Okay, realize that ablation procedures are more accurately for patients who suffer from an active reentrant node that often results in paroxsysmal supraventricular tachycardia and in some instances can lead to fibrillation. The incidence tends to increase with age in these patients. You do not have such a condition.

Ablation destroys the node and thus, the condition is corrected in most instances, with some cases enduring for various reasons. The procedure can also be used for other instances of dysrhythmia that originate from within cardiac tissues. You need to be aware that vagus nerve-induced palpitation events are extra-cardiac in nature, meaning that they exclusively originate from outside the heart and simply stimulate the cardiac tissues as a consequence of wayward nerve impulse by the vagus nerve, much like the sort of wayward or irregular nerve impulse can cause an eyelid to experience twitching, a condition known as myokymia. Precisely like the benign nature of a twitching eyelid, vagus nerve-induced palpitation events merely constitute the heart muscle responding to a nerve impulse and are entirely benign as well. Thus, ablation techniques do not provide relief from vagus nerve-induced palpitation events due to their actual origin.

A "block" in the context of cardiac electrophysiology is merely the absent arrival expected from an electric signal being passed from one point through the heart to an intended point. It does not actually constitute a blockage of any kind in the context normally thought of with respect to the heart. There are many reasons for the occurrence, but you should realize that such incidental findings are entirely common in normal, healthy persons and would entirely unrelated to the presence of vagus-nerve induced palpitation events of the type you and the others here are experiencing.

In sum, I cannot medically advise you regarding the ablation procedure but merely share information with you necessary to make a more informed decision.

And to clarify my posting regarding the release of epinephrine, the intent of my comments was to illuminate the fact that most people who experience symptoms they incorrectly be due to hypoglycemia, are actually due to the effects of epinephrine. Because eating suppresses the compensatory actions of epinephrine release, it is alternatively presumed that eating has restored proper serum glucose levels. This is an example of cause-and-effect thinking which is highly inaccurate as a basis for determining the nature of events which are complex.

True hypoglycemia is quite rare and is only observed with some regularity as reactive hypoglycemia in the context of patients suffering from diabetes.

The reason that vagus nerve-induced palpitations occur when you are hungry is because the vagus nerve innervates the GI tract as the pneumogastric nerve. Hunger can induce actions that result in wayward nerve impulses which travel upward along the vagus nerve proper until they reach its terminal endings, one of which is the heart. This connection is quite well known and results from irritation of the cardio-esophageal junction, which explains why patients experiencing reflux can also experience vagus nerve-induced palpitations.

Eating a meal can very commonly reduce the incidence of such palpitation events by virtue of the physiology described above.

You can certainly undergo testing for hypoglycemia, but I'm constrained to point out that not only is the condition rare in otherwise healthy persons, other clinical features and symptom patterns exist which you make no mention of and therefore, would highly suggest it not to be present. It is, however, a non-invasive and inexpensive test, so if it brings any reassurance to your own need to know, then by all means proceed if you feel it warranted.

You'll be fine. It's important to be cautious about self-diagnosis and the implications which can arise as a result, the most troubling of which can be the headlong pursuit of medical tests to confirm your suspicions that are being based in the absence of the requisite medical background and experience.

Best regards,

Rutheford Rane, MD (ret.)