Difficulty exercising after aFIB and SVT ablation

Thank you Gloaming for the thoughtful and thorough analysis of recovery process. As a CCRN in cardiology and as a SVT and Afib patient I am frustrated at the lack of explanations from the Electrophysiology team. They are crazy busy yes but also typical lack of communication skills and a narrow focus excluding often the person in the bed.
I have had a paroxysmal Afib ablation last year with pretty good success now that it has been 1 year post and SVT ablation this past March.(so far so good but remain on Sotalol for now) The exercise tolerance is compromised however and there is no guidance for that. Kind of on your own to figure it out.

I would control my pace, keep an eye on HR (if it climbs much above about 130 when walking, you might wish to slow or pause). You can push it later when you 'know' or feel it in your bones that you're ready for a greater effort. That may be a month from now. Also, keep an eye on electrolytes if you're going to be sweating some, and of course keep the fluids up. Also, keep a snack with some carbs so you don't 'bonk' and maybe encourage a cranky heart.

Is there a particular reason you're still on Sotalol? Were you taking it when you had your Holter at about Week 10-12? If so, that's very surprising to me....both that you're still taking it and that you were on it during the Holter. I don't want to pry, but in my admittedly limited exposure to all things AF/SVT and the various people posting here and there about their experiences, the idea is to be off anything except the usual (statin and DOAC for risk management) so that the Holter indicates a veridical record of the heart's true condition.

I believe that they are taking it much more slowly this time, I am currently in my 12th week post SVT ablation. I will be monitored via Zio Patch for 2 weeks while still on Sotalol, then depending on results possibly go to a slow wean of the Sotalol and remonitor. Then again depending on results of that go to discontinuation of the Sotalol. I actually prefer to do it this way because if I were to come off the Sotalol right away and then subsequently need to go back on it I would need to be readmitted for 48 hour monitoring per protocol for that drug. I do not want to have to do that again!
So this is what I assume their plan is but getting the info out of them is like pulling teeth. And this big Boston teaching hospital in department I worked in 😂 for many years.

As gloaming says, be patient with your healing. I had an ablation in 2021 and my heart rate was on the high side,, and highly variable, for a number of days. My cardiologist said that was expected and that I was "just along for the ride." I started hiking and cross-country skiing about 10 days after the ablation, up to about 6 miles. Worked up to 10+ miles carrying weight about 1-1/2 months after. I was completely out of A-fib except for occasional blips after 2 months. About 4 months after my ablation I went to Nepal for two months of trekking, hiking up to 18,250' without any problem.
So, have patience and take it as it comes. Everyone is different, but it sounds like you are in good shape and can expect a successful recovery. All the best!

Will do on all those things. When my HR gets into that 130-140 range, I typically stop for a bit until it goes back to ~100 then back to it!

Some people have minor bouts of arrhythmia now and then during the 'blanking period.' Some don't. Some have so much ectopy that their ablation obviously didn't work and they'll have to go back for a re-do.
Some people are biking and hiking literally two days after their ablation. Some report that they still haven't recovered full functionality months later.
Some report that their hearts calmed down very soon and they have felt great ever since. Others report high resting heart rates in the high 80's for literally months and months afterwards, although almost every one of those that have reported this undesired outcome have later come back and said their heart returned to its normal rate after about a year.
From this you should take that we all naturally deal with what has been done to us and what we have experienced that got us there, meaning the disordered heart. Your system is dealing with your operation normally, as much as that may seem unfortunate or unwanted. I think you should keep doing what you are doing, but don't push it. If you're tired one day, or even a whole week, give it a rest! You can resume your regimen the following day or week. What you don't want happening is a return to high amounts of ectopy or arrhythmia. That would be a sign that your operation was probably not going to be successful ultimately. The research suggests that this is especially true later in the blanking period. Those who have short runs of ectopy in the first four or five weeks have a better prognosis than those who think they're home free for the first couple of months and then suddenly they get breakthrough arrhythmia again...that's a bad sign. The idea is that your heart 'should be' calming and repairing itself as time goes on, so ectopy after several weeks suggests the calm heart is welcoming the pre-ablation conditions of unwanted electrical signaling.
Honestly, don't fight this. Decide you're going to enjoy puttering and letting your system climb down from off the wall. A day will come when you'll bounce out of bed and you'll know you're ready to start reclaiming normalcy again.

Great post. I am having an ablation done on Wednesday of this week.I have been in constant AFib for 4 years. This post gives me an idea what to expect in recovery. Thanks very much.

Great post. I am having an ablation done on Wednesday of this week.I have been in constant AFib for 4 years. This post gives me an idea what to expect in recovery. Thanks very much.