Palpitations Need Help!

Ok this is the problem.

As many of you know I received my PM in August 08 for vaso vagal syncope. I passed out at home went to the ER and had a 5 second pause during a tilt test.

All has been OK until December 21 when I went into AFib for 16 hours before I converted on the drug Flecainide. Well my EP, who was on call at the local hospital, treated me. He sent me home and told me to take 50mg of Flecainide twice a day and follow up in his office in 30 days. Well I have followed his orders and all was well until yesterday when I started having Palpitations frequently. I mean very frequently and they are really affecting my ability to do everyday activities. This sucks. I am a 40year old who is very active and all of a sudden the past 6 months have been difficult.

I have suffered form Palpitations every now and then since 2003 and have wore the holter monitor 4 times and every cardiologist says they are benign palps and that they can't hurt a person.

Well after the AFib episode I asked the docter whether my history of palps and the vaso vagal problem were connected to the first time AFIB episode and he said he did not know but that the palps could have been the precurser and that I'd have to be monitored closely as I get older.

Today I called my Cardiologist and informed the nurse that I was having frequent Palps and she scheduled me for Monday Morning to see a nurse Practitioner because the Doctor is in the Lab and his schedule is booked. SUCKS!

ANY Advise WOuld be helpful!

Anyone else with these nasty palps all day long!

Shouldn't The Flacainide be controlling these episodes? If not is an ablation the cure?

How much drug therapy do they attempt before the ablation attempt.

Lastly will an ablation make a person PM dependant?

2 Comments

Jeez

by Angelie - 2009-01-09 04:01:26

I have been on and tried EVERYTHING, and I'm only 33. I've been at this as well for about 8 years.
I have had 3 failed ablations. Neither of them caused my pacemaker, but one caused phrenic nerve damage. Pacemaker is always a risk though with any ablation, as well as other risks.
An ablation does not make someone pacemaker dependent. It will only make you dependent on a pacer if they ablate your AV node, or accidently ablate your sinus node. It really depends where they're at in your heart and what they're ablating.
Pacers sometimes make palpitations worse until the docs get them programmed right. Pacemakers DO NOT sure a-fib, or a-flutter.
Ablation is a possible cure for certain arrhythmias but not without it's risks. It's also VERY expensive. Some of the catheters that the docs use cost 8-10 thousand dollars a piece.
I would try different medicines first. Sometimes certain meds work whereas others do not. Also I have first hand experience where meds work for a little while then they just stop and then the palpitations return like wildfire. That goes as well with ablations. The docs can ablate tissue to stop arrhythmias, it works for a while and then your symptoms return. An ablation isn't always the answer. Sometimes it ends up helping forever and they're considered "cured". Sometimes it helps for a while and then after a while symptoms return and the patient is right where they started. Sometimes an ablation can make things worse than they were before. It all just depends on your particular problem.
Hope your palps get better. I would try a different medicine, or a change in dosage.

Let us know how you're doing.
Angelie

Palpitations & Afib

by traeh - 2009-01-11 09:01:37

Hi Malston01

Sorry to hear your heart arrhythmias are continuing. I suffered from progressively increasing symptoms since 1993 so I know how exactly what you are experiencing - it is truly debilitating.

Your benign palpitations detected by the Holter monitor are likely to be ectopic beats ie extra beats which follow a normal conduction path through the heart. These are considered harmless - in fact most of the population have some of these every day and are totally unaware of them. However large numbers of these ectopics every day can be a indicator that afib may develop in time. Your cardio/EP is therefore spot on with his intention to monitor you closely in the future.

Angelie's comments are very well made and I concur with everything she has said. I too have been tried on every drug and subsequently had three ablations - right posterial atrial ablation, left atrial catheter ablation (cf surgical Maze procedure) and AV nodal ablation with permanent pacemaker insertion. I very much agree with Angelie that it would be wise to exhaust the drug route before considering ablations, especially the AV node.

AV nodal ablation will ameliorate the symptoms of paroxysmal and chronic afib but the atria will continue to fibrillate with up to 30% of heart output lost and an ongoing need for anti coagulation therapy. AV nodal ablation is non reversable so you would be permanently pacemaker dependent even if your sinus rhythm was later restored. I reverted to sinus rhythm about a year ago just after flecainide was withdrawn as it was not preventing occasional atrial tachycardias. This may now allow my warfarin (coumadin) to be withdrawn leaving metaprolol (a beta blocker), but I will always be pacemaker dependent.

I really hope you find a treatment that deals with your afib and as Angelie says, please let us know how you get on.

traeh

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It may be the first time we've felt a normal heart rhythm in a long time, so of course it seems too fast and too strong.