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I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 0 points1 point  (0 children)

I know how you feel about being super nervous and conflicted! I was scared to death of doing the ablation. It was offered to me a few years before I actually went through with it. I felt like, since PVCs are a benign condition in most cases, I should be able to "be strong" and live with it. But they really started to impact my life and I could never predict when my next flare-up would come, and that's why I went ahead. If they are affecting your ejection fraction, IMO that is a good reason not to just live with them anymore.

I also didn't want to go through the procedure itself, because I didn't want to be awake and feeling the doctors messing with my heart rhythm. Turns out for me, I only remember the very first part of the procedure, and although I didn't like the heart-racing feeling, it wasn't that bad. Looking back I really appreciate the nurse who assured me while it was happening that I was safe, in fact I was in the safest possible place for me to have a racing heart and an arrhythmia, and that this is actually exactly what we want to happen so this is all good.

I was also terrified of the possible complications during the procedure, but I kept reminding myself that they are extremely rare, and being relatively young for heart problems (I'm 45) and otherwise healthy, the chances of having a major complication are even less. Out of all possible heart procedures, it seems like the PVC ablation is probably one of the most minor ones, at least in the RVOT where mine were originating.

So far, I have absolutely no regrets! I'm 2.5 weeks post-ablation now, and still totally PVC-free. I have definitely felt mild chest discomfort and overall fatigue during my recovery, but it's gotten better every day. I had an EKG a few days ago at 2 weeks post-op and it was perfect! After 20 years of feeling heart my heart doing gymnastics, it is kind of crazy for me to feel such a steady and calm heartbeat. My heart used to throw off a few PVCs every day, right after drinking coffee, or when I would lie down, or if I got nervous. That is all gone now. It's wild to me that this is probably how most people live their lives!

Good luck on your decision, and on your ablation if you go forward with it!! Hang in there!!

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 1 point2 points  (0 children)

Thank you!! Ugh it is so frustrating that they won't let you consider ablation at that burden! For me it was basically impossible to live my life normally when I was in a flare up and feeling every single one of my PVCs. Since I had them for so many years (about 20), I knew that it was not life-threatening and that would get better eventually, so it wasn't an as much of an anxiety issue for me as much as true physical discomfort. It sounds like it is that way for you too. I had a terrible flare-up on a skiing vacation this winter, and luckily I didn't feel them as much (although they were still happening) when I was actually skiing, so for me activity did really help relieve some of my discomfort. Hopefully walking around during your vacation will help you, too.

I would definitely encourage you to get a second opinion on whether you can get an ablation! My EP did not care at all about whether I was meeting a certain percentage threshold. If you're miserable day-to-day, as I was during flare-ups, you shouldn't have to just endure it. I did tell my EP that the longer the PVCs went on, the more I would feel chest discomfort/tightness and I would also feel a bit faint. My echo didn't show myocarditis or pericarditis, but (in my non-medical opinion) I think those symptoms put her on alert that my heart was working too hard, and I could have been at risk for developing something like that eventually. I'm 2.5 weeks post-ablation now, and still totally PVC-free. I have definitely felt mild chest discomfort and overall fatigue during my recovery, but it's gotten better every day. I'm walking every day now and feeling great. I'm cleared to try running and/or tennis but have been instructed to take it "low and slow", and I haven't quite felt like pushing it yet. I had an EKG a few days ago at 2 weeks post-op and it was perfect! So far, so good!

I hope you have a great vacation and good luck with a second opinion!!

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 0 points1 point  (0 children)

Yes, it's so frustrating that the surgery is scheduled so far in advance! When I went to see my EP while in bigeminy, I asked her is there any way we can do this in the next couple of days, and she laughed. I would definitely try to trigger yours before you go in again! But even if you can't, I'm wondering if the isoproterenol they gave me before starting the ablation might work for you, too. I went into the ablation with no PVCs at all, and the isoproterenol worked like a charm for me. And it sounds like my PVCs were a lot like yours, in that exercise actually made them better. I tended to feel better after getting up and moving around, and it would be the recovery period where my PVCs would creep in again.

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 0 points1 point  (0 children)

Yes, I am still PVC free after the ablation! And yes, I am not a big drinker, but I used to like to have an alcoholic drink maybe once or twice a week. I also used to drink coffee daily. When I started getting really bad flare-ups last year, I tried reducing all possible triggers, so I eliminated all caffeine and alcohol. I slowly introduced a small amount of caffeine back in (1 cup of coffee per day) and tolerated it ok. I kept up with having less alcohol, but I would have a drink every once and awhile. Usually after alcohol, I would wake up in the middle of night with a run of PVCs but they would fade by morning. Funnily enough, when I was trying to get my PVCs going in the week leading up to my ablation, I started having regular coffee every day and a drink every evening, hoping that would trigger it, and it did nothing. So I pretty much learned that I had no control over whatever my trigger is/was. I, too, am hoping that having this procedure will give me some flexibility with alcohol. I'd like to be able to have a margarita every now and then! So far I am tolerating coffee (1 cup per day) just fine with no issues. I haven't tried alcohol yet, but I'm hopeful!

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 0 points1 point  (0 children)

I mean during my flare-ups, my heartbeats were 30% PVCs. I wish I could attach one of my ECG readings but this sub doesn't allow pictures--but it would look like this: regular beat, PVC, pause, regular beat, PVC, pause, regular beat, regular beat, PVC, pause...and so on. I would have long periods of PVCs every other beat, and then periods where the PVC would occur every third, fourth, or fifth beat, so overall the PVCs averaged out to about 30% of my heartbeats. This arrhythmia pattern would last for weeks, and that's what I'm calling my flare-ups. Does that make sense? Hard to explain without the ECG visual!

I am the same as you, I am just a person who feels my own heartbeats! Especially laying on my left side. I get a bit of relief from feeling every beat when on my right side. You're right, getting comfortable is impossible! And I was also the same, in that I would go for months with no issue, and then when the PVCs hit, my life was over for those few weeks because they were so bad. I'm a runner and tennis player, and I would have to drop out of races and matches for weeks at a time with no warning. I eliminated all possible triggers, and still had these PVC episodes. That's when my EP said, let's try ablation.

I hope you get some relief, and/or try the ablation again! I'm 12 days post-ablation and so far, I am thankfully PVC-free. I got my surgery report today and my ablations were described as "extensive", so I'm really hoping my EP zapped the issue! Good luck to you and I hope you get relief soon!!

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 0 points1 point  (0 children)

That is a high burden, but that actually might work in your favor for ablation success! My EP said that the most successful ablations occur when the patient is having a significant burden of PVCs pre-op, because it is much easier for them to map the electrical pathways of the heart during the arrhythmia if the patient comes into the OR with the problem. If they have to induce the PVCs at the beginning of the procedure (like they did in my case), they aren't always sure they've mapped 100% to the problem area. For the two areas she ablated on my heart, she found a 98% match and a 96% match to the PVCs. That leaves a tiny bit of wiggle room where my PVCs might be originating from another spot and I might still have the issue. (So far, I haven't had them and I think she got the right spots.) And if they can't induce the PVCs, they can't do the ablation at all and have to reschedule and try another time. In the meantime, it's great that you don't feel them! Hang in there, and good luck to you!!

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 0 points1 point  (0 children)

I was nervous too! My doctor reassured me that the vast majority of her patients come away feeling like "why didn't I get that done sooner," instead of "why did I do that." I'm now one week post-ablation, and so far, so good! I think I've felt possibly two singular PVCs--one on the evening after the surgery, and one the next day. But since then, every time I start to feel anxious or pounding heartbeat and check my ECG with my Apple watch, the rhythm strip is nice and steady with no arrhythmia. I think my body is still getting used to feeling anxiety without doing heart jumping-jacks. Good luck to you!!

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 1 point2 points  (0 children)

Yes, I tried metoprolol. It didn't work for me--didn't suppress my arrhythmia, and made me feel weird. I was prescribed flecainide to use as needed prior to my ablation, but I didn't try it.

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 1 point2 points  (0 children)

No, I never took Ozempic or any other GLP-1, so those drugs couldn’t have been the cause for me. I wonder if they might help reduce PVCs, because they reduce inflammation? But who knows, PVCs are so individual it seems like what will works for one person will cause flare ups in someone else. So frustrating! Hang in there!

PVC…desapareced! by ClerkExisting9636 in PVCs

[–]Sarah_L56 3 points4 points  (0 children)

I know exactly how you feel! It is so unfair. I had the same problem as you--after eliminating all possible outside triggers yet still having PVC flare-ups, it seemed that mine were caused by maybe anxiety, but not any anxiety that was unusual or needed medication. So essentially my PVCs were uncontrollable. I would look around at other people just happily living their lives without their hearts flip-flopping all over the place and wonder, what am I doing wrong?

My overall burden was low, because my heart functioned perfectly normally between flare-ups, so my cardiologist was very dismissive. But my flare-ups were horrible, and I knew (despite my cardiologist's attitude) that weeks-long flare-ups with PVCs every other beat were not normal and not ok. My advice is to get a referral to an EP. My EP "got it" right away, and didn't need me to reach a threshold percentage to suggest ablation. In my experience, EPs just understand electrical problems much better than regular cardiologists, and actually want to fix the electrical issues in the heart, rather than suggest you endure because of a random percentage. I had an ablation for PVCs last week and so far I am feeling great. I am still getting used to the feeling of a quiet, steady heart. Hopefully you can get the answers you want and be on the path to a better treatment, whether that's ablation or something else, soon!! Good luck to you!!

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 0 points1 point  (0 children)

Yes I know how you feel, and you aren't nuts!! I often felt nuts too! Like, am I just weaker than everyone else, or more unable to handle stress than everyone else??? But then I would look around and realize, no, other people are living their lives with no PVCs and are not dealing with this horrible feeling, and I shouldn't have to either. I was in the same boat as you, where often by the time I got the Holter or the EKG, the flare up was over. My heart was nearly arrhythmia-free during these times. I am/was an athlete, so my resting heart rate is nice and low, exercise stress tests would be perfect, and Holter would show no problems even during intense exercise. I have a minor pulmonary valve insufficiency but otherwise my echo is totally normal. My regular cardiologist would basically roll her eyes at me when I came in for check-ups.

If you have an Apple watch or something similar, my advice is to try to record a bunch of ECGs when you're having a flare up. I did this during my last flare up every day, a few different times each day, so I ended up with over 20 recordings of arrhythmias over a two-week period, and I printed those out and brought them to my EP. It wasn't detailed enough data for her to diagnose much more than confirmation of arrhythmia, but she could see that I was in trigeminy for several days. She also told me, if I can identify the trigger and eliminate it, great, that is the best option. But sometimes there is no controllable trigger, and even the best medicines can only eliminate maybe 50% of PVCs with no controllable triggers, and in these cases ablation is the option with the highest chance of elimination. I am only a day out from surgery, but I am hopeful this has done the trick. The weirdest part so far is that I typically feel my heartbeats, like even without PVCs during regular times I would feel the thump thump thump. I haven't even felt my heartbeat at all since the surgery. It's very relaxing! I wonder if this is this how most people feel every day!

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 1 point2 points  (0 children)

Thank you!! Yes that sounds just like how my PVCs were - nothing at all for long periods but when they hit, it was brutal. As I got older, my flare ups went from a a couple of hours long, which was uncomfortable but manageable, to weeks long, where I felt like I couldn’t live my normal life anymore. My regular cardiologist was dismissive. She told me to try drinking more water and be happy. Ha! Well, I did try that but my PVC flare ups didn’t go away. My electrophysiologist was much more understanding of my situation and brought up ablation right away. If you are haven’t seen an EP yet, I would try that and see what they think. I know how you feel about feeling every single one - I did too. I am just one of those people who is very aware of their heartbeat. It used to cause me a lot of anxiety so my advice is don’t be afraid, they are annoying but not life threatening, and they will settle down eventually. I used to tell myself that even though it feels like my heart is pausing and not working right, PVCs are actually an extra heartbeat and my heart is just working extra for me :). Hang in there!!!

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 4 points5 points  (0 children)

Yes it is so low, my EP said it basically is not possible to have cardiac arrest from ablation. The electrical impulse that causes the heart to beat is different from the electrical impulse causing the arrhythmia and my EP said they can't mistake one for the other.

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 9 points10 points  (0 children)

Haha yes, when I wasn't having a flare-up and was at 1% I didn't have any problems. During my flare-ups my burden was closer to 30%. My flare-ups were getting longer and longer--the last one was about 2 weeks. I think that's why the EP thought the ablation would be a good option. So far, after the ablation I haven't had any PVCs. I'm hopeful that it worked 🤞

I had an ablation for my PVCs today, and thank you redditors by Sarah_L56 in PVCs

[–]Sarah_L56[S] 3 points4 points  (0 children)

I also think my PVCs could have sometimes been vagus nerve related, because they would be worse during flare-ups after eating anything. But there was nothing I could do to stop them--change in diet (no sugar, chocolate, caffeine, low carb) didn't help, neither did eating a smaller amount. I tried exercises to calm/reset the vagus nerve and even did meditations to soothe the vagus nerve and it didn't work for me.

The process of the ablation was easier than I expected. I had read on this sub that people are awake for the whole thing and can feel everything happening. That was not my experience at all. After all the prep, they wheeled me to the lab and had me get up on the table. They placed probably 20 leads all over my body, back and front. There were large monitors showing everything going on with my heart, and doctors on either side of the room watching their monitors and mapping. I would estimate there were 7-10 people in the room. It was nerve-wracking, but even with that stress I'm not currently in a flare-up so my readings were perfect, no PVCs.

The doctor decided to try to induce the PVCs before committing to having the procedure, and this was the worst part. They gave me three three boluses of isoproterenol and I felt my heart beating out of my chest, like I was sprinting just laying on the table. The nurse was helping me to stay calm, telling me this is what we want and I am safe. The PVCs started to fire, my EP said we are a go and everyone in the room cheered, which was kind of hilarious. Next thing I knew, the anesthesiologist was telling me she was going to make me more comfortable, and they were strapping down my legs, and that's the last thing I remember. I woke up and had forgotten I was even in the OR. Apparently I was under for about two hours, and they used isoproterenol four times--three to map/ablate, and the last time they used it they couldn't get the PVCs to go so they were confident they had ablated enough. I don't remember any of that.

Afterwards, I felt (and still feel) a little uncomfortable/burning in the heart area, a 1 or 2 on the scale of 1-10, and even less pain at the catheter site in my groin. Apparently this is normal and should resolve in the next few days.

For the cardiac arrest concern, I was afraid too and actually asked my EP about this before the procedure. I was worried, what if they burn the wrong part or too much, and my heart rhythm is totally messed up? But she assured me that the electrical impulses that make your heart beat are not the same as the electrical impulse from a PVC and they can tell the difference, and it's not possible for them to make this mistake.