What downside have you experienced after an ablation?

That's a distinct bummer if it turns out to be a complete reversion to AF, yogal. Did it stop, or is it still in AF? If it comes and goes, but mostly stays away, there's a good chance you'll be in normal sinus by the time you get your Holter assessment in about six weeks...unless your electrophysiologist feels there's no need because you are still experiencing confirmed AF. I hope your heart settles. I managed a whole six days before my GP felt my wrist and asked me to go get a proper 12 lead ECG at the local hospital. That was when I was placed on amiodarone and told to stop metoprolol. My hear rate was about 180 and didn't want to stop, but I was also getting those long pauses, which scared everyone.
BTW, your ablation was 'pulsed field' ablation, the latest and greatest. 😀

Hi mishel-- By now you may have made your decision about ablation. Of course, all of the cardiologists and esp. the EP's are pushing ablations like crazy, but even though I have AF episodes every 2 weeks or so, my episodes feel mild and I don't get nausea, dizziness, pain, etc. as many do. Flecainide works in 2-4 hrs for me, with no side effects. Even Pulsed Field Ablation still has risk and downsides that don't seem to get discussed. Ablation still is no sure thing, and most people seem to have to stay on blood thinners, flecainide, etc. even after ablation. Every one of my friends who has had an ablation has needed a 2nd and even 3rd, and even then they are still on meds, maybe for life; I only take flec when I get an episode. If flec stopped working I might consider a Cox Mini-Maze or its variant, or maybe a Pulsed Field Ablation if I were having daily AF episodes, but only with a specialist who has done over 1,000 of them. My final caveat is that I have other health history that I don't want to stir up by the possible effects of an ablation. Yes, amiodarone is a strong drug, but my mother has been on it for 25 years at 100 mg per day with no side effects (& no AF!); so I think of it as a possible back-up if flecainide were to stop helping me. Sorry to go on so long! But yes, I'm one who is doing flec instead of ablation and don't regret it. All best wishes, Diane

The success and failure rates for ablation vary by a wide margin, and this in unfortunate. Some of it is due to the complexity of the case, but the fact is that the very best EPs have a higher success rate for first and second ablations than do the majority of EPs...and it is the latter that contribute to the disappointing 25% failure rate. The best EPs have skill and experience, but also patience, time, a willingness to be open-minded, and are not formulaic...they are essentially artists at their craft. So, it behooves the patient to shop around and to get in line for the best procedures, even if it means a 3-6 month wait. If you get among the best, they will take YOUR time with you, assess you properly, map your atrium properly, and then do what they see they must do so that you needn't return to them in a few months or a year or two.

gloaming - as you recall I had my first ablation March 4th. I had a terrible sore throat, cough and mucous so under doctor’s orders I bought Tylenol cough and cold over the counter which did the trick. Then it’s the tired feeling throughout and I have a good day followed by a bad day. I’ve also had four episodes of palpitations which stop on their own - I was told to expect this. Just wondered how long you think this awful tiredness throughout my body will last. I get a holter test in April as well as a followup appt.. Thanks. Andrea.

Andrea, I could only guess with the same accuracy as you. I can't explain the feeling of exhaustion. If you are in NSR 99% of the time, that is good, and the early blips are to be expected. Hopefully they will diminish in frequency to 'zero,' although nobody should expect to be free of the occasional PAC, even those with no history of heart rhythm problems.

You may be experiencing a weird form of psychological 'relief', the feeling a tired body has when it can finally relax and fall asleep. We call it the 'sleep of the dead.' There may even be a small component of depression, but my guess is it's a form of anxiety, maybe even because you're still getting some palpitations and you are nervous about your prognosis. You have been under strain, you ARE exhausted, and you need for time to pass, for you subconscious to let go, to stop fretting, and for you to begin to believe that you are recovering....normally. The same way everyone else has to. It's just that you're the only 'you', and your body and mind get to play the game the way they want to. For you, it's being exhausted. I wouldn't fight this or worry about it. Remember, some people report a steady heart rate that runs for months after an ablation in the mid to high 80's, some even higher. I dunno about you, but I wouldn't be pleased with that. Yet, most come back to their forumites and report that their heart rate has returned to near-normal, maybe mid-70's, which took a long time, and was worrisome, but here it is in the much more relaxed stage one hopes for.
The Holter will tell the tale, especially if you wear it for at least 15 hours, and if you do what you feel is normal for your routine during that time, including a brisk walk or a treadmill...whatever. And further, my expectation would be that you would have been asked to cease all medications but for the DOAC like Eliquis, and maybe a statin or thyroid medication, but that should be about it...with doctor's instructions followed strictly. Then, the Holter will give everyone a veridical assessment of your heart's tendent rhythm.
Please try to relax, put your mind at ease, try to spend time on other matters, and in time your heart should calm...and so will you.

I was having 8-10 SVT episodes a day that were infringing on my QOL to the point that I didn't leave my house. I was put on ditilazem but that didn't help. Still had the episodes although maybe they were a bit less intense. I researched ablation for a year. Researched the EP doctor who is the head of the Electrophysiology program at the hospital where I decided to have it done. It was supposed to be a day procedure and home by evening. Unfortunately, the nicked my heart and within an hour I was in cardiac tamponade, chest compressions brought me back and a port put into my chest. I am now 5 weeks out and my recovery has been horrible (pleural effusion that had to be drained and another hospitalization and now multiple medications and steroids) and they now say I have Post Cardiac Injury Syndrome. Something that can reoccur after the initial treatment. If only I had had a crystal ball I would never have gotten this done. I would have tried higher doses of medicine to see if that would have helped even though it would have made me more tired. I am an exercise instructor for the last 45+ years and feel like this has ruined my life. I am in the 5th week of recovery and so far do not see the light at the end of the tunnel. I hope I am wrong and I make a full recovery but the anxiety and depression weigh heavily after something like this happens.

Thank you gloaming. I was instructed to stay on my blood thinner Xarelto and my Beta Blocker Sotalol 80mg. Yesterday was an off day feeling exhausted with shortness of breath and little energy and that’s when I had a two hour episode of palpitations in the evening before bed so I just tried to relax and let it calm down by itself, I had a good sleep and feel almost normal today. It just seems every other day I’m really tired. I know it hasn’t been very long since the surgery and being 79 years of age doesn’t help. Anyway, I’ll see what the 48 hour holter reads April 1st and will let you know. Your responses are very reassuring. xo

Sorry for all this, red. To me, although understandable and realistic, it's disappointing that there isn't more quality control in the EP field. There is wide variation between EPs in terms of results, but there should not be. Maybe it's just how darned complex and difficult heart arrhythmias are, and how relatively new the various treatments are, drug and mechanical, but you'd think the failure rate for a simple PVI, if that's all that was done for you, would run in the 90%+ range.
I hope that time and optimism, what you have left, will bring you welcome relief and improvement.

Thank you. My SVT was AVNRT and they say it has been there since birth. It didn't give me a huge problem until menopause and then it really ramped up. I tried everything - very clean diet, no caffeine, researched everything I could to try and stop it naturally. Valsalva worked all the time when I was younger but with it happening so often if I didn't lay down right away as I got older and get it under control I would risk it lasting a long time. It totally impacted my life and my ability to go visit my kids and grandkids, friends and family, because I didn't want to drive my myself because AVNRT could happen at any time and it made me feel breathless anxious. During this time I lost my husband and then my mom and the stress just kept building.

My EP was highly rated but she also brought in a fellow that I had not met right before surgery and I'm just wondering if he assisted and he hadn't been doing this very long. Unfortunately, there is no turning back and I hope to be in a much better place in 4-8 months. I have to believe that because what else is there?

There is always a redo. I had to have two, seven months apart. My EP was the top trainee for the Canadian Cardiovascular Society for 2002-2003. He frankly warned me that even he has a 25% failure rate for first ablations. His success rate on second attempts was a bit higher than 80%. I won with the odds, but only on the second go.
I know people who have had literally scores, yes 'scores' of cardioversions, mostly because none of them took for long. They have had three, five, six, ablations until they found the right EP. In this one case, six ablations, is was Dr. Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin, and his patient was an EMT who also knows his 'stuff'.
Your attending cannot have a person handle your treatment unless they ask your permission, or except during an outright emergency when there's nothing left but to have the trainee/assistant step in to do something critical. So, I doubt there is anything poorly or improperly done that could be attributed to a trainee...but I guess anything is possible, or at least plausible. I would scream if I learned of it and had not been advised or asked beforehand.