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Afib after failed ablation for SVT
My husband was born with WPW, and had an ablation for SVT around 2008. No incidences of SVT until Feb, 2026. He was unable to get his rate down by the vagal maneuver. His rate was around 160. He was in SVT per the EKG. Went to the ED, Procainamide drip got it down within 20 minutes. . Went to an EP, who stated that the only thing he could do was ablation. He was taking Metoprolol 25 mg BID at the time. Fast forward a month later, attempted during EP study to get the heart into SVT and was unable to after several attempts. So a failed ablation. When he came out, he was in afib (paroxysmal) off and on. Finally caught on EKG, started on Eliquis and Sotolol. Sorry for the long post, but has anyone had this experience?
His cardiologist is willing to see if he can be weaned off of the Sotalol in October, and hoping that this is something that will be resolved after the "blanking period". All the EP suggests is another ablation. Any information would be appreciated.
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Hi I also started on Eliquis and Sotalol Q. why does your Cardiologist want to get off sotalol
Your husband is a 'complex' case, and the SVT is paroxysmal, or intermittent. An EP can sometimes elicit the arrhythmia by 'challenging' the heart using chemicals. It works....often....but it also doesn't work for all hearts. He can't ablate tissues willy-nilly and hope for the best because that can be both counterproductive AND risky for the patient. We all want only the necessary tissues ablated....thanks very much.
I am not qualified medically, so this is just my thinking: the Sotalol seems to work okay, or well enough. Maybe so well that the EP cannot do his job. Also, Sotalol is more potent than metoprolol, for example, because it is a Class III anti-arrhythmic drug and is a 'non-selective beta blocker.' Metoprolol is selective. I think your EP wants more of a fair fight. He wants your husband off Sotalol before long, and that is likely to bring on the detectable locations when he does the mapping and tries to find the right places to apply the ablative energy....whatever kind he intends to use or knows is best for your husband's condition.
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1 Reaction@gloaming Thanks, very informative. The EP basically just wants to do an ablation. Right now is the blanking period where the cardiac tissues are still healing. The cardiologist is wanting to see if this is the case, thus the weaning. If another ablation is needed, there will be consultations first to see all options and since the original issue was SVT, more studies and mappings seem likely
@bigj Hello. The original issue was SVT, not afib. After the attempted ablation for SVT and unsuccessful, he went into afib. The hopes are that the cardiac tissues are healing during the 3 months after the ablation so a chance of getting off the medication. Solatol has potentially bad side effects Thankfully it has worked well with no bad side effects.