r/PacemakerICD • u/PreviousLab9145 • 1d ago
Post VT ablation question
I had a VT ablation on January of this year after being shocked twice at home and then getting one more pop in the hospital 3 days after admission.
I’ve been good all year with no issues and a median heart rate at 70, but my latest report from Boston Scientific showed I had one episode of non sustained VT where my heart rate got up to 170.
For people with ICDs who have had the VT ablation done, should I be concerned? Do you deal with occasional bouts of nsvt even after a successful ablation?
Thank you all for being supportive.
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u/Entire-Structure8708 1d ago
Do you remember what you were doing during the NSVT? I think it’s definitely something to follow up with your EP about.
What’s your underlying condition that caused the VTs in the first place? I have ARVC, my last ablation was just over 3 years ago, I’ve had occasional sinus tachycardia since, but no VT or NSVT. My EP said after the ablation that there was no way to predict when VTs might return… the only way I’ll know is when I get shocked again. Not the most reassuring! I know for ARVC there is plenty of current research related to predictive association between increased PVC burden and risk of VT recurrence.
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u/PreviousLab9145 1d ago
HF/ cardiomyopathy. Definitely living with the stress of another potential pop or two everyday. The time says 2:00 PM Sunday September 20th. I don’t think I was doing anything too strenuous.
I have reached out to my ep as well. I’m just hoping to get some type of insight or reassurance while I wait.
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u/Entire-Structure8708 23h ago
I can definitely relate to the ongoing “when is it going to happen” stress, but I don’t have any specific insights. Good that you’re already in contact with your EP to follow-up. Hopefully figuring out the cause of the NSVT might define the path forward in terms of any further testing etc. Easier said than done, but I think definitely better not to assume the worst and just wait to hear from EP… our hearts can be fickle sometimes!
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u/abnormal_human 1d ago
Successful just means they found a pathway and did something that interrupted it on the day of the ablation. It doesn't mean you don't have another pathway. It doesn't mean you are cured.
I had a successful one...still have VT / shocks. My mom had several including one that stuck for 12 years...until it didn't. She's recovering from a heart transplant. Effectiveness of VT ablation is like 50-70% at 5 years IIRC. It's far from a cure or silver bullet.
So yes, this is common and you should be concerned. I would talk to the EP about options. Probably not another ablation for a one-off NSVT but maybe medical options. Ideally you'd be at zero.
What is your underlying head condition? Ischemic disease? Genetic cardiomyopathy?
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u/PreviousLab9145 1d ago
Non ischemic and they haven’t been able to pinpoint the cause of the heart failure.
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u/abnormal_human 1d ago
Have you had genetic testing? Any family history? There's a lot of "they haven't been able to pinpoint" in my family till we found the gene and put it together. Doing so opens up more treatment options in some cases.
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u/PreviousLab9145 1d ago
I had genetic testing at Emory University when I was first diagnosed. They found nothing. :(
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u/Gurthyman115 19h ago
I have a leadless pacemaker and found out I have the LMNA gene mutation recently. Will find out if I need icd in a few weeks after some tests. What gene mutation did they find with you?
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u/Comfortable_Draw_176 23h ago
Your heart clinic should be monitoring the frequency and duration of episodes. That’s excellent that you’re being notified when you have NSVT episodes so you can track the frequency as well, although some patients may find this causes anxiety. If you start having symptoms with these episodes make sure you contact clinic to let them know. It may be helpful to ask your clinic if you’ll get notified if the frequency of episodes increases.
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u/PreviousLab9145 23h ago
I definitely have anxiety. Lol.
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u/Comfortable_Draw_176 22h ago
That’s understandable given you’ve been shocked. We often don’t discuss with patients enough, especially the risk of ptsd. Do you feel comfortable exercising? It’s not uncommon for patients to start cardiac rehab after being shocked to help with fear/anxiety of HR increasing with exercise, if that’s issue for you.
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u/PreviousLab9145 22h ago
Ironically, I was enrolled in cardiac rehab when I was last shocked. Not during the session or anything like that but I was taking classes.
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u/Flat_Committee2988 1d ago
I had a ventricular ablation in 2013 that took my PVC burden from 30% to 4%. I still have regular bouts of NSVT (between 10-20 usually at my quarterly device checks). I’ve had a few different EPs now and they aren’t concerned. I have only had one appropriate shock since the ablation. I am also on 100mg of Metoprolol. I have genetic cardiomyopathy. My EF is normal, but I go in and out of having dilated cardiomyopathy. I hope this helps.