Atrial Tachycardia and Epicardial Ablation

Posted by marib @marib, Jul 28 5:54pm

Hello. 20 years ago I had an attempted ablation for Atrial Tachycardia. The EP could not reach the part of the atrium where he found the problem without damage to the phrenic nerve so he ended the procedure. I have been treated with medications since then but nothing working well now. Had a nuclear stress test last week and very quickly went into atrial tachycardia with a rate of 184. My blood pressure was 190/70. The EP has mentioned an Epi Cardinal ablation that is more complex than the usual ablation. Has anyone had this type of ablation, and could you tell me about it?

@marib Hi and I would like to welcome you to connect. Yes I have had 2 of them. As you know from.your first ablation, that was probably done from inside of the heart, this type is done from the outside of the Heart. So they go thru the front and into the sac around the heart. Mine was from the front but based on where they think the problem is they may go in from a different position. The idea is that they may be able to reach the path that's causing the tachycardia.
Now mine wasn't successful mainly because of a few factors. I was pretty sick with a bad cough which made to much movement during the first one of that type so it could not be completed. So they had an approximate location and wanted to do an MRI to get a better location but due to my pacemaker was very blurred. So they were unable to find it and also because I have had so many my heart could not take anymore ablations.
So anyway I also know they will do an angiogram to identify where the blood vessels are so they don't ablate one. With mine I was on the table like 7 hours trying to find it and they never did. Like I said my heart had a lot of issues so this was a last attempt to fix it. The thing I have been told is it's trickier than a normal one so my suggestion is to find out how many you Doctor has done. And maybe look up and see if you can find reviews on the doctor you have. I might even get a second opinion. I wish I could say more positive things about mine except that for me it led to other options. I made out well overall I now have a new heart and for the past 2.5 years been doing great. Life is different as a transplant recipient and I had to give up things but it's always a blessing to know there are options. Please let's is know how things go on your journey.
Have a Blessed Day
Dana

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@danab

@marib Hi and I would like to welcome you to connect. Yes I have had 2 of them. As you know from.your first ablation, that was probably done from inside of the heart, this type is done from the outside of the Heart. So they go thru the front and into the sac around the heart. Mine was from the front but based on where they think the problem is they may go in from a different position. The idea is that they may be able to reach the path that's causing the tachycardia.
Now mine wasn't successful mainly because of a few factors. I was pretty sick with a bad cough which made to much movement during the first one of that type so it could not be completed. So they had an approximate location and wanted to do an MRI to get a better location but due to my pacemaker was very blurred. So they were unable to find it and also because I have had so many my heart could not take anymore ablations.
So anyway I also know they will do an angiogram to identify where the blood vessels are so they don't ablate one. With mine I was on the table like 7 hours trying to find it and they never did. Like I said my heart had a lot of issues so this was a last attempt to fix it. The thing I have been told is it's trickier than a normal one so my suggestion is to find out how many you Doctor has done. And maybe look up and see if you can find reviews on the doctor you have. I might even get a second opinion. I wish I could say more positive things about mine except that for me it led to other options. I made out well overall I now have a new heart and for the past 2.5 years been doing great. Life is different as a transplant recipient and I had to give up things but it's always a blessing to know there are options. Please let's is know how things go on your journey.
Have a Blessed Day
Dana

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Thank you for your reply Dana. My fear is I could come out of this procedure in a worse position than going in. I do have a second opinion appointment in August. I am not sure the EP’s where I live have enough experience. I have been dealing with SVT/Atrial Tachycardia for over 20 years and need an EP with a lot of experience and a good track record. I wish you well with your new heart and your new life.

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@marib that's great that your getting a second opinion. The other thing maybe to consider is getting to another place that can offer more options as to Doctors. I myself live in Arizona and besides some excellent doctors I am very pleased with Mayo Clinic but there are other great heart hospitals. If you were either near Arizona or Kentucky(my first ep now lives there) plus Mayo has hospitals.in Minnesota and Florida it might be worth travel also. I would love to hear how it goes with the Apt in August.
Dana

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@danab

@marib that's great that your getting a second opinion. The other thing maybe to consider is getting to another place that can offer more options as to Doctors. I myself live in Arizona and besides some excellent doctors I am very pleased with Mayo Clinic but there are other great heart hospitals. If you were either near Arizona or Kentucky(my first ep now lives there) plus Mayo has hospitals.in Minnesota and Florida it might be worth travel also. I would love to hear how it goes with the Apt in August.
Dana

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I am in Minnesota and am thinking Mayo here, however, I would need someone to drive me. I feel uncertain about the 2 EP,s here in Duluth MN. I want an EP with lots of experience.

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@marib yes it looks like a bit of a drive. I was not very knowledgeable about Mayo prior to my Transplant, but I know that for me it was actually recommended by my EP doctor who was outside the Mayo network. But now I am so grateful he did. I don't know much about Minnesota and the options for transport there but maybe someone here on connect from that area may have some.
Have a Blessed Day
Dana

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@danab

@marib yes it looks like a bit of a drive. I was not very knowledgeable about Mayo prior to my Transplant, but I know that for me it was actually recommended by my EP doctor who was outside the Mayo network. But now I am so grateful he did. I don't know much about Minnesota and the options for transport there but maybe someone here on connect from that area may have some.
Have a Blessed Day
Dana

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I have just messaged the EP, that is new to me, asking for specifics of the procedure and if I am a good candidate. In order to make an informed decision, I asked how many of this type of ablation he has done and what his success rate has been. Thank you for your support Dana!

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Hi @marib, I also add my welcome to Mayo Clinic Connect and am so glad you decided to join and become part of the discussions. Below I have included a link for Mayo's cardiac electrophysiologists (EP) Study site as well as a helpful website that gives you multiple options for traveling from Duluth to Mayo Clinic in Rochester. Because it is a destination medical center, a lot of transportation companies make it fairly easy to travel from different parts of the state.

EP Study site – https://www.mayoclinic.org/tests-procedures/ep-study/doctors-departments/pdc-20385000
Travel options from Duluth – https://www.rome2rio.com/s/Duluth/Mayo-Clinic

Mayo has 9 different physicians that specialize in EP studies. On the site you can click on each physician to see their credentials. I am very interested in knowing what the electrophysiologist that you contacted comes back with. Will you let us know when they respond?

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Thank you Amanda for the information. I will look at it later today. I have looked at the Mayo Clinic site and watched a video of a doctor describing the procedure and all that goes into it. It did not show an actual procedure, though. I would love to come to Mayo for this, but, am nervous of managing by myself. I do want to reach out to someone at Mayo after I get a follow up here. How do I choose the best EP for Atrial Tachycardia rising from the crista terminalis, which I am told needs an Epicardial ablation? I want to choose the EP with the most experience and successful outcomes. Is that something that would be chosen for me?

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Hi @marib, yes it would, but you always have a say. The coordinator in the Central Appointment Office that will help you make the first appointment asks you a series of questions to determine the best physician for you. They take into account your diagnosis and your requests for experience.

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@marib

Thank you Amanda for the information. I will look at it later today. I have looked at the Mayo Clinic site and watched a video of a doctor describing the procedure and all that goes into it. It did not show an actual procedure, though. I would love to come to Mayo for this, but, am nervous of managing by myself. I do want to reach out to someone at Mayo after I get a follow up here. How do I choose the best EP for Atrial Tachycardia rising from the crista terminalis, which I am told needs an Epicardial ablation? I want to choose the EP with the most experience and successful outcomes. Is that something that would be chosen for me?

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Dr AJ Deshmukh is outstanding. He is my Mayo EP and
was trained by the best of the best.

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@marib

Thank you Amanda for the information. I will look at it later today. I have looked at the Mayo Clinic site and watched a video of a doctor describing the procedure and all that goes into it. It did not show an actual procedure, though. I would love to come to Mayo for this, but, am nervous of managing by myself. I do want to reach out to someone at Mayo after I get a follow up here. How do I choose the best EP for Atrial Tachycardia rising from the crista terminalis, which I am told needs an Epicardial ablation? I want to choose the EP with the most experience and successful outcomes. Is that something that would be chosen for me?

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I had an ablation performed by Dr Deshmukh. My daughter is a cardiology chief USArmy. She came to Mayo procedure. She was impressed and very much liked Dr Deshmukh. He is good.

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When I looked at the Mayo site in Rochester MN, I searched for an EP who does the more complex Epicardial ablation and only saw 1 EP that listed Epicardial ablation. I hope there are more that are experienced in this procedure.

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Hi, @marib I'm happy to see some others gave you some information. I'm looking forward hearing back when you have been able to talk to that other EP Doctor, Also it looks like some really good recommendations for Dr AJ Deshmukh. It looks promising that you have some options. Please keep is updated and we are here to help. Have a Blessed Day
Dana

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@amandaburnett

Hi @marib, I also add my welcome to Mayo Clinic Connect and am so glad you decided to join and become part of the discussions. Below I have included a link for Mayo's cardiac electrophysiologists (EP) Study site as well as a helpful website that gives you multiple options for traveling from Duluth to Mayo Clinic in Rochester. Because it is a destination medical center, a lot of transportation companies make it fairly easy to travel from different parts of the state.

EP Study site – https://www.mayoclinic.org/tests-procedures/ep-study/doctors-departments/pdc-20385000
Travel options from Duluth – https://www.rome2rio.com/s/Duluth/Mayo-Clinic

Mayo has 9 different physicians that specialize in EP studies. On the site you can click on each physician to see their credentials. I am very interested in knowing what the electrophysiologist that you contacted comes back with. Will you let us know when they respond?

Jump to this post

Thank you Amanda for the links above. I have had a video consultation with a heart rhythm specialist at Mayo. Dr. Killu. He has changed my heart medication and I am scheduled for additional heart related testing at Mayo in Rochester MN the end of this month. I was most impressed with Dr. Killu as he listened carefully and looked at my other health issues and scheduled testing for those as well. I have 4 testing appointments and 2 consultations over a couple days. I like how they schedule so efficiently so I can get a lot done in several days. My son is driving me and I am hopeful for answers and a plan.

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@marib

Thank you Amanda for the links above. I have had a video consultation with a heart rhythm specialist at Mayo. Dr. Killu. He has changed my heart medication and I am scheduled for additional heart related testing at Mayo in Rochester MN the end of this month. I was most impressed with Dr. Killu as he listened carefully and looked at my other health issues and scheduled testing for those as well. I have 4 testing appointments and 2 consultations over a couple days. I like how they schedule so efficiently so I can get a lot done in several days. My son is driving me and I am hopeful for answers and a plan.

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@marib That's great news im sure glad you were pleased with the first video apt sounds like you found a great doctor. Is he the specialist you were looking for on Epidural Ablation? Im confident that you will be pleased with the care you get up there.
I also see you have found some transportation. That will make even more pleasant to have your son there with you.
Have a Blessed.Day
Dana

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