SVT(AVNRT) - Post ablation experience - Won‘t reccommend
I am 38 year old man and I was diagnosed with AVNRT (a common type of SVT) after two episodes that were terminated with adenosine in the emergency room. I had this issue for long time, but used to get reverted automatically hence not diagnosed. I underwent an EP study and catheter ablation at the Prestigious COSTLY Private Hospital in Trivandrum(If you Know you Know),Kerala,India performed by an experienced electrophysiologist.
I am sharing this not to scare anyone, but because I wish someone had told me these things before I made my decision.
## What happened
The ablation procedure itself went smoothly in the operation theatre and I was shifted to room in 4 hours. However, 12 hours after the procedure I developed a post-ablation AV
conduction disturbance — meaning the electrical pathway between my upper and lower heart chambers was damaged during the ablation. My Holter monitor showed intermittent third degree (complete) heart block episodes, Wenckebach patterns, and a ventricular rate that needed medication support (Deriphyllin/theophylline) to stay adequate. After seeing the holter report doctor was suggesting possibilities of pacemaker implant.!
I am now two weeks post-procedure. I have stopped the medication two days ago and my heart rate is holding at 70-80 bpm on its own — which is encouraging. But the situation is still uncertain and I am under monitoring. I have not been cleared to return to normal.
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## What I wish I had known
**1. Medicine first. Ablation only if medicine fails.**
AVNRT can often be controlled with beta blockers . I was steered toward ablation relatively quickly. In hindsight, I should have tried medication more seriously and for longer before agreeing to a procedure. If you are tolerating your episodes and medication is controlling them reasonably — take your time before choosing ablation.
**2. Large private hospitals have financial incentives to perform procedures.**
I say this directly: Private hospitals are revenue-driven institution. Ablation is an expensive procedure. I felt the recommendation to proceed came faster than it should have. Please get at least 2–3 independent opinions — ideally from doctors who have no financial stake in whether you undergo the procedure or not. A government institution or an independent senior cardiologist will give you a more unbiased assessment.
**3. "Low risk" does not mean "your risk is low."**
Every consent form and every doctor will tell you the complication rate is 1–2%. That sounds small. But if you are the one in fifty or one in hundred — that risk is 100% for you. I am that person. Please understand this concretely before signing consent.
**4. The ablation is done without a camera inside your heart.**
This is something most patients do not realise. The procedure is guided by electrical mapping and assumed anatomical landmarks — not direct visualisation. Every human heart has slight anatomical variations. When the ablation catheter is working millimetres away from your AV node — the critical pathway that connects your upper and lower heart — a small miscalculation or anatomical variation can cause permanent conduction damage.
**5. Get your second opinion from SCTIMST(If you are in Kerala or Tamilnadu)or a similar institution, not another private hospital.**
If you are in Kerala, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) in Trivandrum is a premier government cardiac centre with no profit motive. Their opinion will be based purely on your clinical situation.
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## My three key messages
- **Wait. Think carefully. Get multiple opinions.**
- **Try medication seriously before agreeing to ablation.**
- **Understand that rare complications, when they happen to you, are not rare at all.**
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I am happy to answer questions from anyone facing a similar decision. I have gone through this experience in detail — the EP study, the procedure, the post-ablation monitoring, the ECG interpretation, the Holter analysis — and I can share what I have learned.
Wishing everyone here a smooth recovery and good health.
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*This post represents my personal experience and opinion. It is not medical advice. Please consult qualified cardiologists before making any treatment decisions.*