Our expert says:
Congenitally corrected transposition refers to the situation where the left and right ventricles (“main pumping chambers”) have in effect swapped places. This in itself is not necessarily a problem, but congenitally corrected transposition is often associated with other anatomical abnormalities, such as holes in the heart or abnormal valves, and with cardiac arrhythmias. (You mention you also have an abnormal valve.) It sounds like you now have an abnormal heart rhythm, probably atrial fibrillation, which your doctors treated with Sotacor and subsequently Tenormin and Isoptin. This then caused electrical block between the upper chambers (atria) and the lower chambers (ventricles) and as a result the Tenormin and Isoptin were withdrawn. This is a common problem in patients with atrial fibrillation, namely how to control excessively fast heart rate, at some times, without aggravating a tendency for excessively slow heart rates, at other times. Drug therapy is often unsatisfactory and a good alternative strategy is the so-called “pace and ablate” strategy which involves putting in a pacemaker, followed within a week or two by an ablation procedure which isolates the atria from the ventricles and therefore prevents the ventricles from going too fast. The pacemaker can then easily be programmed to ensure optimum heart rates both at rest and with exercise.
Pace and ablate is a very effective strategy and need not be influenced by the fact that you have a “weakish valve”. If drugs cannot achieve a good balance between palpitations on the one hand and heart block on the other, then pacing followed by an ablation is a very good treatment. The probability of success is very high and it sounds as though your cardiologist knows exactly what he/she is doing. Most patients who have this procedure feel very much better afterwards and are very pleased with the treatment.
Best wishes for future health, JT.
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