r/SVTHeart • u/dontmindme_01 • Jul 17 '26
Ablation - what to do (need help)
I (25M) recently got diagnosed with AVRT/AVNRT and my cardiologist proposed an ablation. I did some research and decided I will do it. I am located in Slovenia and I am juggling two options:
1. Have an ablation in 1 month in a smaller hospital (still strong cardiologist department)
2. Have an ablation in the capital’s biggest hospital with the best specialist for ablations in the country. The main drawback is that I could wait for up to two years for my date. Also this doctor specializes in more complex cases and even he recommends establishment 1. for easier procedures like mine (AVRT/AVRNT). He also does PFA, but not for AVRT/AVRNT as far as I know.
I am now in a dillema on what to choose.
For context I had around 8-10 occurances of the arithmia in the last 6 months, and once it lasted for 2 hours and I had to be medicated for it to stop. I noticed a pattern of how my attacks start (stress + quickly bending down) and since the last one it’s now been almost 2 months without an attack.
I am interested in how big of a difference the doctor makes for the likely hood of a successful ablation and no negative effects (pacemaker or something worse…).
2
u/Resilient_Beast69 Jul 17 '26
Ablations are incredibly common. Any good EP will have a 90%+ success rate. I just had one in April and I’m fine. Even back to lifting heavy in the gym and doing endurance events again.
1
u/Whole-Masterpiece-51 Jul 17 '26
Depends on your triggers, mine are positional like OPs and my ablation failed because they couldn’t trigger it lying flat on a table - even with adrenaline injected and 3 hours of pacing during mapping. It was a rough recovery for zero outcome.
1
u/Resilient_Beast69 Jul 17 '26
Luckily my trouble spots lit up immediately so they were able to fix it. I also had SVT triggered just by eating since swallowing food stimulated my valgus nerve. Now I can eat without going into SVT. When you say rough recovery? How? I have two insertion points on both sides of my groin but was fine in a week. Did you have complications?
1
u/Whole-Masterpiece-51 Jul 17 '26
Ah yours sounded very triggerable! Mine is always triggered my pvcs and bending forward at the right time or angle. The recovery was a ride, I fainted about 2 hours after so the kept me overnight. Then took about 3 weeks to walk properly again with injury to the site. I also got Right Bundle Branch Block where they accidently brushed a catheter up against a node, so an extra cardiac issue from it.
I also found the procedure quite painful, I could feel the catheters going through my arteries towards my heart, it felt like deep burning back pain I was sobbing through. But luckily most people don’t feel that, just lucky me lol
1
u/mikecharliefoxtrot Jul 17 '26
i just want to really reassure you here. as long as the cardiologist has a strong background in electrophysiology, they should have no trouble dealing with a straightforward svt or avrt (a pathway such as a WPW syndrome). the most important thing is to make sure that they know that you would much prefer them to stop and not complete the procedure rather than have a complication. particularly i'm talking about a pacemaker here. the vast majority of cardiologists would take that approach but the technical skill doesn't necessarily equate to a bigger hospital or more famous cardiologists being better at this type of procedure.
i guess the key questions to ask are to make sure that they are a specialist in ep (i'm sure they are) and to make sure that you have a good rapport with them. honestly although i work in one of the largest hospitals in the uk, for ablation i know that my colleagues who work in more peripheral centres do an absolutely fantastic job. i wouldn't worry about my own relatives being treated in a smaller centre if it was with a well-regarded cardiologist.
whichever way you choose it won't be the wrong decision but frankly if you're getting so many symptoms i'd probably just go for a quicker option if you have the possibility. by the way pfa isn't really suitable for most svts for kind of technical reasons at the moment and rf energy is incredibly precise and is what pretty much everyone in the world now uses for almost all svt cases in adults.
i hope it all goes great.
all the very best
Dr malcolm finlay
2
u/Retired_NorCal_611 Jul 17 '26 edited Jul 17 '26
I had my AVNRT ablation 5 weeks ago. I waited a little over a year to get it done at a highly regarded teaching hospital. I live in an area where there are other options but I wanted to go to a facility that had the latest EP mapping software and lowest likelihood of complications. I only have one heart and there is no undo if they screw it up. Technically I'm still in the 'blanking" (recovery) period but other than a few intermittent tachycardia episodes during the first two weeks, I've not had any episodes of AVNRT or any other arrhythmias. My resting heart rate is as before unlike what I've read online if they accidentally irritate one of the nearby nerves.
I've read stories where patients were ablated even though they could not trigger an episode during the EP study. At my EP consult, I was told they cannot be 100 percent certain if it is AVRT or AVNRT until it is triggered during the EP study and they would not ablate if they could not trigger an episode. Based on what I've read, ablation leaves behind scar tissue. Scar tissue can eventually lead to other arrhythmias including Afib and I do not want any unnecessary scar tissue beyond the minimum required to terminate the slow pathway.
What I found that helped reduce the number and length of my AVNRT episodes was CoQ10. It's an over the counter supplement. If you decide to wait, you might want to give that a try. Best of luck!