Ablation for V-Tach (Ventricular Tachycardia) at Mass. General by Dr. Vivek Reddy—Coping with ICD Shock
By Ryan Townsend, 2008
I had an ablation performed at Mass General in Boston, MA by Dr. Vivek Reddy. The procedure that was performed on 4/25/08 was not viewed by my specialists down in Miami as very promising; however, it was worth a shot. They were skeptical due to the type of Cardiomyopathy that I have which basically is that my septum is very thick between the ventricles, and that my particular ventricular tachycardia “VT” was too fast. The last two EP studies revealed a VT that was too fast to map because it did not support a blood pressure and did not allow enough time to see the problematic circuits. I had tried several med which didn’t work well. I pressed on. I researched through the internet, Google, and other patients that have had successful ablations. The most important thing I did is put it in God’s hands, and let him guide me to the answer to my prayers.
EXPLORING OPTIONS WITH DR. REDDY
I felt pretty confident despite the negative outlook I received from my doctors and found myself in Boston. I went in for my consultation and was told the many different ways my problem can be ablated. They use radio frequency, cryoablation (freezing), or an alcohol injection in your coronary arteries that is basically a controlled heart attack which kills the muscle where the bad circuit lives. All these methods are typically done through the groin vessels. Another approach is to pierce the skin above the sternum allowing access to the sac surrounding your heart through which the doctors can introduce their instruments and ablate circuits on the surface of the heart if necessary. This is known as the percutaneous (through the skin) approach which is not done by your “average” EP doctor. I’m not sure how many doctors practice this particular procedure; but after researching on the internet, it seems to be very few.
ABLATING THE V-TACH
My ablation lasted 10 hours. I woke up and heard the wonderful news that it went extremely well. I was in pain, but it was tolerable and extremely worth it. My heart had a total of 8 circuits which could cause VT, two of which were extremely active causing me to get defibrillated or “shocked”. Four to five hours of the procedure consisted of mapping the heart and finding the problems. They used a balloon pump to keep my blood pressure up while VT was induced, which is typically used in Open Heart operations.
They ablated with radio frequencies and hit one of the worst ones on the surface of the heart by the percutaneous (through the skin) approach.
The outcome, according to Dr. Reddy, was an 8 out of 10. There were two circuits deep in the ventricular septum which they left alone, because they believed they were not of significance. And they did not want to damage any more of the heart then needed. I later read the procedure summary in which there was also a notation stating that the coronary vessel supplying the area was not easily identified. This meant that Dr. Reddy was considering an alcohol injection; however, he was not certain about the outcome.
AFTER THE ABLATION
The first week and a half I felt pain in my groin. I also had some chest discomfort the first few days. It became worse as the Madrol, a corticosteroid used for inflammation, was stopped. I was extremely uncomfortable. I tried my best to “deal with it,” however I couldn’t handle it any longer. I knew it was pain from the burn on the surface of the heart and not a heart attack. The doctor then put me on the Madrol again. This time instead of a few days, I was on it for a month.
LIFE AFTER V-TACK
Do I feel a difference? Yes, absolutely. Before this I could barely walk at a normal pace without feeling dizzy. This is my second miracle! (My first miracle was surviving a cardiac arrest when I was 30. No personal history to explain it. I was in top physical condition. I survived because of 10 minutes of CPR provided by my best friend until EMS arrived. I read somewhere that only 10% survive sudden cardiac death.)
Before this in December of 2007 an ICD device had been inserted in my heart which shocked me an average of once a month to get me out of a V-Tech attack. Once it shocked me 28 times in 14 minutes. An ICD shock feels like a kick in the chest. The worst part of the whole thing is feeling your heart start to go crazy and anticipating the shock. It beats dying. But going through a V-Tach storm is like being on the edge of life. All I can say it was the worst experience of my life. Now my life is totally changed.
Almost two months have passed. My activity level has been much better. The PVCs were quite frequent at the beginning but have decreased once I passed the 1 month mark. Just recently while recovering from a chest cold, I became extremely flush and my right arm went numb. I decided to get checked out at the hospital; however, it had diminished by the time I was evaluated. Was it an anxiety attack from a short run of V tach? I don’t know. All I could tell you is that I felt that same way right before I used to get shocked. According to what I’ve read on ablations, it can take months to a year before the PVCs calm down and in some cases even disappear.
Over the past 6 months I had spent 35 days in the hospital with 7 invasive procedures and 7 noninvasive procedures and who knows how many doctor visits. I had been shocked 4 times. Once I was shocked multiple times, as i mentioned earlier. I have 4 cardiologists caring for me now.
This story is my testimony that God is real and he listens to his children’s prayers. I never lost faith in all of this. And I pray that if you are in the shadows of fear, call on the name of the Lord to give you the light of hope.
I have learned a lot about ablation and medication options. Please look into getting your arrhythmia fixed. Devices are a “God send.” However, ablation can CURE the problem for many people. At the very least, it will decrease or even eliminate future shocks. I pray for the day that ablation eliminates the need for ICD therapy.
I hope this finds patients, family or friends of ICD patient’s well and full of hope.
Contact me with any questions. I will help you find whatever I can with the resources that are available to me.
Lieutenant/Paramedic 6 years
Ryan Townsend is a firefighter/paramedic with V-Tach due to a special type of Cardiomyopathy in which the septum between his ventricles is very thick. He nearly died from Sudden Cardiac Death when he was 30 years old, and had to have an ICD Implantable Cardioverter-Defibrillator) installed. The shocks saved his life, but were hard to put up with. The ablation procedure he experienced is similar to that for A-Fib. [It’s been suggested that A-Fib.com should investigate and write about V-Tach, since it is so similar to A-Fib and is often treated by the same doctors.