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Cardiac Ablation

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LILS

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Howdy, Masters of the VA system,

I'm not sure if you can answer my questions, but I thought I would ask anyway. Here's some history on my issue. I've had cardiac issues for many years now: On blood pressure meds for 15 years due to high BP/rapid heart rate. Since about 2004, I've noticed increased palpitations. I got checked in 2005 and had a holter monitor done and I had approx 7,300 Premature Ventricular Contractions (PVCs) in 24hrs. The doctor (Internal Med) didn't know what to make of it since all my other basic tests were normal. I was stationed overseas on an island, so the docs were limited. He said maybe it was anxiety and I should go see a psychiatrist. I felt he just didn't know how to fix it, so he used that as a cop out, even though I knew I didn't suffer from anxiety. He said PVCs can be pretty normal and it was no big deal.....maybe he was secretly working for the VA. Anyway, I blew off my PVCs for 4yrs, until I noticed them increasing. Unlike some people, I can feel each one of those arrhythmias; thousands a day are annoying! A few months ago, I went to see a cardiologist and had all the holter monitor tests (3 of them), electrocardiogram, etc, done. My PVCs had increased to over 12,000 a day. He said that yes, PVCs are normal, but not if they are over 5,000 for a extended amount of time. He said the doc should've followed up better. Well, the cardiologist referred me to an Electrophysiologist (EP) and I am scheduled for a cardiac ablation later this month.

Below is an excerpt from the VA ratings. Ok ladies and gents, here are my questions: What in the hell does the below excerpt mean?? I'm being admitted for the ablation, but it's only overnight, and according to the EP will more than likely be on anti-arrhythmic medication for the rest of my life, even after the procedure. Is this something I can claim, and if it is, how in the world would I know what category I fall into? Does the ablation procedure count separately from the high blood pressure claim, since the anti-arrhythmic med will take care of both? I know there are a couple of people on this site that had cardiac ablations done in the past; hopefully you're still out there and can fill me in on how you handled everything. Thanks to anyone that can help decipher the below excerpt for me. Because the way I read it, I would get 100% and I know that's not right! LOL. :rolleyes:

7011 Ventricular arrhythmias (sustained):

For indefinite period from date of hospital admission for initial evaluation

and medical therapy for a sustained ventricular arrhythmia, or; for

indefinite period from date of hospital admission for ventricular

aneurysmectomy, or; with an automatic implantable Cardioverter-

Defibrillator (AICD) in place........................................................................... 100

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent.......................... 100

More than one episode of acute congestive heart failure in the past year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or; left

ventricular dysfunction with an ejection fraction of 30 to 50 percent............... 60

Workload of greater than 5 METs but not greater than 7 METs results in

dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray.............................................................................

...... 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or;

continuous medication required........................................................................

.. 10

Note: A rating of 100 percent shall be assigned from the date of hospital admission for initial evaluation and medical therapy for a sustained ventricular arrhythmia or for ventricular aneurysmectomy. Six months following discharge, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter.

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  • HadIt.com Elder

LILS,

I will try to give you my best opinion. My husband has the same condition as you.

First most people to my knowledge have hypertension like me and I take my meds and go on.

We are talking about two different illnesses. Hypertension and Heart A and V Fib.

The Ablation is for the irregular heart beat and to my knowledge, yes you will take medication

to keep your heart regular and if you are the lucky ones, you heart will stay regular.

This medication will not to my knowledge lower your blood pressure, only regulate your heart beat.

Again, to my knowledge , you would be claiming for two medical conditions.

Hyptersion and Irreqular Heartbeat.

You mentioned 100%, Please don't let me scare you, but we are talking about a very

serious condition.

Again, I am not doctor only the wife who lives with my husband each day with the same

illness.

Anyone please feel free to correct me if I am wrong.

Always,

Betty

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Thank you Betty for all the info. You are absolutely correct about the anti-arrhythmic not being used to control BP. I don't know why I assumed it would. I guess I will be adding another medication to my pile. As far as being scared, I've always been told PVCs are normal. Even if they're occuring way to often like mine are, it's not an emergency to get them controlled right away like Ventricular Tachycardia, Supraventricular Tachycardia or Ventricular Fibrillation. So, in my mind (I could totally be wrong), the 100% rating would be for those conditions. But I don't know how specific the VA gets, as far as breaking down what type of ventricular arrhythmia. <br>

Edited by LILS
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  • HadIt.com Elder

Why are you having the Cardiac Ablation?

I read your post, what is the name of your heart condition?

My husband has A-Fib with Flutter.

I looked this up on the internet.

When is ablation appropriate :

Many people have abnormal heart rhythms (arrhythmias) that cannot be controlled with lifestyle changes or medications.

Some patients cannot or do not wish to take life-long antiarrhythmic medications and other drugs because of side effects that interfere with their quality of life.

Most often, cardiac ablation is used to treat rapid heartbeats that begin in the upper chambers, or atria, of the heart. As a group, these are know as supraventricular tachycardias, or SVTs. Types of SVTs are:

Atrial Fibrillation

Atrial Flutter

AV Nodal Reentrant Tachycardia

AV Reentrant Tachycardia

Atrial Tachycardia

Less frequently, ablation can treat heart rhythm disorders that begin in the heart’s lower chambers, known as the ventricles. The most common, ventricular tachycardia, may also be the most dangerous type of arrhythmia because it can cause sudden cardiac death.

For patients at risk for sudden cardiac death, ablation often is used along with an implantable cardioverter device (ICD). The ablation decreases the frequency of abnormal heart rhythms in the ventricles and therefore reduces the number of ICD shocks a patient may experience.

For many types of arrhythmias, catheter ablation is successful in 90-98 percent of cases – thus eliminating the need for open-heart surgeries or long-term drug therapies.

Edited by Josephine
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Thanks for more info. My docs told me ablation is usually done on the atrium, but can be done on the ventricles too. I'm having it because my PVCs can't be controlled with the beta-blockers or calcium blockers I've had over the last few years. My cardiologist said due to the # of symptomic PVCs, that an ablation might be the best bet. The EP suggested the same thing, since the meds I take are not controling the PVCs and are making me exhausted, so an anti-arrhythmic drug would be even worse. I'm only 37 and work in a hospital and I can't function on these meds, at least at the doses I'm on; all I want to do is sleep. The EP said, even if he can't take care of all my PVCs, he should be able to get most of them, where I can be on a lower dose anti-arrhythmic.

My family has a bad history of heart problems. My dad, his sister, and my grandfather all had some type of heart issue and died before the age of 45, due to a complication with the heart. My father had a massive heart attack while sitting on the couch watching TV. I think his sister had heart disease. Unfortunately, that's all I know about them, so I don't even know if they all had heart disease or what. I didn't know that side of the family well, and over the years, I don't know anyone on that side now. Anyway, PVCs and heart disease have nothing to do with each other, but both my cardiologist and EP said the # of my PVCs everyday (16% of my total beats), could eventually cause cardiomyopathy. But for me, feeling thousands of PVCs a day is taking it's toll on me mentally. It is very distracting and when there is a run of them back to back, it causes me to be short of breath. I guess in a sense, the benefits of ablation (for me), outweigh the risks.

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