Recovery after RF Left Atrial Ablation

The research I have seen says that you want the glitches, if they can be called that, EARLY in the blanking period, but not LATER in the blanking period. The prognosis for a successful ablation (free of diagnosed arrhythmia for one full year) is considerably better if you have short runs of AF or other ectopy in the first three/four weeks, than if they suddenly crop up on week 8. I'm not sure, but you probably still have three/four weeks to go, maybe more, in your blanking period? So, you'll have to await your turn with a Holter monitor at about the Week 12 point or so.

It is also true, across the ablation field, but with variance between EPS, that index ablations fail at the rate of about 25%. Second ablations have a somewhat better success rate with 15% failure. I needed two, and I have been free from AF for nearly two years (14th of this month). My first ablation went okay, but my heart seemed sluggish and unhappy if I went for a slow walk, which we are encouraged to do even the next day. My HR climbed to 128 with a slow shuffle. Then, Day 6, I climbed into our hot tub, and promptly felt AF starting. I was at my GP's office two hour later for the post-surgery checkup as requested in my instructions upon release from the cath lab, and he immediately said I had AF at the moment. He sent me to the hospital, and I was admitted and spent the night in the ICU. My HR was 30, and I was told to cease metoprolol, which I had been taking according to instructions as a prophylactic. I was placed on amiodarone, which thankfully corrected my AF to NSR over night.

The new ectopy can be disconcerting, but it is not unheard of, and the pamphlets given to me when I was released warned that many patients have ectopy for a while after an ablation, and that it usually goes away. The instructions said to go to an ER if the AF lasted more than 24 hours with a claimed rate of 100 or more.

I don't know what is going on in your body, so I can't address your question about sudden or gradual. For me, the onset of the new ectopy was sudden, and very dismaying. It kept returning every three weeks or so until I was ablated a second time, about seven months after the first go. Even then, at the two week point, I was back in the ER after the second ablation, again with AF. They sent me home after a 10 mg drip of metoprolol, and I converted at home. Never had another lick of AF since. Again, for me, suddenly back, and then suddenly gone.

I had an ablation last September after a few years of episodes , maybe 3 to 4 a year during exercise. I went to ER several times, sometimes with rapid heart flutter. I was given standard drugs, then went hom. I eventually learned to stay home with it often for up to 2 hours before I went in. Doc said it was ok as long as I didn’t develop other symptoms .
After I finally got tired of it all, I had the ablation. I too had a looper recorder for 2.5 years before it died.
My procedure was uneventful and I got back to exercising after 2 weeks. I did casual biking on my trainer and walked on treadmill. I was experiencing heart flutter once in a while. Around Christmas time for a week I had 3 episodes lasting 1-2 hours. I called Doc about it but he was on vacation and of course it was a Friday. I talked to PA. She would get back to me about it. They said I probably have to wear a heart monitor for a week if it continues. Well, it had stopped happening , my heart rate slowly dropped to under 125 with vigorous exercise and I continue to feel much better. In fact, it’s the best I’ve felt in years. So it does take several months before you feel normal.
Reach out to your cardiologist and see what he says.

Thanks for the reply and info about your recovery. I am aware of all the predictions and expectations of the medical community regarding recovery time line, but more interested to hear from the public about their experiences. It sounds like you felt better as time went on. Good luck and my prayers are with you.

Thanks for your reply. This info is helpful. I also workout with weights and aggressive cardio. I'm now 3 weeks post Ablation and have had 4 Afib episodes plus an SVT as well as the PVCs, etc.
Am I reading that correctly? You had 3 episodes 4 months post Ablation?
Good Luck, and my prayers are with you.

I was ablated in late July of '22. Six days later, in the ER and put on amiodarone to stabilize my HR. Tried to go off amiodarone at the seven week mark, but my AF returned. Told to try two more weeks, then commence the 'weaning' off' period of two weeks again. That worked, and I was free of AF for two months..so we're in late October by now. Had more AF walking my toddler grandson up the street, he holding onto my pinky finger. I sent a recording of my AF taken by my Galaxy wristwatch to the physician who did the ablation 13 weeks earlier. He agreed that it was back, and that he would schedule me for a redo. Meanwhile, over the New Year period, seven weeks later, I had more AF (purchased a new Toyota Highlander, and the experience set my heart into AF). They tried three cardioversions over three successive days, and none of them lasted more than a few hours. So, this is now two instances of AF from the time I started the amiodarone six days after the index ablation. I finally converted on my own, and was more-or-less fine until he redid the ablation on 14 Feb of 2023. Then, two weeks later, another bout of AF. I was greatly annoyed and unhappy. However, I went back into NSR about six hours later, and have never had another AF experience.

It was about 3 months but I’m doing great now. Only my heart rate can’t seem to go over 125 and that might be a problem trying to get power on my bike.

I understand perfectly. I noticed the same thing when I was between ablations...I had to monitor my HR closely while out for a walk. When it got near 119, I would slow right down to a plodding pace or stop for a few minutes. But things can change quickly, depending on where one is in the cycle of AF. I was actually going pretty well in late January of 2023, despite having been told that I was now two weeks away from a needed second ablation, and was able to literally jog up a long flight of outdoor steps near a sandy cliffside at the ocean. We're talking about 160 risers, with a short 30 meters between them and the next flight which was not as steep, but had the same number of risers in a longer path. Looking back on that experience wistfully, but with a heart happily in NSR, I don't do more now than to plod up those stairs....but I do it regularly.

I would urge you to just do what you know you can do, and what you 'think' your heart can do. In time, with healing, you may find yourself 80% of the way back, and that might have to be 'it' for now. Or, you may find yourself back to your old self in about a year's time, and still happily in NSR.

Wow! 160 risers, to stairs coming out of sand. You're advanced hard core. Some good advice here with an inspiring story.
Thanks for taking time to share your experience. There are a lot of people in need of our stories. It helps heal and relieves anxiety knowing what to expect. This type of information can't be found in medical journals or post-op pamphlets, so any authentic testimonial is much appreciated.

Two weeks prior to the steps episode, I had been in the ER three successive days getting cardioverted. None of them worked. In fact, when I presented the first day of the three, the physician attending asked for me to be given adenosine, which put my heart into duress and slowed it right down. I was warned it would be a horrible, dreadful (as in a feeling of dread) when the drug hit my heart, but that it would be over inside of a few seconds. As the feeling of doom came over me, and I was alert for all of this experience, the internist triumphantly said, 'See, it's atrial flutter, not AF,' to the team of nurses around me. The slowed heart showed much more discrete information on the ECG panel display, allowing everyone (except me feeling more and more grateful to be rid of that awful sensation and flat on my back) to see what he meant. The flutter was news to me, and AFAIK, the only time I have had it.

I just looked up afib vs. atrial flutter and read one is as dangerous as the other, both increasing the risk of blood clots and strokes. Also that both are treated with ablation. So what did the internist plan to do differently for one vs. the other?