Tachycardia following Ablation

If you have never had an ablation it’s natural to be apprehensive about the upcoming procedure. It really is a non event in terms of any discomfort or pain. You check in, spend some time waiting till they’re ready for you and the next thing is you’re waking up and waiting to be released. It does take up a good part of a day so bring your phone or a book. Best wishes and let us know how it turns out.

The risks of damage or death, across the entire practicing EP field, is about 1.4% for an ablation. This is very low. People buy lottery tickets where they think they have a chance of winning when it's 0.00000005%. Yes, the loss of a coupla bucks is pretty small by comparison, but they spring for the bucks when their chances of winning are 10M times less!! And only one or two people will run down the street waving their huge check out of the 10M ticket purchasers.

Something else to consider; where is your headroom now that you're on the max doses? What's left for you...amiodarone? A pacemaker? Wouldn't you rather submit to an ablation, with that hefty 80% probability of success, than to have your AV node nuked and then leads wired to your heart?

I understand your fear. I had some misgivings about an ablation. But, when I weighed the relative risks of continuing to lose ground with drugs that lose ground, and to figure that mitral valve prolapse or atrial enlargement might lead to heart failure....AND then to add how terrible my AF made me feel, just with the anxiety? I practically begged to be placed in a line-up for an ablation. My first ablation failed. Bad luck. But, because of the low risk, I was otherwise fine. Just PO'd. Seven months later, another ablation, and in 13 days I will have two years free of AF or anything except the very odd triplet of PACs....which we all have anyway, healthy heart or no.

I had ablation i. 2015 then a few years later I had episodes of fast heart beat up to 180-190 so I had another ablation in 2019. So far since then I have had a few episodes (2) not last more than 20-30 minutes averaging 175 heart beats . This year it’s been about 3 episodes- June I was checking out I’d grocery story 3-5 mins 170 beats, on a cruise end of July 170 for about 3 minutes and yesterday 155 for about 3 minutes.
I tracking with my Apple Watch and I do ECG. The ES says I do not show Afib and said if episode last over I believe 30 minutes take ditalizm.
So far they haven’t last but it causes so much stress and anxiety because I like to travel and I don’t want to worry if it’s going to happen. Suggestions?

Just thinking as an objective observer who doesn't know you or your general health, age, history, etc, it seems to me that your heart just goes off once in a while. It might be stress, might be illness, might be....something you ate, thought about, feared....whatever. But the point is that you aren't in tachycardia most days and for an hour or more at a time. You have this seldom. So, with a prescription for diltiazem in hand, and IF you know for a fact that it does work for you when you take it (when you need it), I don't see why you should be unduly anxious or let your travel plans go by. What you may wish to do is to keep a record of your episodes, when, how long, how they made you feel. Then, over time, you will see if they begin to come on more and more frequently, or if they (also) last longer, or make you feel more faint, dizzy, short of breath, more anxious. At some point you'll know you need to get a more aggressive treatment. You don't want the condition to get worse if you can help it, or to become more advanced and less difficult to manage, say with just diltiazem. If you keep records, you'll have something to show your cardiologist which will do two things: show him/her that you are in this all the way and serious about record-keeping and monitoring its progression.; and it will allow that person to see any changes as evidence that you have collected which may induce a prescription for more advanced care.
You are in the early stages, apparently, and this will be dangerous only in the event that it suddenly converts to a long-lasting and dangerous arrhythmia at high rate. This is not your history so far.
The only caution for you is a big one; insurers will want you to answer truthfully about all known conditions prior to embarkation. If you fib, they'll find out from a physician who has been caring for you when you go to claim for travel, lodgings, and medical treatment when traveling and things go wrong. And if you do answer honestly about an existing diagnosis of paroxysmal tachycardia, they will state up front that you are NOT covered for that while you travel under their policy. You're on your own. Something to think about.

I had ablation i. 2015 then a few years later I had episodes of fast heart beat up to 180-190 so I had another ablation in 2019. So far since then I have had a few episodes (2) not last more than 20-30 minutes averaging 175 heart beats . This year it’s been about 3 episodes- June I was checking out I’d grocery story 3-5 mins 170 beats, on a cruise end of July 170 for about 3 minutes and yesterday 155 for about 3 minutes.
I tracking with my Apple Watch and I do ECG. The ES says I do not show Afib and said if episode last over I believe 30 minutes take ditalizm.
So far they haven’t last but it causes so much stress and anxiety because I like to travel and I don’t want to worry if it’s going to happen. Suggestions?

Why not consider having a loop recorder implanted? It is the size of a paper clip and a simple outpatient procedure. It records every heartbeat via an App on your phone and sends it to your doctor’s staff for review. You would be freed from the ongoing task of perfect record keeping and communication.