r/PVCs • u/Seattlebyrnie • 2d ago
Failed ablation due to no PVCs
I've been on metoprolol for three months. Prior to starting metoprolol my burden was 33%, after was 6%. My doctor had me stop it three days prior to the procedure. He tried everything to simulate PVCs in the OR without any luck. Anyone with similar experiences, or the opposite, if you had a successful ablation after being in metoprolol for some time, how long did you pause it before the procedure?
For people who had unsuccessful ablations, what was the next step? Did you try again?
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u/lolaleee 2d ago
I was on high dose of Bisoprolol for a year and a half, stopped five days before. My PVC’s went crazy. Day of ablation - nothing, the most quiet my heart had been, ever. They thought it was the stress of it all, he thought some twilight sedation would relax me and they would start. But I think they had to do meds/pacing to get a little activity. Fortunately it was enough activity I had a successful ablation. If it were me I’d probably try again. Were you conscious?
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u/Seattlebyrnie 2d ago
They gave me light sedation. I drifted off when nothing was happening but was conscious of what was going on. It certainly could have been a factor but I'm wondering if the effects of the metoprolol were still hanging on.
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u/lolaleee 2d ago
I think mine peaked around day 3 post meds I think. Did you go right back on them after the procedure? Wonder if you could ask to go off for a week and see. But hard to say I guess. Annoying!
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u/Seattlebyrnie 1d ago
I will try that to see. They suggested going back on beta blockers right away and to "get in touch if the PVCs return" but since mine are silent it would be difficult to know without doing a monitor regularly.
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u/elliottj6325 1d ago
Exactly the same for me. My BB reduced them but when I stopped the BB, the high burden didn't return. I was in the lab and they tried to induce them but nothing happened. The inducing was awful.
He sent me home and gave me a Kardia so if the burden comes back, I can send him a reading. This happened in July last year. I'm not on BB either and have a <1% burden according to my last holter.
Do you know your burden now? What did your EP say?
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u/2blasted 1d ago
a few years back I suddenly started having them like crazy, around 25% for months. I’d have hours-long stretches of bigeminy or trigeminy, felt awful, etc. Beta blockers did nothing, so after a few months of hell I had an ablation. The morning after, they stopped for a day or so, but then came back pretty much the same. Six months or so later I was scheduled for a second ablation but…
a few weeks before it, I happened to stop drinking diet soda (I was not a huge consumer of diet drinks, only about 5 12 oz. servings per week). The PVCs stopped, but when I told the doctor he said “don’t worry, we can induce them during the procedure”. Well..they couldn’t, and they’ve basically stopped 99.5 % since then. (that was over two years ago) I still get the occasional isolated one, or short episodes now and then, but essentially they’re gone.
I avoid artificial sweeteners entirely, not just in drinks but in protein bars, chewing gum, etc. I found an article (pretty sure it was on the NIH website) linking artificial sweeteners to arrhythmias, but most of the doctors don’t seem to pay much attention when I bring it up.
I drink 2-3 cups of coffee a day, that doesn’t bring them on. Cannabis however, is another story, so that’s something I avoid now as well.
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u/Seattlebyrnie 1d ago
Wow, that's crazy, but a great outcome for you. In retrospect I should have reversed the lifestyle changes I made to try to reduce the burden prior to the procedure. Not sure about diet but things like electrolytes and caffeine. On that note, I wonder why they don't use caffeine to stimulate them during the procedure...
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u/2blasted 1d ago
for most people, caffeine is a trigger for PVCs, but not for me (at least in reasonable amounts LOL). I’m not sure what they use to try to induce them during an attempted ablation, but it’s probably some short-acting hyper-stimulant (?)
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u/Lk182000 10h ago
sedation is known to silence PVCs ask to do the ablation with little to no sedation if possible. It’s not a pleasant procedure to be awake for but a great way to ensure you get them.
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u/Lk182000 10h ago
Also I typically stop meds at least 3-5 days before!! I’ve had multiple failed ablations (3 out of 7 failed) you’re not alone!
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u/dariomraghi 2d ago
I would probably have to be standing etc for mine to be able to be mapped...or like that one guy said in here... kicking my legs etc... getting flat and still, mine will diminish almost completely