Heart Ablation for Bigeminy

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New Member

Date Joined Sep 2014
Total Posts : 3
   Posted 9/22/2014 9:41 PM (GMT -6)   

I've stumbled upon this forum when searching for peoples experiences with heart ablations.

I'm 33 and have I have had bigemy for years (about 7 years), although, it wasn't diagnosed. I just thought I had a slow heart rate, feels like my heart rate is 40 bpm most of the time, turns out I'm not super fit tongue and I have a bigeminy heart beat. I had a holter monitor done and 50% of my beats are PVC's. The monitor said I had 55k PVC's. My Echocardiogram showed that my heart was normal.

I feel ok most of the time. I've recently gained a little weight and it feels like I've noticed symptoms now. Kind of feel like need to catch my breath when I'm resting. Often feel fatigued. I get lightly dizzy sometimes. Nothing too bad.

My Cardiologist and Electrophysiologist has suggested I have a heart ablation because having more than 10% of your heart beats as PVC's can weaken the heart over time and he does not recommend medication, as I am only 33 years old and he says most young patients can't handle the side effects.

My questions is:
Have any of you had success with your heart ablation?
Are there any questions I should ask my doctor?
Any advise would be very appreciated.

He says the procedure should only take a few hours and that I would be home a few hours after recovery and that I should be able to go back to life as normal within a couple days.

Was that your experience?

My sister-in-law have a heart ablation for a different reason and she said it took about 6 weeks to feel better.

I look forward to hearing what any of you have to say.

Thank you!

New Member

Date Joined Sep 2014
Total Posts : 3
   Posted 9/28/2014 3:48 PM (GMT -6)   
I had a cardiac ablation procedure in May, 2011, to correct bad episodes of RVOT (Right Ventricular Outflow Track Tachycardia). My heart was otherwise healthy, but I was getting these episodes on a regular basis. Almost to the point of passing out at times, but then perfectly normal a minute later. The episodes came and went at random.

After trying meds with no success, the ablation procedure was recommended. I decided to go for it. In my case, I have had great success. Almost cured completely. I still get some PVCs and other mild rhythm irregularities occasionally, but nothing bad.

The procedure itself was very easy. No pain, and home the next day (often, it's the same day). I had no bleeding problems or discomfort in the groin afterwards.

I would recommend using someone who is experienced. A friend of mine had an ablation for A-Fib, and didn't have good results (nothing bad, just little improvement). Found out later that the doc didn't have much experience. He tried again with a leading guy, with great success.

Good luck! If you happen to be in NJ, and need a recommendation, let me know.

New Member

Date Joined Sep 2014
Total Posts : 3
   Posted 9/29/2014 5:50 PM (GMT -6)   
Thank you Cyclist56. Thank you so much for taking the time to reply. That is very good to hear that yours worked for you.

My doctor does seem very young. He says he's done 160+ heart ablations, a 3rd of those being the kind of ablation I would be getting. He says it is the most common.

I'm not in NJ, otherwise I'd take you up on that recommendation! Thanks again :)

Regular Member

Date Joined Jan 2014
Total Posts : 394
   Posted 9/30/2014 3:57 AM (GMT -6)   
Cyclist56, it's my understanding that afib ablations are more complex, therefore it doesn't surprise me that your friend may have had less than ideal results.

GirlinSLO, are you in constant bigeminy 24/7? My heart runs through various patterns at times, bigeminy being one, tri or quadrigeminy as well. Bigeminy is frustrating. I'll be at a computer at work and can feel the bigeminy start, I really start to feel odd while it lasts.

I saw two Electrophysiologists for very frequent PVCs. Both felt that ablation would reduce or eliminate them. The first EP I saw said my PVCs were "probably" in the RVOT. The second EP had the nurse continue to collect my EKG data until a PVC was visible in each of the EKG leads on the EKG print-out. He disappeared with the print-out sheets and returned several minutes later. He said that my first EP was wrong, that the source of PVCs was in the Purkinje Fibers, which is harder to get at, but still possible to ablate. The following demonstrates why the location of the PVC focus is important, in terms of risks to the patient.


"The RVOT is a straight shot from the right femoral vein to the outflow tract. There are very few impediments to catheter manipulation.  The LVOT requires arterial cannulation and the catheter goes up around the aortic arch and then down to the aortic valve.  Because of the curve in the catheter, when you turn the catheter counterclockwise, it actually moves clockwise in the heart and vice versa.  In short, it is technically more difficult.

The RVOT is thinner and it is easier to achieve closer to full thickness ablation.  If your PVCs are coming from the middle or epicardial myocardium, it can be more difficult to ablate from an endocardial approach.  There are three "layers" to the heart muscle from inside to out called endocardium, middle or M cells, and epicardium."

Acvording to the above: RVOT catheter is placed in a vein (low pressure) and is a straight shot. LVOT requires access via an artery (high pressure), and the course (route) is more complicated. Also, Infrequently, some patients are not able to be successfully ablated by these routine procedures and doctors may need to employ, during a separate procedure, a technique called epicardial ablation (versus endocardial ablation that you are considering). Epicardial ablation is done with a small incision into your chest, and the catheter is coursed to your heart, and the offending tissue is ablated.

He continues:

"The risk of pulmonary embolism is low and small emboli are filtered by the lungs.  When you are on the left side, small emboli can cause a stroke or other embolic events.  The risk is very low, but never zero."

If you are truly in bigeminy all the time, that will make mapping much easier and increases the likelihood of success."

Blood returns to the heart's right atrium, goes to the right ventricle, to the lungs, through capillaries in the lung, returns from the lungs, to the heart's left atrium, goes to the left ventricles, then out to the body. So, a procedure on the right side of your heart would have any small clots filtered by the capillaries in the lungs, but if perchance anything were dislodged from the left side the clots would flow out to the body.

As was explained, inducing the arrhythmia during ablation is essential to successful mapping and ablation, if you are in bigeminy all the time, this enhances your chance for success.

From another source, the following question/answer emphasizes a point I initially wanted to make in your situation, namely that geminy patterns can be atrial or ventricular in nature, though re-reading your post, I see that you mentioned PVCs as the culprit.


"Question: I was wondering if being in bigeminy most of the day can have a long term effect on your heart? Also can anxiety contribute to bigeminy? What treatment options are available for this arrhythmia? I have had some lightheadedness with this while doing some activities.

Dr_Baez-Escudero: It depends whether the bigeminy comes from the atrium or from a premature ventricular contraction (PVC). Ventricular bigeminy has been sometimes associated with PVC-induced cardiomyopathy. This basically means that the heart can get weak over time if you are in constant bigeminy. Anxiety can be a contributing factor. Catheter ablation of a PVC causing bigeminy can be curative. Consultation with an electrophysiologist is warranted."

Ask your doctor for his/her opinion on the location of the PVC focus.

Make sure your doctor explains the possible risks of the procedure overall and with emphasis to the specific area that he/she feels is the source of the bigeminy.

And make sure your doctor has fully explained non-procedural options (medications).

Medication of this nature require supervisory hospitalization to initiate, my doctor said I'd need to be in the hospital 48 hours to start the requisite medication (actually he said that several may need to be tried until they found the ideal drug). And there are risks with anti-arrhythmic medications as well even once you're placed on them in a hospital, though with a healthy heart and periodic monitoring and examinations, these risks are minimized.

It is my understanding that patients receiving ablation may require overnight hospital stays for several reasons, but one of those reasons is if the procedure done later in the day and they may want you to stay for observation.

Not every ablation is a success, but so many are. Kitt, a moderator at HealingWell, would explain not to be discouraged by people that post in forums that they had issues with ablations. Rightfully so, she explained that most procedures are successful, these people tend not to show up in forums.

Best of luck, please let the forum know how everything goes.

Post Edited (JungRulz) : 9/30/2014 3:04:01 AM (GMT-6)

New Member

Date Joined Jan 2014
Total Posts : 2
   Posted 9/30/2014 4:25 PM (GMT -6)   
i was getting 15,000 a day
go for the ablation
so far its worked for me
its been 6 months
dr how did mine in san francisco

New Member

Date Joined Sep 2014
Total Posts : 3
   Posted 10/7/2014 4:00 PM (GMT -6)   
Thanks for the replies.

JungRulz - your reply was very informative! I am scheduled for an SVT heart ablation. To answer your question, I do have bigeminy all day (55k a day). My monitor showed that I have a few bouts of trigeminy and quadrigeminy, but that I was pretty much always in bigeminy. Oddly, I only feel discomfort from it occasionally. I haven't felt a normal rhythm for 7 years! I'm excited to feel a normal rhythm again :)

I have another appointment with my electrophysiologist soon and I'll use this useful info to ask questions.

Magoo555 posts like your give me hope :)

Veteran Member

Date Joined May 2010
Total Posts : 8384
   Posted 6/2/2015 3:12 PM (GMT -6)   
old post - but I'm new to bigeminy. My holter monitor showed 1200 early beats with some bigeminy. I started a low dose of a beta blocker (2.5 mg of bisoprolol) about a month ago and completely eliminated my meager daily dose of caffeine a week ago.

I'm still feeling the early beats and bigeminy frequently throughout the day. I only feel breathless occasionally and I'm trying to decide if my light headedness is due to the bigeminy or something else.

So my question is - when do I ask my PCP for a referral to an electrophysiologist? These posters above talk about holter monitor results that are 10x worse than mine and lasting for years. I've only been struggling with this for 6 months.

I think my next step is to go back to the PCP and discuss increasing my beta blocker. What else?
52 yrs old, IBD diagnosis in spring '01. Proctitis, gastritis, ileitis.
Currently taking Pentasa (3g/day) generic Colazal (9 6 pills/day), Sulfazine (1.5 g/day), Prevacid, folic acid, vit. D (2K iu), flax seed oil (2 tsp/day), psyllium (2 tsp daily), rectal meds as needed. Gluten free as of 5/30/11. Remission from Aug. '11 until November '14.

Elite Member

Date Joined Mar 2009
Total Posts : 20254
   Posted 6/2/2015 8:25 PM (GMT -6)   
bisoprolol is good. used it after my x2 by-pass. however it was discontinued. i am a definite learner driver, but i am trying to offer some some assistance on the forum when i can. back to the doc. have your blood pressure checked. take care.


Veteran Member

Date Joined May 2010
Total Posts : 8384
   Posted 6/3/2015 10:09 AM (GMT -6)   
my blood pressure is low. One of the issues with increasing the beta blocker would be lowering it even more, I think. At my check-up this past Monday morning, my bp was 104/69.

I don't think bisoprolol could be discontinued because I'm taking it. Thanks for the reassurance about this med.
52 yrs old, IBD diagnosis in spring '01. Proctitis, gastritis, ileitis.
Currently taking Pentasa (3g/day) generic Colazal (9 6 pills/day), Sulfazine (1.5 g/day), Prevacid, folic acid, vit. D (2K iu), flax seed oil (2 tsp/day), psyllium (2 tsp daily), rectal meds as needed. Gluten free as of 5/30/11. Remission from Aug. '11 until November '14.
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