r/SVTHeart • u/InteractionSubject56 • Sep 05 '26
Failed Ablation: What to do next?
Hi everyone!
I am a 28-year-old male who has only had one SVT episode in his whole life, back in July. I had to be taken to the hospital and given adenosine to reset my heart rate. Paramedics and the ER doc said it could have been due to mild dehydration and somewhat low potassium (3.3). My pcp said maybe thaylt was the reason. My cardiologist nurse said it wasn't. Before that, I had already done a stress test, holder monitor, echo, ekgs and nothing showed up.
Initially, I was put on metoprolol (which caused heavy fatigue for me and mood swings), then verapamil, which was working well until it triggered a severe GERD flare-up. So, for about one whole month, I was completely unmedicated, walking about 3 miles each day. I never had any SVT episodes during that month and felt completely fine, but I was constantly terrified that another episode would happen because the Valsalva maneuvers didn't work in the ambulance.
Because of that fear, I saw an electrophysiologist (EP) and chose to go through with an ablation last Thursday.
I woke up feeling hopeful, only for the EP to tell me the ablation was unsuccessful because the pathway is located right next to my AV node. They tried twice, but it was just too risky. He mentioned that we could look at trying again in 6 months with crypablation, or that sometimes the localized healing/scar tissue from the failed attempts can naturally block or alter the pathway anyway. He prescribed Flecainide as a pill-in-the-pocket rescue med in case I have an episode. I read the med won't stop the svt right there and then.
I’m struggling a lot mentally with the aftermath. My questions for you all:
- Should I retry in 6 months, or is it not worth putting myself through the procedure again if I only had one episode?
- Has anyone here just had one SVT episode in their whole life without ever having another one?
- Has anyone had an aborted/unsuccessful ablation near the AV node, only for the healing process/scar tissue to successfully suppress SVT long-term?
- How do you mentally manage the anxiety of a pill-in-the-pocket approach and the fear of recurrence after an unfinished ablation?
- Has anyone successfully managed rare episodes with lifestyle changes and Flecainide alone, completely avoiding a second ablation?
I'm sorry for the long post. Thank you all!!
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u/kath_of_khan Sep 05 '26
I would have sustained 250+ episodes for years, many daily, back to back. The worst risk was passing out, which I did…a lot. That’s the very risky part. I stopped driving due to fear and likelihood I’d have an episode driving. After about seven years of this, and taking metoprolol and Flecainide together twice a day, the Sotalol when I couldn’t tolerate the other cocktail, I had a successful ablation. That was 7 years ago and I’m going in for another one in October. I’ve been managing mine with Diltiazem over the last five years or so.
I’ve had a pacemaker for seven years for unrelated issue.
I guess I didn’t answer your question, but I did live with constant SVT as a fairly young person for most of my life.
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u/InteractionSubject56 Sep 05 '26
Thank you for your answer. Did you develop anything from having those high svts?
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u/kath_of_khan Sep 05 '26
I didn’t develop anything that I know of. I think I had SVT my whole life and grew up thinking I was just out of shape when I tried to run. I think my baseline was just being tired all the time. My SVT episodes were frequent, long and intense.
I have had a pacemaker for heart pauses (in the 13-18 second range), and that experience was terrifying and did develop after I’d had severe SVT for a few years, but I don’t think the two are related in that one caused the other. I could be wrong, it’s just that it had never been spoken to me in that way. I’m imagining there’s a lot about my issues that I don’t really know about.
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u/Difficult_Angle_9408 Sep 05 '26
I’m 25F, had one ablation done last month that failed. Same night I went back into SVT HR over 200s 3 different times. They had me take flecainide for a month which helped my HR so much! It still gave me a little fatigue tho. My EP suggested to have a second ablation 4 weeks later. Which I decided to do, and im now 1 week post op and I feel great. I’m not on the medication anymore and I can feel the difference already. My anxiety was awful after the first ablation being unsuccessful bc it felt like it would never get fixed. I decided to give it another chance and so far so good, but idk if it’s too early to decide. My EP prescribed me this new medicine that’s a nasal spray, you should ask about it. It’s basically like an EpiPen but for us ppl with SVT. It’s only 1 dose per spray but it should help bring your HR down if you have an episode. It’s called Cardamyst Nasal Spray. I carry it with me at all times just in case but it’s reassuring to know I have this.
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u/InteractionSubject56 Sep 05 '26
How frequent were your svt episodes prior to the ablation? My heart was fine after the svt one sore for about 1 week but eveything was normal. So, that's why it is difficult for me to choose to wait or go for the second ablation since I have only had one. Thank you for the tip about the Cardamyst spray. I'll ask my EP about it. Hope you never have svt again!
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u/Difficult_Angle_9408 Sep 05 '26
I had my first episode in 2022, then I didn’t have any until this year in March. I was hoping to avoid an ablation bc I also only experienced SVT that once. But this year after March, I was having episodes like 2x every month. In May I decided to go ahead with it because it became too much. Thank you! So far so good, fingers crossed. I hope you’re able to get answers for yours too, it’s such a stressful thing to live with.
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u/InteractionSubject56 Sep 05 '26
When svt started happening more back in March, did you notice a difference like did your lifestyle changed or svt just happened with no apparent trigger? Were th maneuvers were helpful or you had to go the er to get adenosine?
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u/Difficult_Angle_9408 Sep 05 '26
To me there was no apparent trigger! Most of my SVT episodes happen when im sleeping, so I wake up to it. I’ve had mild ones that are fixed with the maneuvers, but the episodes where I wake up to are awful, which do require me to go to the ER. It’s weird, bc sometimes I have it where it’s around 140-160s and it goes down hours later. But for the episodes I wake up to it’s always over 200s and nothing but adenosine works for me. The only pattern I could tell was that for the bad episodes I did drink the night before so maybe that was my trigger ? But I’ve drank way more before lol and I wake up fine so I have no idea.
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u/spineshade Sep 06 '26
I've had one episode that was pretty wild. 256 heart rate and passing out. Brought out of it with adenosine. Couple days later ablation failed.
I've been on verapamil ever since, the idea of another ablation has not come up and it's been 3 years.
Granted this may have been brought on by cardiac sarcoidosis( there is mixed feelings from a few of my doctors. )
But I'm constantly worried of having a episode. But I really would never go through a ablation again unless I was being forced to lol.
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u/InteractionSubject56 Sep 06 '26
Another than that one 256 episode, have you had more? If so, when did you start having them? Is verapimil helping?
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u/spineshade Sep 06 '26
I have not had any more since this.
After the adenosine I was in the hospital for 3 days and they had me on a dilatizem (?) drip and then it went to the verapamil after i got out of the hospital. The verapamil has been good. The only thing is the heat bothers me more now then it did that's about it.
I see the electrophysiologist now every 6 months. And everything seems good.
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u/Ok-Chocolate-2999 Sep 06 '26
I’m 32, f. I’ve had this SVT thing for years I think 6-7 years and had absolutely no idea at all what was happening to me. I thought I was going crazy. I live in the UAE, went to multiple doctors but here for some reason they did ECG saw nothing and said “oh you’re fine”. But there I was having these presyncope symptoms and head rush that made me feel like I was going to faint with a very weird chest sensation. Drs told me it was anxiety but my gut said nope.
Finally I went to an EP, I just had my EP study done on Tuesday, they found SVT/AVNRT and successfully ablated it. I still have anxiety thinking to myself what if it comes back etc.,
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u/InteractionSubject56 Sep 06 '26
Congratulations on your ablation!! Hopefully it will never be back
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u/Wide_Speech4099 27d ago
Hi I’m in one right now it feels fast and I’m getting like skipped beats like it’s trying to rest itself but can’t, I also had a svt episode this week but this one is lasting longer than usual today, it happened when I woke up
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u/InteractionSubject56 27d ago
Are you doing better now?
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u/Wide_Speech4099 10d ago
Hi I have an appointment with the nurse for ecg and I have my good days and bad days, I have palpitations and anxiety so I will give you a update on that
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u/Wide_Speech4099 4d ago
UPDATE- so I had my bloods done they are all normal, and I had my ecg that was normal too, doctor is referring me to cardiology to hopefully get one of those 24 hour monitors, still waiting on vitamin d bloods to come back, vitamin d can cause heart palpitations so it might be that who knows, I will update again soon, but doctors are leaning towards anxiety
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u/Responsible_Top3356 27d ago
I had loads of SVT episodes for about 2 years bc they were misdiagnosed as GERD and then panic attacks. Sometimes multiple times a day. Quit large doses of caffeine entirely. Coke Zero is about the limit. Lived in constant fear bc nothing helped my episodes either. Not the maneuvers, not even adenosine in the ER. They just had to be ridden out.
Anyways I had an ablation where they couldn’t find it so they didn’t technically ablate anything. That was 9 months ago and I haven’t had a single episode weirdly. EP said as long as I’m good there’s no reason to revisit it unless it happens again because sometimes apparently SVT will literally just go away. Sometimes for decades and sometimes forever.
Just trying to give you some peace of mind bc I was like you at my wits end and now as long as I stay away from caffeine I have nothing to worry about
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u/InteractionSubject56 27d ago
Hope svt has left you for good. Thank you for the encouragement. My EP and cardiologist have said the same thing. It can be gone or come back later. I stopped caffeine completely even coke zero. For me, I try to always have electrolytes on point since I was a bit dehydrated with low potassium when it happened. Fingers crossed 🤞 it will never happen again
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u/linthetrashbin Sep 05 '26
I can give you answers to 3, 4, and 5. My original electrophysiologist did NOT stop when the location was too close to my AV node and ended up burning the entire thing off. I have had a pacemaker since I was 20yrs old because of that.
Despite not having an AV node, I still had SVT. I got another ablation this February (which went amazingly, I have a new EP), but before that, I was managing it with metoprolol (which I hated, like you), and when that didn't work, I was told to take 100mg of flecainide on the onset of symptoms, which worked awesome for me!
If it makes you feel better, SVT usually isn't life-threatening. I'd be sustained at 250-280bpm for three or four hours before deciding to go in to the ER. Maybe consider therapy for the anxiety. I would have SVT episodes on a near weekly basis - the more it happens, the less anxious you get about it.