Post Ablation Blanking Period...has anyone experienced this?

Posted by cece55 @cece55, Jul 28, 2023

Hi Everyone...This is CeCe55 and I have some questions and hopefully will receive reasurrances from some of you concerning the blanking period after my second heart ablation.

I had my second ablation on May 18th of this year and it has been a lot harder to pass through and heal than my first one. My first ablaltion was in May of 2021 and I was doing well for over a year and a half. Last year in December I started having tachycardia and heart flutters which would last all day and then convert to normal rhythm. I did not experience any Afib (I wear a loop monitor under my skin).
I had these episodes every 3 to 4 weeks. January, February, March....
By April I decided to go ahead with a second ablation. I had to use a second doctor for this ablation because my first doctor was not doing procedures at this time. No one would give me the reason why. The second doctor came highly recommended and I like him.

I am now entering my 11th week post ablation and will see my doctor on August 16th. The beginning of my blanking period started with very short bursts of tachycardia which I was told was normal. When I get tachycaradia, whether it is short or a day, the conversion to normal sinus rhythm is scary. There is a pause and I feel like I am sinking ...then it passes and all is well for several more weeks. My doctor is not concerned, but I haven't seen him in several weeks.

The question I have is has anyone continued to have arythmias this far along and graduated to full healing? Can the blanking period be longer than 90 days? I have gotten most of my strength back and am feeling much better. It is just these episodes that are still happening. My doctor said he had repair work to do from the first ablation...closing up scarred openings and ablalting areas that were not ablated the first time. Has anyone experienced these heart pauses and understand the symptoms I am experiencing?

I am pretty depressed that I might have made a bad decision with a second ablation and made everything worse. I didn't seem to have a choice, though.

Can anyone help me?

Thank you and bless you,
CeCe55

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

As a general rule, the blanking period is meant to terminate at about the 10 week mark, give or take, and the Holter monitor assessment should take place within three to four weeks afterwards. Also, any prophylactic drugs such as flecainide and metoprolol, should be terminated at or earlier than the end of the blanking period so that the Holter results are not confounded.

The literature I have seen suggests that experiencing the odd 'glitch' of PACs or AF, or flutter, and even some tachycardia, is best if it's in the first four weeks. If the first four weeks are good with NSR, but then odd runs begin to take place, this is generally a poor sign with a poorer prognosis. So, ideally, and empirically, a person who has some arrhythmia or tachy early after an ablation, and then the heart quietens down, is going to have a better recovery and will probably enjoy freedom from arrhythmia for quite some time. Later in the blanking period, and beyond, PACs and other problems usually mean something was missed.

I wish I could have provided more positive information, but you should probably not fret too much for the time being. Let your heart heal, and let the Holter say what it will say. And, it could still be that your heart needs time to settle down, and that it WILL eventually settle. Many report taking up to a year until they realized that they were fine and that their heart rate had returned to normal...finally...instead of the elevated 80 BPM in some cases, even higher. Your EP should contact you soon about the Holter, and ideally you will be off medication that alters heart function for about 10 days or more prior to that assessment.

REPLY

Hi CeC55,
I had a single ablation for AF & AFl in August 2020 and was experiencing frequent PACs and some atrial tachycardia for months afterward. (Also had a loop recorder implanted about 3 months post-ablation). The last bout of AT occurred about 7 months into that first year and I had a rate drop of more than 50%, causing that disturbing sinking feeling. As I understand it, your EP can select a more sensitive setting on the loop recorder to catch those rate drops. Such sudden drops might promote a more malignant arrhythmia.

The good news is that that incident seems to have been the last hurrah, and I have been in NSR and normal rate ever since. I have gone from 8,000 PACs a day to just a few hundred.😊

I wish the medical establishment would be more upfront about the true length of the healing process after an ablation. Everyone has their own timeline.

Hope this helps!

REPLY

Hi Thisnthat,

Thank you so very much for responding to my cry for help and understanding. I need to hear these positive answers and that everyone is different in how we heal. Bless you for adding hope to my day.

My EP has already selected the lowest setting on my loop recorder so that he can monitor me to the best of his ability. I was actually called in to town for a cardiology appointment even though I was on a beach vacation the week of July 4th. The device tech had read several pauses on my recordings and they wanted to talk to me and reassure me that they were not concerned. I just need to learn how to handle the sudden drops when they happen since they can be so frightening.

Thank you for understanding just what the sensation felt like and for relating your experience. I am hoping to add to this subject in a couple of months by saying all is well!

Cece55

REPLY

Hi Cece55,
It DOES help knowing someone else has experienced the same thing! There has been only superficial communication from my EP’s team, so it’s so nice to have this forum!
If I were to have a pause of 4 seconds or more, that would raise an alarm. But it’s all been good…there IS light at the end of the tunnel! 🤞

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