Heart Rhythm Conditions – Welcome to the group

@carly14 It's baloney...my uneducated and untrained opinion. It 'helps' if you happen to be in AF at the time of an ablation, and yes, they can induce AF most of the time using adenosine, caffeine, isoproterenol, and other chemicals, but if you are an early patient, just diagnosed, NOT IN full-time AF, then most likely all the EP has to do is to isolate the pulmonary veins, and that does not require you to be in AF. In fact, since your atrium is not beating chaotically, his/her placement of the energy tip is more predictable and controllable. So, in a sense it's actually better if you're in NSR at the time.

For a second ablation, in my case it was that he had missed one small gap around my 'third' pulmonary vein, which he was hell-bent on re-doing... a full PVI. When he zapped that one tiny gap, my heart immediately went into happy NSR and has remained there, coming up to 3.5 years now. In your case, your disorder may have found a new path, and it WOULD indeed by handy to have that actively firing at the time he begins to map your rogue circuit(s) and zap them.
I hope you see that it's a nuanced question and response...it depends on what we're looking for, your history with AF and with corrective measures, including a previous (successful, or did it fail inside of a year?) ablation. And, to be completely reasonable and fair, his particular training might have made it clear, and predictably reliable, that it's best to have your heart in active AF at the time because it makes stopping it so cut 'n dried. One zap, and your heart resumes steady, unbroken, NSR. He would challenge your heart with isoproterenol, and your heart stays in NSR? Great, he's just found and isolated the problem circuit...which is what all of us want for you.

So, I call baloney, but....I'm not your EP, I don't know all about your history, and you aren't gonna pay me anyway. Take it for what it's worth. And I would go back and ask him for three more minutes to 'splain why. I would think it a great use of my time, and you may just end up getting the procedure you need. Right?

Hello, My name is Reggie. I am 58 year old recently diagnosed with SVT and captured on ekg. After 2 hours of rapid heart rate and fluttering I sent to the ed and as rhey were about to cardiovert I recovered.

I have Sarcoidosis and had a bout if Covid 2 years ago where I established a rapid heart rate. Standing is impossible without symptoms and near collapse. Exercise i tolerance, extreme fatigue. I have been on immunotherapy for the sarcoid in my lungs and seems to have been in remission.

I was seen by cardiology and have been on bisoprolol during this episode. They increased my dose and after a few days I couldnt eat feom nausea so the stopped it. Then I was switched to caedizam and that made thinga worse and was seen back to ed. I am now at 180 extended release with 4 changes to get to this dose. Still having rapid heart rate and when on the short acting had another episode that last 1.5 until all measure were unsuccessful at home, I took Verapamil...30 min later normal rhythm.

The electrophysiologiest will not do a ablation till he can stimulate it again. How do you know if you can and when does that seem reproducable?

My rheumatologist requested a cardiac cat scan and I am pending a second echo and the results of a 15 ekg. Prior cat scans, stress tests only determined tachycardia, bo abnormalities A physical therapist did a modified table test and assumed pots but I was on the blocker bisoprolol already so not too conclusive. I had ortho hypostatic BP, and rapid heart rate and advised to treat as if pots.

I have now occasional fluttering and rapid heart rate of 145 when doing light activity before sob, and tremors, fatgue and near collapse or crash set in. If I do to much I am out for days with extreme exhaustion.

@reggie68
This article may help you to situate your case and what the EP has told you about being able to stimulate the SVT prior to applying energy to tissue:
https://onlinelibrary.wiley.com/doi/10.1111/jce.16496