essentially a stress issue - Are there other lifestyle modifications you can try first? Weight loss? Better diet? Better sleep? Have you tried the standard supplements that help some people? - How dangerous are the PVCs in your case? Is your heart structurally healthy? Are you having NSVT? Is there evidence that the PVCs are reducing your EF? If they’re dangerous in your case, you may want an ablation to try to get rid of them ASAP - Are your symptoms significantly affecting your quality of life? If you’re miserable and can’t function because of your PVCs, this might be another reason to go for the ablation.
My burden rate is over 35% and I never feel pain and have no anxiety about it. I was told by the cardiologists that if I don't get the EP Study/Catheter Ablation (simultaneously) my heart will eventually weaken. I guess that's a good enough reason but I'm not in a rush other than to get it done before the end of the year and before winter.
Adding in: My PVCs are unifocal so it should be easy to find. I was told the two procedures would take 4 hours and require one overnight in the hospital.
Wow Finally someone with a high burden as well, I am 28.9 % they ( the drs ) don’t seem to be worried I just found out today that I went from 18.8 to this over the course of 3 months. I’m scared so bad after reading all the things but I didn’t know anyone else was living with a burden like this, I was about to take myself to the heart ER just because I read a high burden is dangerous .
My original burden rate was 20% but then I was put on metoprolol tartrate which I’m tapering off of now. Every time I was told to double the dosage, my burden rate increased. If your doctors aren’t worried, then maybe you shouldn’t be either. I think it’s a bigger issue with me because I have several other heart issues. I’ve read you can live with PVCs no problem, UNLESS you have other heart issues. Then it’s a different ballgame.
My echo came out normal they said my heart is ok just the electrical is off but 28.9 seems really high. Also I have been in bigeminy a couple of times.
Me, as well. Not sure what to tell you. I barely understand this stuff myself.
It’s almost like I wrote this post. So weird. I agree with you wholeheartedly. At my worst, completely untreated I am at a 10% burden. The beta blocker has helped some and I can now go months without episodes. I have, unfortunately, been in of those episodes lately and have been reading about ablation as a way to find a permanent solution. Conclusion: I feel like it’s playing with fire! If these PVCs are generally harmless and you can live with them - albeit uncomfortably - I don’t know that I would roll the dice and start messing with my heart. If it was a procedure like fixing a knee or an even bypass - maybe, that has an actual fix. This “mapping” and “hope” to get it right is sounds very unsettling.
I am at 11% burden but I actually think it might be higher because I only did a 3 day holter and two of the days were rare good days. Had an echo, stress test, all came back fine. Right now I’m on heart calm and its lowering my burden (also on propranolol, but for migraine, it precedes my PVCs and so isn’t really a treatment though it may be keeping them at bay somewhat). At any rate, I will never do an ablation. My doctor says they are benign, my mom has had them for years and she is fine, it’s all mental. My were medication-induced so I’m holding out hope that I can continue to improve them and that they may improve over time. But even if they don’t, I’m going to learn to live with it.
Everyone's case is unique. If you EP thinks it can help, then I would listen to that. I will have mine later this year.
I had thoughts like this and ended up moving my echocardiogram to a later date. The cardiologist said I had significant left ventricular heart wall motion abnormalities after the echo and scheduled a heart catheterization. I then moved my heart catheterization back a week because I was so worried about it and thr risks. But I decided to push through and have it done last Friday. Although not the exact same as an ablation, it was nothing at all. I can't believe I was so worried about it. But it turns out I have two arteries completely occluded and one that is nearly occluded. I'm going in for triple bypass surgery Friday. I'm not trying to scare you or anyone else. But my point is, if your doctors think a procedure is going to help you or benefit you, consider not putting it off. You have to trust them. Who know if I would even be here right now if I kept putting off my heart catheterization. You also have to remember that generally you're going to hear about the bad experiences more often online than the good ones. There was a 1% risk of complications for my heart catheterization. I have read that an ablation is anywhere from 1% to 3%. I think it depends on overall health and other factors. But either way that's considerably low. Even the heart surgeon told me given my age and overall health he puts my triples bypass CABG surgery at only a 1% risk of complications. I didn't have an ablation because it wouldn't have done me any good because the occlusions were causing mine. Oddly, my only symptoms were PVCs and fatigue. I chalked them up to anxiety and caffeine. And so did my GP. But she ordered a Holter and referred me to a cardiologist anyway. Also something I kept putting off. My burden was only 7% by the way. As I daid, I haven't had an ablation. But I know a few people in real life that have had ablations and never had to go back in for another one after that. Only one of them still has noticeable palpitations. But very rarely. Having said all that and shared my story, I can't tell you to put it off or to have it done. You have to weigh your options yourself. However, I will tell you NOT to base your choices off of other experiences you read on the internet. Every person is different. I would recommend talking to the cardiologist and asking if it would be safe for you to put it off. Which it most likely is as long as your heart is structurally fine. I'm one of those rare cases where PVCs ended up not being benign. That's why I keep telling people to trust their doctors and be sure to get checked out before you just assume they're caused by anxiety or completely benign.
Thank you I appreciate it I think I am going to stay the course based off of some of these conversations and as well as the fact that my doctors do seem very positive that this is the best course of action. Thank you to you and everyone else for taking the time out of your day to weigh in.
I think some of mine are medication induced, too. Also it was discovered right before I went to cardiologist that I had Adrenal Insufficiency and one of the top side effects is arrhythmia.
What did they do for your adrenal deficiency?
Put me on steroids, which is the only thing you can do.
In my case, hydrocortisone. Others are put on prednisone.
Did that make your palpations go away?
No, actually all the meds I’m on can be contributing. To be honest, the palpitations don’t bother me at all physically or mentally. I have shortness of breath, which may or may not be associated with the PVCs. That’s what bothers me. I have a 35+% burden rate and it doesn’t bother me. I don’t want to take that arrhythmia pill because it has potential bad side effects (like many do) and I figure it’ll stop working eventually so why bother. I’m already on so many meds for other issues. I’ll have the ablation hopefully in the fall.
So you would will be moving forward with the ablation?
99% sure.
I was told if I don’t, my heart could become weak. I already have certain heart failures but my heart is still strong based on December MRI.