Questions about ablation for SVT.

It's day surgery, and in both my ablations I was walking out the door of the ward by 1900 hrs.

There are two possible 'worst parts of catheter ablation': a sore and very dry throat from the intubation (after you're out) and the TEE (trans-esophageal echocardiogram, like a Sigmoidoskope up the bum, but this one down the esophagus to monitor how close the energy tip gets to the phrenic nerve and the esophagus itself to avoid damaging them), and the second 'worst thing' is lying on your back for three/four hours after the surgery unable to move so that the incision in your inner high thigh can commence closing off. At least, I can tell you that from MY two ablations. Some have the sore throat, some don't. I mentioned the horrible experience of the first ablation to my anesthetist who came by just before I went in for the second ablation months later, and he seemed genuinely appreciative that I had mentioned it. When I came to, no sore throat. Again, some get it, some don't.
You DON"T have months of recovery. Unless something goes very wrong (1% of cases, so very low), you might find it tough to do much for a couple of days, then more, and most find that within a week they feel like a million $. If the ablation works, your heart rate might be elevated by 10 beats each minute, sometimes 20, and a few patients report that it took almost a year to come back down to 60-ish. Most, like me, it takes maybe a month, two at most.
My advice, in case it might mean something for you, is to get the ablation sooner than later. Two reasons: you're already sliding toward more frequent bouts of SVT, so that's a sign things are slipping....and secondly you do want someone around who might bring you a cup of tea/coffee, make a sandwich, walk the dog....some little thing that you will probably feel you don't want to do for the first couple of days...honestly, if it goes more than two days, I guess that's the way it's gonna be for you. Most feel really good, much improved, inside of three/four days.
The risk of a stroke for AF (atrial fibrillation) is about six times higher than it is for non-arrhythmic patients. I haven't checked what it is for SVT, but if the EP wants you on a DOAC, maybe just an aspirin each day, then take it. You have a three month blanking period (actually about 10 weeks) after an ablation, and you've had inflammation-causing scarring done as the point of the procedure. This raises the risk of clotting and a stroke. The DOAC (direct-acting oral anticoagulant, like Eliquis or Xarelto as examples) minimizes that risk until the EP deems you free of all but the lowest typical risk for your age and for other comorbidities you may have.
Can't trigger the SVT? This is also a problem for AF sufferers like me. I was fortunate in that as each ablation was coming up, my anticipation put stress on me and I began to fibrillate. They had no problem dealing with me. When the patient's heart won't play nice in the cath lab, they can stimulate the heart chemically with caffeine, isoproterenol, and with adenosine. One of those might cause the SVT to happen.
The increased anxiety after an ablation is nothing with which I am familiar....UNLESS....the whole thing was a bust and the EP didn't zap the right places. I wasn't anxious when, at a whole six days after my index ablation, I was in the local ER with a runaway heart. They put me on amiodarone and I was fine until the second ablation. No, not anxious, even though I realized he had failed to stop my AF. PO'd, yewbetcha, and very disappointed. But I had done tons of reading and new ahead of time that 25% of all index (first) ablations fail. I had been waved over to the unlucky group, and I was NOT HAPPY! So, I was PO'd.

The success rate for SVT ablation is very high. Much better that afib ablation odds. My cousin had SVT episodes at least once a year for probably 30-40 years. Very scary. But when she had it happen while on a fun Grand Canyon hike to the bottom and had to be air lifted out that was the last straw. She had the ablation. It was easy peasy for her and she has now been free of SVT for years. Life changing for her. Prayers for your decision and a successful outcome. ❤️

I had an ablation done a year ago finally after years of dealing with svt where my heart rate would jump to 220. I was concerned about getting it done at first but eventually agreed to do it. Since that time I've had zero issues and my only regret was not taking action sooner.

I recently read that 85% of people who have SVT do not get an ablation, according to an unnamed 2024 study. That speaks volumes to me. Ablation is an option I’m considering but it’s a complicated decision, to be sure. Good Luck!

@cedarbog If that statistic is true, it would almost certainly be that they don't get accepted as a candidate for an ablation, either by a potentially referring cardiologist or by the electrophysiologist him/herself. If one is refused for the operation or referral, then the patient lives, or suffers. as he/she is until their natural death.

This might only mean that most EPs don't feel SVT is dangerous, or they have personal poor records of success ablating SVT, or the patients move on with their lives and die unannounced. This was the problem with AF (atrial fibrillation) until about 20 years ago. Polled cardiologists and electrophysiologists told the surveying team that few, if any, of their arrhythmia patients came back after being prescribed drugs to help the problem. It wasn't until that research team began following up with as many such patients as they could find that they learned many of them had simply died within about five years. This would be typical of patients who were led to believe there was little anyone could do for them, and that chemical intervention was all they could be offered. As anyone who researches AF will soon see, it's a progressive disorder that can, not will, but CAN, result in heart failure if it progresses to the last stage called 'permanent' AF.

We have come a long way in 20 years. Not only has our understanding of arrhythmia improved, but so has our treatment of it. SVT is correctable, and should be, for the majority of patients. All it takes is seeing the right specialist who has experience in complex cases. Not all cardiologists are A-list, and the same can be said about electrophysiologists. It behooves the savvy and determined patient to start doing some fact-finding, including about whom within a day's driving time, or two hours flight time, is likely to be able to help you due to their skills and experience.

@cedarbog
My cousin was never told by any doctor in 30-40 years of SVT episodes that there was a solution. Also, she did not seek medical care with each episode as I think they were relatively short maybe 1-3 hours and far apart. It wasn’t until she was airlifted to a hospital that a cardiologist told her he could easily fix that with ablation. She immediately signed up and was cured. So I would love to see a breakdown of reasons those 85% don’t get ablation. Maybe they didn’t even know about ablation. Maybe their episodes are years apart? Maybe fear of the unknown. Who knows, but I’m betting more details would shed some light.

Hi there,

I had an ablation for SVT and AFib just one week ago. I feel fine today and aside from some bruising at the incision sites, i might not know that i had an ablation. I had a higher than normal heart rate for a few days but it’s now back to normal. I even did a light hike with my dog yesterday. Keep in mind, medical teams usually disclose everything that could happen even though it may not. Feel free to reach out with any questions.