Ectopic Heartbeats and ablation

Rick · medicine forum beginner Joined: 27 May 2005 Posts: 13

Hi,

I'm posting from the UK.

My wife was diagnosed with VT four years ago and had an ablation to 'cure'
it. Ever since then she has suffered from frequent ectopic heartbeats. She
will go some days where every second or third beat is ectopic. This gives
her tight feelings and pains in her chest, makes her feel light-headed and
dizzy (as if she is not getting enough blood supply to her head) and leaves
her breathless very quickly.

She is only in her thirties and sadly her body is intolerant of all the
heart medications (beta-blockers etc) that her Doctor has tried on her.

Her cardiologist insists that
(a) Ectopic heartbeats would not make her feel ill and
(b) Doctors in the UK will not use ablation to 'cure' ectopics in the same
way they do for VT.

I was wondering if anyone else had had similar experiences and if Doctors in
any other countries would treat ectopics with ablation. If I can get her
treatment abroad then that's what I will have to do.

Thanks in advance,

Rick.

Andrew B. Chung, MD/PhD · medicine forum Guru Joined: 25 Mar 2005 Posts: 8540

Rick wrote:

anonymous · medicine forum beginner Joined: 14 Jun 2005 Posts: 6

It is not common, but not unheard of to treat frequent ectopic
ventricular contractions with catheter ablation. Of course, there would
be many specifics about your wife's case that her cardiologists/
electrophysiologists would be privy to that would determine her
suitablilty for such a procedure, but it is not out of the question.

Kamran Ahmad, MD, FRCPC
Cardiology resident, Queen's University
Kingston, ON Canada

Here is an example:

J Cardiovasc Electrophysiol. 1999 Jul;10(7):924-34.

Radiofrequency catheter ablation of frequent monomorphic ventricular
ectopic activity.

Seidl K, Schumacher B, Hauer B, Jung W, Drogemuller A, Senges J, Luderitz B.

Herzzentrum Ludwigshafen, Cardiology, Germany.

INTRODUCTION: Frequent ventricular ectopic beats can result in
severe symptoms and may even be incapacitating in some patients.
Although radiofrequency catheter ablation is an effective and safe
therapy for drug refractory idiopathic ventricular tachycardia, it has
not been widely used in ventricular ectopy. The purpose of this study
was: (1) to assess the potential role of catheter ablation in
eliminating monomorphic ventricular ectopy in symptomatic patients
regarding feasibility and safety and (2) to determine the usefulness of
various mapping strategies. METHODS AND RESULTS: Forty-one patients with
symptomatic ventricular ectopic activity (right ventricular origin in 23
patients, left ventricular origin in 18 patients) were enrolled. The
mean frequency of ventricular ectopic beats was 1512+/-583/hour
documented by Holter ECG monitoring. These patients had previously been
unable to tolerate or had been unsuccessfully treated with a mean of
3+/-1 antiarrhythmic agents. The site of origin was mapped using
earliest endocardial activation times, unipolar electrograms and pace
mapping. Radiofrequency ablation was successful in 34 (83 %) of 41
patients. Multivariate logistic regression analysis revealed pace
mapping as the only independent predictor for a successful ablation site
(P < 0.01). After a follow-up of 3 months, the overall success rate was
71%. The mean frequency of ventricular ectopic beats after successful
ablation was 12+/-10 ventricular premature beat/hour. CONCLUSION:
Radiofrequency catheter ablation is an effective and safe treatment for
frequent symptomatic drug refractory monomorphic ventricular ectopic
activity. Pace mapping predicts best successful ablation of ventricular
ectopic beats.

Publication Types:

* Clinical Trial
* Multicenter Study

PMID: 10413372 [PubMed - indexed for MEDLINE]

Rick wrote:

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