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jimana
@jimana

Posts: 28
Joined: May 10, 2016

Should I consider ablation?

Posted by @jimana, May 10, 2016

jimana
79-year old male Caucasian
Excellent health and regular exercise with history of hypothyroidism. No history of cardiovascular problems. Vegetarian for 16 years, with excellent diet high in fruits and vegetables. No history of hypertension or cardiovascular issues until Feb 21, 16. Life-long boundless energy, almost never tired even after intense physical activity. Post-prandial glucose levels usually at mid- to upper 90s. Former runner with asymptomatic Bradycardia for 45 years. Resting heart rate has been from upper 20s to lower 40s, but immediately responsive on demand.

Feb 21, 16 – Sudden onset of A-fib after a meal. Ambulance to ER, Cardizem brought it under control.
Mar 3, 16 – Echo-cardiogram and treadmill, went into A-fib at end of treadmill but controlled with Valsalva.
– Echo normal (64% EF) and treadmill normal. Heart structurally and functionally normal.
Mar 25, 16 – A-fib. Controlled with Valsalva. Blood, EKG, X-rays normal.
April 25, 16 – A-fib for 10 minutes but controlled with Valsalva.
April 27, 16 – A-fib immediately following a meal while driving. Paramedics called. Pulse in 220 range. Administered Adenosine twice to stop heart. Paddles used three times before sinus rhythm and transport to ER. Blood, EDK and X-rays normal.
April 28, 16 – Next day cardiologist recommended pacemaker and antiarrhythmic.
April 29, 16 – Pacemaker implant and began 50MG Flecainide b.i.d.
May 3, 16 – ER with irregular pulse and BP 228/95. Clonidine and Ativan administered in ER.
May 4, 16 – Flecainide increased to 100MG b.i.d., and metoprolol 25MG b.i.d. begun.

NOW – Feel fine upon arising but within one hour after taking Flecainide and Metoprolol feel weak, dizzy, shortness of breath for two hours. Anxiety high during episodes. Otherwise can walk several miles on treadmill with no problem and BP goes down significantly with exercise. Can’t stand these chemicals and side effects. Looking for alternatives. Should I consider ablation?

REPLY

Welcome @jimana,
Thanks for the details of your very recent events. I can imagine that your anxiety is high. This is all so very new. A number of members have asked about ablation and others have shared their experiences. Check out this discussion https://connect.mayoclinic.org/discussion/i-was-just-diagnosed-with-svt-and-cant-seem-to-find-any/ where you’ll meet @martishka, @topaz @gonefishinmt.

Also see this discussion thread where @billmichalski @twptrustrek @jhoffmanj are discussing AFib issues https://connect.mayoclinic.org/discussion/good-morning-im-almost-66-years-old-with-infrequent-afib-and-on/

@colleenyoung

Welcome @jimana,
Thanks for the details of your very recent events. I can imagine that your anxiety is high. This is all so very new. A number of members have asked about ablation and others have shared their experiences. Check out this discussion https://connect.mayoclinic.org/discussion/i-was-just-diagnosed-with-svt-and-cant-seem-to-find-any/ where you’ll meet @martishka, @topaz @gonefishinmt.

Also see this discussion thread where @billmichalski @twptrustrek @jhoffmanj are discussing AFib issues https://connect.mayoclinic.org/discussion/good-morning-im-almost-66-years-old-with-infrequent-afib-and-on/

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Thanks so much for your help. Stopping my heart chemically and using the paddles to shock me three times made me convinced I never want A-fib again and will do anything to prevent a recurrence. I look forward to reading the advice and posts of folks more experienced than I.

Hi. I had cardiac ablation 10 days ago to try to elimi ate my A- fib. Im still scared it wont stop. Ive had two small episodes since that lasted 2-4 hours. Im afraid somehow ill set it off.

@nadine66

Hi. I had cardiac ablation 10 days ago to try to elimi ate my A- fib. Im still scared it wont stop. Ive had two small episodes since that lasted 2-4 hours. Im afraid somehow ill set it off.

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Welcome @nadine66,
I moved your message to this discussion that @jimana started earlier this evening asking about ablations. I look forward to @martishka joining this conversation to tell you about her experience with ablation.

Were you told that you may experience small episodes after your ablation?

Hi Jimana,
You are so fit, I am very impressed.. You sound like a strong and healthy person. That really works in your favour. And you want to get rid of the A FIB- What I don’t understand is what kind of pacemaker you have. I’ll just back up- I have had A Fib as well but it was accompanied by SVT – a rapid heart rate. In order to have a pacemaker I would have to have had my Sinus node ablated which meant that I would be pacemaker dependent. My heart would still beat if the pacemaker failed- at about 20 BPM. The idea is that by ablating the Sinus Node (the headquarters for your heart’s electrical system) you essentially have stopped the rapid heartbeat of SVT (up to 220 for me) I didn’t go that route and several years later began my journey with ablations. After 4 failed attempts I had a pulmonary vein ablation which cured me. The idea is that the rogue signal starts in one of the pulmonary veins. By ablating ( or burning ) around all the veins and the atria you create scar tissue so that when one of those rogue signals goes off it hits the scar tissue and dissipates. I couldn’t be happier with this solution. Most people have success after one or two ablations- I was an anomaly. And that shouldn’t discourage you. My only question would be whether or not you are still a candidate for an ablation since you’ve had a pacemaker. You would have to ask your dr about that. I can understand your fear of being paddled. I have had a lifetime of SVT (I was born with it). And when the episodes necessitated hospital visits I was sometimes told I would have to be cardio converted. I always objected, since I knew that with a verapimal drip, some calm thinking on my part, and a healthy dose of ativan I could convert spontaneously. That was true for me for over 25 years. I hope this helps you and I wish you the best. Try to remember that Afib is not a disease, and can be controlled. Good luck, martishka

@nadine66

Hi. I had cardiac ablation 10 days ago to try to elimi ate my A- fib. Im still scared it wont stop. Ive had two small episodes since that lasted 2-4 hours. Im afraid somehow ill set it off.

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HI Nadine.
You need to talk to your electrophysiologist. I;ve had 5 ablations and it is expected to have “episodes” after. Your heart has been prodded, probed and either heat or cold ablated. It reacts by beating erratically. After my PVA pulmonary vein ablation I had 3 months of some runs of tachycardia. some PVC’s. (premature ventricular contractions which are benign) and some AFib. it is all part of the healing. I know its unsettling but hang in there. It seems to me that 2=4 hours is a bit long and I would ask my dr. I had holter monitors at different points post ablation (2 weeks, 4 weeks, etc…) We also have an AFib clinic here with nurses and a pharmacist who are trained in that area) They have our charts and get to know you…. So I often called to review my symptoms and discuss what to do. Perhaps your hospital offers that service. But if not, I Would speak to EP
All the best, martishka

I’d suggest you consider what your cardiologist recommended, and I didn’t see ablation on that list.

@nadine66

Hi. I had cardiac ablation 10 days ago to try to elimi ate my A- fib. Im still scared it wont stop. Ive had two small episodes since that lasted 2-4 hours. Im afraid somehow ill set it off.

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Thanks for your response. I will check Into the info you suggested.

@martishka

Hi Jimana,
You are so fit, I am very impressed.. You sound like a strong and healthy person. That really works in your favour. And you want to get rid of the A FIB- What I don’t understand is what kind of pacemaker you have. I’ll just back up- I have had A Fib as well but it was accompanied by SVT – a rapid heart rate. In order to have a pacemaker I would have to have had my Sinus node ablated which meant that I would be pacemaker dependent. My heart would still beat if the pacemaker failed- at about 20 BPM. The idea is that by ablating the Sinus Node (the headquarters for your heart’s electrical system) you essentially have stopped the rapid heartbeat of SVT (up to 220 for me) I didn’t go that route and several years later began my journey with ablations. After 4 failed attempts I had a pulmonary vein ablation which cured me. The idea is that the rogue signal starts in one of the pulmonary veins. By ablating ( or burning ) around all the veins and the atria you create scar tissue so that when one of those rogue signals goes off it hits the scar tissue and dissipates. I couldn’t be happier with this solution. Most people have success after one or two ablations- I was an anomaly. And that shouldn’t discourage you. My only question would be whether or not you are still a candidate for an ablation since you’ve had a pacemaker. You would have to ask your dr about that. I can understand your fear of being paddled. I have had a lifetime of SVT (I was born with it). And when the episodes necessitated hospital visits I was sometimes told I would have to be cardio converted. I always objected, since I knew that with a verapimal drip, some calm thinking on my part, and a healthy dose of ativan I could convert spontaneously. That was true for me for over 25 years. I hope this helps you and I wish you the best. Try to remember that Afib is not a disease, and can be controlled. Good luck, martishka

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@martishka – Thanks for the interesting account of your journey. You are most fortunate that you have arrived at a solution. My pacemaker is “on demand” set at 60 BPM, so I am not dependent on it. I assume this means an ablation is still possible, but have yet to hear back from my cardiologist. BTW, I like your username 🙂

I posted my story just a few hours before yours – see JohnDL. I’ll add to this additional information based on what I understand is your situation (please understand I’m not a doctor). I had one ablation before the one that worked. The one that worked for me required the ablation to be performed in the left chamber. Since the doctor enters the heart thru the right chamber he “poked” a hole between the two chambers (it is something this group developed as I understand it). Check around as one must find a doctor who can do what you need done.

I had an ablation for a-fib and it has been great

Liked by nadine66

@johndl

I posted my story just a few hours before yours – see JohnDL. I’ll add to this additional information based on what I understand is your situation (please understand I’m not a doctor). I had one ablation before the one that worked. The one that worked for me required the ablation to be performed in the left chamber. Since the doctor enters the heart thru the right chamber he “poked” a hole between the two chambers (it is something this group developed as I understand it). Check around as one must find a doctor who can do what you need done.

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Thanks so much for the info. All Ive had to listen to has been Doctors who seem to take forever to come up with a plan, then not giving me info on the plan. Ive had 2 episodes since the ablation but very short and not as intense. But no word of a plan going forward. I guess i will have to insist on some answers. I have several other problems going on butt I can’t go into them right now I’ll get back to you as things move along thanks again for your help.

Never heard of an episode after the ablation think I willbe more observant the episodes are not fun

Thanks for the reply and my problems. I also have COPD diabetes and that seems to have an effect to what the doctors want to do and getting them to get together to discuss what the next plan of action should be has been a real trip. I’ve had two small episodes A-fib since I had the ablation. They have been less intense and shorter an hour or so. My problem is getting all the specialized doctors together to decide on the next plan of action if we should do nothing and see if it completely stops or if I’m going to have to do the ablation again. Once again thank you for your input.

@1pepper2

Never heard of an episode after the ablation think I willbe more observant the episodes are not fun

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Hi thanks for your comment I on the other hand have received a lot of
comments about people having to have the ablation two or three times. Until
they find the correct path whatever that means anyway they’re not too
forthcoming with information that’s why I got on the website and ask a few
questions I appreciate your comments and if you have anymore please I need
all the information I can get I have also COPD and diabetes and these
specialized doctors getting together to come up with a plan is a real job.
When they were going to do the operation they discovered I had an iron
deficiency. So that means another doctor in the mix. Wish me luck thanks
again.

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