Ablation in 2 weeks, looking for guidance and advice in preparing.

Posted by davidtrey @davidtrey, Sep 9 3:40pm

Hey friends ❤️,

I (44/m) have had AFib 4 times in my life. At 25, 30, 35 and most recently at 44 in July or 2025. After my most recent time, I was cardioverted in the ER and released that day. Like a dummy, I started an SSRI 2 days after I was home to reduce my stress levels. Wouldn’t you know it was a few days after that I had AFib again, and had to be cardioverted again.

After the cardioversion I was put on Amiodarone and had strong side effects including 90 hours of straight insomnia. I was then switched to Flecanaide with Diltiazem. Although I have major fatigue and brain fog from Flec, my heart is in a stable rhythm.

I was referred by my cardiologist to an EP and had my consult last week. He wants to ablate for AFib and also try to ablate for SVT since it was seen on a monitor I wore. He has noted there are small risks with each. I’ve been advised to stop Flecanaide and Diltiazem 3 days prior to the ablation, which makes me nervous I may convert back to AFib. I’ve been advised to call their office, not the ER, if I do find myself in AFib as they may want to see it when they ablate.

Looking for insights from folks who have been through a similar path as me. This whole experience has brought me a fair amount of anxiety and I’d be lying if I said i wasn’t nervous.

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

gloaming | @gloaming | Sep 9 5:01pm

Hi, and welcome to 'the fold'. We are mostly all arrhythmia students and sufferers here.
You WANT your heart in arrhythmia when you are wheeled into the cath lab. It's tougher for the EP to ferret out the bad spots with the rogue cells if you are in normal sinus rhythm (NSR) at the time of ablation.
I don't know how much you've looked into your condition, but AF is not lethal. It can be a royal pain, very unpleasant, and you may sense and know when it's happening. IOW, it's the symptoms that are the immediate annoyance and bother, not that your heart is fibrillating. Later on, left unmanaged, yes, AF can be a problem because it tends to progress to more advanced stages and can lead to other heart structure problems (officially called 'remodeling'). But you are still in the earliest stage, 'paroxysmal', and this is when it's easiest to treat, even if it's the hardest to locate. Fortunately, 90% of all early cases of AF are as a result of rogue firing cells found in the mouths of the pulmonary veins. Most EPs will do a pulmonary vein 'isolation' as a first crack at you.
If you'd like to learn more, and would rather watch and listen than to read a lot of articles, please consider going onto YouTube and typing, 'AFib Education Center' in the wide search field above all the videos that show. You'll get a real earful there.
Causes of AF:
a. ischemia (poor oxygenated blood supply to the heart);
b. too much stress (adrenalin and cortisol production over the 'usual' amount);
c. bad sleep, especially due to obstructive or central sleep apnea (a whole 'nuther subject for you to explore....AND be tested for); and
4. various 'triggers' which we all seem to have, and which we all have to discover for ourselves since we're all unique. Alcohol, caffeine, too little magnesium in the diet, too much fat, eating too much and getting indigestion or bending over with a full stomach, and the list goes on and on...

suerte | @suerte | Sep 10 11:07am

At least to my knowledge I had only one episode of Afib. Was on Eliquis instantly and Diltiazem then switched from Diltiazem to metoprolol. Had a cardioversion which last until 3 days before my scheduled ablation. Pulse Field Ablation performed at UC Health in Aurora, CO. While they were performing the PFA, they saw that I also had flutter in both left and right atria. During the PFA procedure they used drugs to induced some form of Afib so they could find the areas that were causing the spurious electric signals. They spent about an hour and a half doing ablations in the left and right atria. I had no real prep before the PFA. Continued on the Eliquis and metoprolol. They did do a CT scan the day before the PFA to provide an accurate map of the organs around the heart so the cardio team could be sure to avoid the organs. I was in recovery for about 2 or 3 hours and then was discharged. I was staying in a hotel and spent an extra before flying home. Since the PFA I was taken off of metoprolol and am only taking the Eliquis. One of the reasons for the Eliquis is my age number in the CHA2DS2-VASc scoring system. I am over 75 which gives me a +2 which puts me at a risk for stroke.

cstrutt52 | @cstrutt52 | Sep 10 7:22pm

I've had AFib for years. In 2024, I had 59 episodes lasting over 20 hours each. I finally had a PF ablation (Mayo Rochester). I don't know why I waited so long. It was a piece of cake. I had absolutely no side effects except for a bruise on one side of my groin for a few days (no pain). No headache. No bumps or lumps. I had to struggle to try to relax for a few days. I can now exercise and weightlift. I carry grandchildren around. I can have a drink and eat too much (once in a while). I had a few short (minutes) episode in the days following the procedure. This is common while your heart settles down. Just be positive. You might shave yourself before getting there (though they will do a good job at it) and pack some loose clothes to travel home in. I was in early in the morning and out shortly afternoon. 73M and had mine done in February. From your perspective, you get wheeled into surgery, you go to sleep, you wake up in recovery. If you are like me, you wake up not feeling like you had anything done.

nevets | @nevets | Sep 11 12:36pm

It's a very safe procedure. Are you having Pulsed Field ablation or Radio Frequency ablation or Cryo ablation? You may want to find out. Pulsed Field is the newest ablation technology, which is what I had in January. I think the prep may be the same for all three ablation flavors. Here's what happened to me: They shaved my groin in the area where the catheters were to be inserted and established an IV line in my arm. I was asked a bunch of medical history questions, then met with the Anesthesiologist who asked more questions. I was rolled into the Cath lab., which was very bright and really cold. There was a cheerful swat team waiting to hook everything up, including patches on my body. They started me off with an IV sedative (nice), asked me to breathe some oxygen through a mask and the next thing that happened, I was waking up in the recovery area. After some rest and a pee the nurse took me for a short walk. I got dressed and was discharged the same day. Although I was given the option to stay overnight. My post ablation went ok, although I always get constipated from anesthesia. I also experienced some coughing for a day or two and minor discomfort on the left catheter entry site. So far so good. No Afib just occasional ectopic heart beats, which have decreased with magnesium citrate (amazing). Fingers crossed things continue going well.

scottbliz | @scottbliz | Sep 12 8:43am

I am 4 days out from an ablation. Your description is exactly like mine. The only exception was a very sore throat and chest pain but it all only lasted 3 days. Day 4 is almost back to normal including the groin soreness The Dr. doesn't think my ablation will work because of all the scar tissue he had to work with. I will get the Watchman implant in 90 days after the heart heals. I was told it takes 90 days for the heart to heal and adjust. I am on 200 mg amiodarone and Eliquis and 50 mg of metaprolol because of all the scarring on my heart. Procedure was simple and with watchman I will go home same day also

gloaming | @gloaming | Sep 12 10:53am

In reply to @scottbliz "I am 4 days out from an ablation. Your description is exactly like mine. The only..." + (show)

In all likelihood, the sore throat was a result of the TEE (trans-esophageal echocardiogram) which is pretty much a given if you had RF ablation. Not that a person getting PFA would NOT get a TEE, but they're generally not needed.

lwools | @lwools | Sep 12 11:37am

In reply to @nevets "It's a very safe procedure. Are you having Pulsed Field ablation or Radio Frequency ablation or..." + (show)

Can I ask what state you live in?

lwools | @lwools | Sep 12 11:43am

In reply to @cstrutt52 "I've had AFib for years. In 2024, I had 59 episodes lasting over 20 hours each...." + (show)

I’m from Minnesota only live in Arizona. I’ve had atrial fibrillation for 3 years but only for a short time. I don’t want to go on a blood thinner but am taking Metoprolol 25mg. I don’t have high blood pressure but seems Cardiologist ythinkbyou should be on these meds.
I am finally going to see a cardiac Electrophysiologist to see about ablation!

scottbliz | @scottbliz | Sep 12 11:57am

In reply to @gloaming "In all likelihood, the sore throat was a result of the TEE (trans-esophageal echocardiogram) which is..." + (show)

yes that was what caused the irritation and hoarseness so it will pass.