I have an EP monitoring my A-flutter. He indicated the first catheter ablation was for the purpose of ‘mapping’
and generally that will not be enough to resolve the issue. I had the second ablation a month or so later, and the EP specifically identified one area that was misfiring. The second one was successful.
When I had my second ablation, I was thinking the worst because of my horrible seven months following the first ablation. To summarize, six days after the first, I was in the ER and kept overnight while they started me on Amiodarone (AKA the drug of last resort). I was back in AF. The Amiodarone corrected my rhythm over night and I was released. Six weeks later, during the weaning off period where I was to stop the Amiodarone, I had to return to the ER due to AF appearing again. A month later, fully off Amiodarone, I was fine, even off metoprolol. Then, two months later, back in AF. I downloaded an EKG from my Samsung Galaxy 4 watch and attached it to an email to the Royal Jubilee Hospital's AF Clinic. The EP called me a few weeks later (nothing happens quickly in the vaunted Canadian 'free' health care system) and agreed that I had recurrent AF, and he accepted what my smart watch recorded. Didn't even want a propere EKG. Nurses were very pleased that he was that kewl with a mere wristwatch's indication. He agreed to try a second ablation, which I had three months later (only because there had been a cancellation).
This time, I got to the two-week mark before I had to rush to the ER. Same thing, a run of AF that wouldn't seem to self-limit. Except, while on a gurney, it eventually did. This time, on my own, and with four pills left over from the earlier Amiodarone, I commenced a 'loading dose' rate on my own advisement. When I told the ER staff, and I was still in AF 24 hours later, they were not dismayed and seemed to feel that my approach to self-medicate at least had a prior history that worked...so why not? Except the Amiodarone had not corrected my heart, so that was abandoned. They tried more metoprolol, and an hour later it still had not helped. Then, about 85 minutes later, my heart reverted. And stayed that way, but now taking metoprolol....again!
Okay, the main message here: We agreed at the ER that since previous attempts to cardiovert me had failed six months earlier over the holidays (this is now 14 Feb), another cardioversion was not indicated. When I related that to the Jubilee outreach nurse (who is an absolute goddess for her skills and patience), she said the ER internist was absolutely wrong. After each ablation, one's heart is essentially a new animal. If it gets cranky in the few weeks after an ablation, the correct resort is to cardiovert!! So, that was a miss for me. She also assured me, firmly, that this time my heart was fixed, the current run of AF notwithstanding, and that I should relax and have faith. Also, to resume 50 mg of metoprolol each day for six weeks, then stop and see what happens. Well, I do have faith in Lindsey Ward, and have told her so. I did what she advised, and am now post-Holter, off metoprolol for two months now, and the Holter showed no AF and no more PACs, which plagued me the first Holter last October.
AF will not kill you. Anxiety might. Almost everyone has a few PACs and AF for one, two, or three runs in the first weeks after a first or second, or a third, ablation. It's perfectly normal. They should self-limit, maybe even running 12 hours or more. When they get to the 24 hour mark, go to the ER and tell them you want a cardioversion because that is Job 1. If it fails, then confer with the EP and figure out if Flecainide or Amiodarone, or a bit more metoprolol might help. My guess, if my own history is an indication, is that you will suddenly find your heart tires of the game and flops back into rhythm.
Ablation is a big deal. It inflames tissue, and leaves scars (fibroids). The heart will be cranky, PO'd, just as any other organ would be if it had been kicked in the slats. Don't forget, that RF probe didn't grow in the left atrium. It was shoved through your septum and then wiggled around, touched to nice soft endothelial tissue, and then it got hot and burned all those lesions. You're bound to have the odd occurrence of arrhythmia.
So, don't fret. Especially if you feel the odd palpitation during the first month. If you get them later, at the eighth and twelfth week, that's a worrisome development and means that the procedure will have to be repeated.
One of the two administrators at afibbers.org had six ablations from three different surgeons, each a failure. He was in a bad way, finally heard of Dr. Andrea Natale, and how he has been AF-free for four or five years.
If an EP says his next step is a pacemaker, I'd run. Fast, and for about a full hour. Find another EP who knows what he's doing.
I was never told that. My friend had his 2nd ablation two years apart. He’s doing great. Mine was three years apart. I feel so much better. The longer you wait I’m sure the worse your heart will get. Just my opinion. If you need another one I wouldn’t put it off. Good luck and prayers to you.
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Can it be a med issue?
I have an EP monitoring my A-flutter. He indicated the first catheter ablation was for the purpose of ‘mapping’
and generally that will not be enough to resolve the issue. I had the second ablation a month or so later, and the EP specifically identified one area that was misfiring. The second one was successful.
When I had my second ablation, I was thinking the worst because of my horrible seven months following the first ablation. To summarize, six days after the first, I was in the ER and kept overnight while they started me on Amiodarone (AKA the drug of last resort). I was back in AF. The Amiodarone corrected my rhythm over night and I was released. Six weeks later, during the weaning off period where I was to stop the Amiodarone, I had to return to the ER due to AF appearing again. A month later, fully off Amiodarone, I was fine, even off metoprolol. Then, two months later, back in AF. I downloaded an EKG from my Samsung Galaxy 4 watch and attached it to an email to the Royal Jubilee Hospital's AF Clinic. The EP called me a few weeks later (nothing happens quickly in the vaunted Canadian 'free' health care system) and agreed that I had recurrent AF, and he accepted what my smart watch recorded. Didn't even want a propere EKG. Nurses were very pleased that he was that kewl with a mere wristwatch's indication. He agreed to try a second ablation, which I had three months later (only because there had been a cancellation).
This time, I got to the two-week mark before I had to rush to the ER. Same thing, a run of AF that wouldn't seem to self-limit. Except, while on a gurney, it eventually did. This time, on my own, and with four pills left over from the earlier Amiodarone, I commenced a 'loading dose' rate on my own advisement. When I told the ER staff, and I was still in AF 24 hours later, they were not dismayed and seemed to feel that my approach to self-medicate at least had a prior history that worked...so why not? Except the Amiodarone had not corrected my heart, so that was abandoned. They tried more metoprolol, and an hour later it still had not helped. Then, about 85 minutes later, my heart reverted. And stayed that way, but now taking metoprolol....again!
Okay, the main message here: We agreed at the ER that since previous attempts to cardiovert me had failed six months earlier over the holidays (this is now 14 Feb), another cardioversion was not indicated. When I related that to the Jubilee outreach nurse (who is an absolute goddess for her skills and patience), she said the ER internist was absolutely wrong. After each ablation, one's heart is essentially a new animal. If it gets cranky in the few weeks after an ablation, the correct resort is to cardiovert!! So, that was a miss for me. She also assured me, firmly, that this time my heart was fixed, the current run of AF notwithstanding, and that I should relax and have faith. Also, to resume 50 mg of metoprolol each day for six weeks, then stop and see what happens. Well, I do have faith in Lindsey Ward, and have told her so. I did what she advised, and am now post-Holter, off metoprolol for two months now, and the Holter showed no AF and no more PACs, which plagued me the first Holter last October.
AF will not kill you. Anxiety might. Almost everyone has a few PACs and AF for one, two, or three runs in the first weeks after a first or second, or a third, ablation. It's perfectly normal. They should self-limit, maybe even running 12 hours or more. When they get to the 24 hour mark, go to the ER and tell them you want a cardioversion because that is Job 1. If it fails, then confer with the EP and figure out if Flecainide or Amiodarone, or a bit more metoprolol might help. My guess, if my own history is an indication, is that you will suddenly find your heart tires of the game and flops back into rhythm.
Ablation is a big deal. It inflames tissue, and leaves scars (fibroids). The heart will be cranky, PO'd, just as any other organ would be if it had been kicked in the slats. Don't forget, that RF probe didn't grow in the left atrium. It was shoved through your septum and then wiggled around, touched to nice soft endothelial tissue, and then it got hot and burned all those lesions. You're bound to have the odd occurrence of arrhythmia.
So, don't fret. Especially if you feel the odd palpitation during the first month. If you get them later, at the eighth and twelfth week, that's a worrisome development and means that the procedure will have to be repeated.
One of the two administrators at afibbers.org had six ablations from three different surgeons, each a failure. He was in a bad way, finally heard of Dr. Andrea Natale, and how he has been AF-free for four or five years.
If an EP says his next step is a pacemaker, I'd run. Fast, and for about a full hour. Find another EP who knows what he's doing.
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3 ReactionsThank you , very encouraging.
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