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Ask The Expert Archive

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Arrhythmias Archive Questions

Below are Dr. Shorofsky’s answers to Arrhythmias questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.

Now displaying records 1 to 15 of 85.

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Q : 1

What is the success rate for PVC ablation if PVCs are unifocal in nature and are found in the RVOT?

The success rate for for typical RVOT PVCs is high. We would normally quote a success of better than 90%. Sometimes, the PVC comes from the LVOT which can be trickier. It can also come from the outside of the heart,which requires a more complicated technique. It is important that the patient has a high number of PVCs in order to perform the ablation and to assess its success.

Q : 2

I have been diagnosed with paroxysmal SVT. Symptoms occur only after an hour of doubles tennis. Next steps for diagnosis and treatment?

The first step is to document the arrhythmia. If it is typical SVT, then the options for treatment depend on how much it bothers you. Options include doing nothing, trying a drug or having an ablation to cure the problem. Most people end up having the ablation since it is curative in >90% of the cases with a less than 1% complication rate. If it is difficult to document the arrhythmia, an electrophysiology study can be done to diagnose the problem. You probably want to see an electrophysiologist (cardiologist that specializes in these problems) to discuss these issues. If you want to see us, you can call 410-328-6056 to set up an appointment.

Q : 3

I have bradycardia. I am in my 50's and have had a pacemaker for 2 years. I am experiencing many pvcs-- 9,000 per day on last holter monitor. These are very disruptive when exercising and often lead to me stopping my daily swim or bike ride, due to chest pressure and dizziness. Should I have these treated by ablation? Everything I read suggests ablation for rapid heart rates? I have tried three different beta blockers but none improved my symptoms. The meds actually made the pvcs worse.

If they come from one or two spots in the heart an ablation is an option you should consider. Discuss it with your electrophysiologist.

Q : 4

I have a pacemaker, it's set at 72, my pulse is over a 100 at times. Should i get it check out?

The pacemaker's job is to prevent your heart from going too slow. It does not do anything when your heart goes faster. If you feel bad when your heart is > 100 or if it occurs when you are truly at rest, you should talk to you physician.

Q : 5

I have PACs. This last bout took about a month to run it's course than stopped suddenly. The time before this was six years ago. Could it be something I eat or is it just the nature of the disease?

It's probably not something you eat, but you can try to avoid caffeine or any other stimulants like tea and chocolate.

Q : 6

I experience dizziness with my PVCs. Is this something I should be concerned about?

If you have frequent PVCs and they are causing these symptoms, you should have them treated. If you heart is otherwise okay, they usually are benign.

Q : 7

How long after the ablation for v-tach is done do you know if it was successful?

The success of a VT ablation depends on the reason for which it was done. If you have a normal heart VT, the success rate is high and recurrence low. If you have heart disease causing VT, then an ablation is just to eliminate the one VT that is causing problems now. It is not considered a cure and you would have a defibrillator to treat other VTs. By its nature, VT comes in unpredictable, irregular bunches.

Q : 8

Can getting lightheaded while laughing be caused by an arrhythmia?

Not usually. It is usually an issue with breathing.

Q : 9

What are the risks associated with the CryoMaze/mitral valve repair procedures? Based on your knowledge, could a puncture occur, internal bleeding, possible fractured ribs, etc.?

The CryoMaze procedure adds little or no risk to the mitral valve repair procedure and should be done at the same time if needed. The mitral valve repair has some risk which can be explained by your surgeon.

Q : 10

I have been diagnosed with atrial flutter. The rapid heartbeat was occurring almost daily. I stopped drinking red wine and the flutter has not recurred for a week. Could the flutter have been caused by the sulfites or something else in the red wine?

Alcohol can sometimes cause atrial flutter but it is more likely than not that it will return. It is a common problem that can be cured if it is causing difficulty.

Q : 11

How rare is Brugada Syndrome? Would it show up on an event monitor even if you didn't feel anything?

Brugada usually will not be seen on the event monitor. It is seen on the baseline ECG or during electrophysiology tests. It is very rare.

Q : 12

I've had WPW for 12 years. My cardiologist was going to ablate it, but decided the risk of sudden death was very low and opted not to. Recently, I've noticed very short but frequent (often 20 times per day) attacks. They usually consist of palpitations lasting for 10-20 seconds. How concerned I should be?

WPW is an extra connection from the top to the bottom of the heart. It can be dangerous but most often just causes rapid heart beats when electricity travels down the normal connection and back up the extra one in a loop that becomes a short circuit. When it causes a problem, it usually is eliminated during an electrophysiology study (ablation). It sounds like it might be time to consider this.

Q : 13

Can untreated arrhythmias cause damage to the heart ?

Some untreated arrhythmias can damage the heart while others do not. It depends on the arrhythmia. If that is what you have, I would see an EP specialist.

Q : 14

I have had three episodes of SVT and I get what feels like PVCs on a daily basis. My PVCs are scaring me because I feel like my heart is going to stop beating when they happen. My cardiologist has assured me that there is nothing wrong with my heart, but I am concerned. Should I get a second opinion?

The SVT can easily be taken care of with an ablation if it is bothering you. The PVCs are a little harder. If they impact your life, you can try beta-blockers. If they do not work and the PVCs all look the same, an electophysiologist could map the source and eliminate them with an ablation. If your heart is normal, the PVCs will not cause any harm. You do not need to be afraid of them.

Q : 15

I had a heart ablation procedure for atrial fibulation a week ago, how am I supposed to feel after the procedure?

You should feel fine. You may still have atrial fib for three months after the procedure. They will want you not to stay in it more than 24 hours. Success or failure is not determined for about 3 months.

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