I want to stress that this post is only my personal experiences of dealing with SVT. I’m by no means an expert in anything to do with the condition and this post shouldn’t replace proper medical advice. If you do want a detailed explanation of the catheter ablation procedure, the British Heart Foundation have excellent online resources, so please check them out. I have merely decided to share my experience in case someone else has the same questions or symptoms that I have had and wants to know if it’s normal. Whatever normal is….
My Supraventricular Tachycardia diagnosis came out of the blue in 2015 and the subsequent hospital stays and cardiology appointments passed by in such a blur, that I didn’t really take in much of what doctors were telling me. I do remember being advised to have the catheter ablation procedure during one of my routine cardiology appointments shortly after my diagnosis but as I was going through a divorce, moving home and understanding my mother’s terminal cancer diagnosis, there never really seemed like a good time to complicate my life further.
In all honesty, I was managing my SVT relatively well. I was on a daily dose of Bisoprolol 2.5mg and it mostly manage to keep the SVT attacks at bay. I still had them but they were much shorter and my heat rate peaked at around 180bpm rather than the 250bpm that it had been before I was medicated. Because I was managing my SVT, it didn’t make sense to have an invasion procedure.
Why I Changed My Mind
I’ve mentioned a few times here on the blog that I suffer with anxiety and depression. It was only when I started to investigate different methods to overcome it, did I realise that one of the major side-effects of Bisoprolol is, you’ve guessed it, anxiety and depression. I wanted to know if it was the medication causing or exacerbating my anxiety and depression. It was then that I realised that I wanted to come off the beta-blocker. In simple terms, I needed to know if it was me or them. I discussed this with the cardiologist who explained that stopping beta-blockers suddenly wasn’t safe and that I would need to be weaned off them, but that without an ablation this wasn’t an option for me.
Another issue with taking Bisoprolol was that it came with a huge list of contraindications. It got to the point where my GP wouldn’t prescribe me an anti-histamine for an obvious allergic reaction without the approval of my cardiologist. Waiting eight hours in A&E to get the go ahead for Loratadine, which is an over the counter medication, was infuriating.
As well as dealing with increased anxiety and depression, since the start of 2018, the lifestyle changes that I had made to avoid triggering an attack stopped working. I was having an increase in my SVT episodes and soon found that I was having a mild episode almost daily. Not only was it exhausting, but it was extremely frustrating. As the medication was no longer working, I spoke to the cardiologist who advised me that I now had two options: increase the medication or have the procedure. Because I’d already begun to feel uncomfortable about taking medication, it was then that I decided to investigate the ablation procedure. When I discovered that it came with a low risk and yet would stop me from having to take daily medication for the rest of my life, I decided to give my consent and schedule the procedure.
The Run Up To The Procedure
Five days before the ablation, I was told I had to stop taking the Bisoprolol in order to make the ablation procedure more effective. What I wasn’t told was the effect that stopping the medication would have on both my physical and mental health. Physically almost immediately, I started getting several episodes of tachycardia throughout the day (and especially at night) which predictably left me exhausted, feeling highly anxious and just not quite myself. The frequent episodes of elevated heart-rate eventually culminated in an prolonged episode of SVT that resulted in me being admitted to hospital in an ambulance when my usual techniques to bring my heart rate down didn’t work. This worried me as I was hopeful of a life without medication and now I began to panic that this wouldn’t happen.
In A&E, the doctors were actually really happy about the fact that I had been having an increased number of SVT episodes. To them, this meant that the procedure had a higher rate of being successful as it would be easier for them to find the faulty pathways in my heart. Whilst in the hospital, I complained to the doctor about not being informed of the side-effects of Bisoprolol withdrawal but in hindsight, not knowing may have been a benefit. I think I would’ve chickened out of having the operation if I’d known I was going to experience an immediate increase in episodes of elevated heart rate.
The Day Itself
I arrived at the hospital at 10am after not being able to eat or drink all morning, and was told that although it was unlikely that I would have to stay in overnight, I had to bring an overnight bag. I, like lots of people, hate hospitals so I made it clear that I wanted to be out as quickly as possible! The nurse, bless her, explained that this might not be feasible. I had to be realistic.
As soon as I arrived, I was taken through to a cardiology day ward and had pre-procedure checks done, such as an ECG, height and weight, blood tests, as well as my blood pressure in every which way possible – standing up, sitting down, lying down… The list felt endless. Much to my annoyance, I had to have a cannula fitted into my arm so that the medication could be administered. If I’m honest, this was the most painful part of the procedure as I have terribly thin veins and had to sit through 3 failed attempts at having it inserted.
The Procedure Itself
I was wheeled to the theatre about 1pm which I’m not going to lie, was quite an intimidating room with screens next to the bed and lots of monitors everywhere. I’ve had a few operations before, including under general anaesthetic, and have never seen an operating theatre like this. I was shocked by the sheer number of people in the room and although their role and purpose was explained to me at the time, I don’t quite remember who they all were.
Within minutes, I was given a dose of local anaesthetic in my groin to numb the area where the wires were going to be inserted and after this initial burn of the needle, I felt no pain at all. I didn’t even realise that the wire had been inserted into my vein and was making it’s way to my heart. I did however see it inside my heart on the huge screen next to my bed, which was a little disconcerting.
Before the procedure I was told that I would be mildly sedated. Having been sedated before, mild is an understatement. It really felt like I hadn’t been sedated at all if I’m brutally honest. I felt completely aware of my surroundings and not particularly calm. However, I am an extremely anxious person by nature and it is hard to keep me calm. Don’t let this put you off.
Throughout the procedure I could hear the cardiologist talking to the technician at the back who was monitoring the steady flow of drugs into my cannula that were controlling my heart rate. This was really weird and routinely throughout the procedure my heart rate would increase significantly before decreasing shortly afterwards.
Thankfully, each episode of tachycardia lasted for less than a minute and was only needed so that the doctors could locate what was causing my frequent bursts of tachycardia. When they found the faulty pathways (and they found three) they then used heat to burn them in order to stop them from triggering any SVT episodes. This felt like the worst heartburn I’ve ever had and just as I felt it was becoming unbearable, it was over. The burning sensation lasted about 15-20 seconds each time. After the last bit of burning, I was told that the procedure was considered a success. I no longer medication.
When I first came back onto the ward about 90 minutes later, I had to stay lying completely flat for two whole hours. This was hard, and a bit boring to be honest, as all I could do was stare at the ceiling. I couldn’t even get comfortable as I was hooked up to a blood pressure machine that automatically took my blood pressure every fifteen minutes. This was not fun. I was also attached to an ECG machine monitoring my heart rate.
After the two hours were up, I was gradually raised until I was finally allowed to be in a sitting position. Because of the puncture in my groin, I had to keep my leg elevated and I wasn’t allowed to move from the bed without support. The nurses constantly came to check on the wound which thankfully wasn’t bleeding too much but was sore and made walking uncomfortable.
Over the first week or so I was absolutely exhausted. Small amounts of activity made me feel tired, I basically slept for the first three days post-procedure. Thankfully, I had no chest pain, just a slight uncomfortable ‘full’ feeling which passed after a few days. I did continue to have almost daily palpitations for around 6-7 weeks after having the ablation. This is normal but at the time, I remembering worrying that it hadn’t worked.
The Follow-Up Appointment
Because I’d been continuing to have palpitations, I was worried about this appointment. The last thing I wanted was to have to restart medication. In fact, I stressed this to the doctor on arrival. Luckily, all of my checks confirmed his earlier prognosis and the procedure was successful. I no longer needed medication but more crucially I no longer had SVT.
I am still under the cardiologist and will have to go for repeat checks, include wearing a heart monitor for a short period of time. This was mainly because there was a slight discrepancy in my original diagnosis of SVT as another at the hospital now thinks that it was instead atrial fibrillation and this needs to be completely ruled out. However, the general consensus was that regardless of the diagnosis, I now have a regular heart rate and that is something I’m grateful for!
Would I Recommend An Ablation?
Obviously this is based on my own experiences, but yes I would. In hindsight, I had a tougher time with the medication to control my SVT than I did with the condition itself. The ablation procedure wasn’t risk-free and was uncomfortable. However, it is low-risk and more importantly a bearable pain. It’s successful completion has meant that I can now lead a normal life. Whatever normal is…