New Doctor = Ablation

I posted not long ago about seeking out a new doctor. After lots of research, I decided to go to the Texas Cardiac Arrhythmia Institute. I’m so glad I did! I have an amazing new doctor, who is very knowledgeable and compassionate. He listened and answered all of my questions, and made sure I understood what was happening.

He has decided that another ablation would be in my best interest. He is going to try an epicardial ablation in addition to the traditional endocardial approach. I have had 4 ablations in the past, but an epicardial ablation has never been attempted.

I am very confident in my new doctor. He has my best interest at heart, and assured me that he would try his very best to make me feel better. I am both anxious and excited at the same time. I am ready to feel better, but I am also nervous about the procedure. I know that there are more risks and complications involved with this type of ablation, but at this point, I really have no other choice. This is my last option. If it works…great! If not, at least I know that we’ve tried everything.

I have done some research on epicardial ablation, but really can’t find much about it. I know the basics of it, but if anyone has any info. or experiences that you could share, I would really appreciate it.

Thanks,
Amanda

7 Comments

try this

by Angelie - 2009-06-09 03:06:57

Out of curiousity in trying to learn more about epicardial ablations, since having 5 endocardial ablations myself, I simply typed "epicardial ablation" into the Google search engine where I found pages of info on this subject. Info about the procedure, it's success rate, common reasons for such procedures, and risks.
I almost copied one page and pasted the info here, that is until I discovered the volumes of info available.

I think it's very important to learn as much as you can about the medical procedures and educate ourselves before the procedure date. Good luck in your learning, and wishing you well with your procedure. Try Google. If for some reason you're still not able to find sufficient info to your liking, let me know and I'll help you research.

Angelie

some research

by Angelie - 2009-06-09 04:06:01

Authors reported 80% success rate associated with epicardial ablation
Epicardial ablation was successful in 8 of the 10 patients (80%). In 1 patient who failed epicardial ablation, VT was ablated using a follow-up standard endocardial ablation procedure, which had failed previously. The other patient who failed epicardial ablation had a diagnosis of dilated cardiomyopathy and required urgent heart transplantation because of hemodynamic instability and refractory heart failure. The authors reported that neither the presence of transmural infarctions nor ventricular aneurysms interfered with catheter positioning inside of the pericardial sac.

During follow-up (mean, 18 months), oral amiodarone was continued in 3 patients. Two years after ablation, arrhythmia recurred in 1 patient who was taking amiodarone, but the morphology and rate of the recurrent tachycardia were completely different from the original arrhythmia. This patient underwent standard endocardial ablation in a different location, which successfully terminated the VT. The researchers observed no significant complications during the study, although 2 patients experienced thoracic pain for 3 days following the procedure and were treated with analgesia.

Based on the results of this study, the authors concluded that epicardial RF ablation should be considered an alternative for patients with incessant VT who are at high risk of life-threatening arrhythmias and they recommended further studies to define the usefulness of epicardial access for VT ablation.

Several safety caveats still of concern
In an accompanying editorial, William G. Stevenson, MD, Brigham and Women's Hospital (Boston, Massachusetts) pointed out several important safety caveats.[2] First, catheter ablation of scar-related VT is more challenging than ablation of supraventricular tachycardias, and experience outside of large centers is limited. Although safety in small studies has been good, hemopericardium requiring drainage has occurred following the procedure, he said, and transient pain consistent with pericarditis is not uncommon. Moreover, damage can occur to the epicardial coronary arteries, the left phrenic nerve, and the adjacent lung; in some patients, pericardial fibrosis from prior cardiac surgery may prevent percutaneous access to the pericardial space. In addition, Stevenson said that long-term follow-up after ablation is still being defined. He concluded that epicardial ablation therapy will largely remain in experienced centers because of technical challenges and the relatively low incidence of patients with incessant VT who have failed endocardial ablation.

Date

by scadnama - 2009-06-09 06:06:36

Thank you both!!!

My ablation has been scheduled for June 25th. Only a couple of weeks away, but this waiting game is killing me!

good luck!

by Tracey_E - 2009-06-09 06:06:56

I'm glad you have a responsive doctor you feel good about! When does he want to do it?

Prayers

by anewday - 2009-06-09 09:06:04

Want to send my most sincere prayers. This is all very new to me, and am trying to understand what many of you are going through....good luck! This time you will pervail.

Finally!

by tcrabtree85 - 2009-06-11 09:06:43

What a answer to prayer that you finally found a good Dr. that hopefully will get to the bottom of this weird irregular rate issue.
I know your nervous but just relax and keep busy as much as you can. I have two weeks of trying to figure out ways to make you laugh. hmmm. gotta start thinking.
Love ya! Talk to you sometime this week my sister.

Tammy

hi

by bradnissan - 2009-10-11 11:10:55

what was your original diag? afib? what was tried first?

You know you're wired when...

Friends call you the bionic man.

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