Me the morning of my catheter ablation procedure.
You just sign some papers and then they take a few vials of blood from you. I also had a chance to meet with Dr. Natale to ask any questions. I didn’t have any so I just told Dr. Natale to get a good night’s sleep and protect his hands between now and the morning. He got a chuckle out of that and assured me that my procedure would be pretty straight forward.
When we arrived at the hospital we were escorted to a temporary room where I disrobed and put on the hospital gown. The picture of me above was taken shortly after I put the gown on. A nurse came in to put my IV in and then the general anesthesiologist came in as well to give me the run down. A couple other nurses stopped by as well.
The EP Lab
Then around 7:15 a.m. they escorted me and my family to the second floor where the EP lab was. I hugged and kissed my family good bye as they went to the waiting area and I went to the EP lab. When I was rolled into the EP lab it was much different than I expected. I imagined this huge room with tons of computer monitors and lots of nurses and various staff. It wasn’t like that at all.
The room was much smaller than I expected and I only saw one giant computer monitor. And at that moment there were only a few people in the room – the three nurses that were prepping me for the procedure. Everything about the EP lab was totally different than I imagined. It was much more intimate and “understated” – and not nearly as hectic as I thought it would be.
The minute I was rolled in they went to work on me. They slid me from the bed I was on to a bigger bed and started putting patches on my back. Then they had me lie down on my back and within a few minutes they put an oxygen mask on me and told me to breathe normally. Literally a minute later the same nurse told me they were giving me the sleeping juice, as she called it. I had no idea they had even hooked anything up to my IV. That’s how fast and efficient they were.
Immediately After the Procedure
The next thing I knew I was waking up with a couple nurses and my family looking over me. It was the most bizarre thing I had ever experienced. One minute I was being told they were giving me sleeping juice and the next minute it was over. Two and a half hours had flown by but it only felt like a few minutes.
When I woke up I felt totally normal. Sure I was tired and groggy but there was no pain or discomfort. It actually felt like nothing had been done to me! I wasn’t even nauseous from the anesthesia which I thought I would be.
As luck would have it, we got the VIP room, which is the largest room in the hospital. I have no idea how that happened but it was a pleasant surprise as my family had all kinds of room to roam. We weren’t crammed into a standard hospital room.
The Urinary Catheter and 6-Hour Bed Rest
The first thing I did as I started waking up more was feel for a tube around my private parts. I was looking for my urinary catheter. As stupid as this sounds, I was more worried about the “pain” of having a urinary catheter removed than I was of the actual ablation itself. I fretted for days about it.
To my pleasant surprise, I couldn’t feel anything so I asked the nurse where my catheter was. She smiled as if she knew my concern and said Dr. Natale didn’t think one was necessary! How did I get so lucky? All that time I worried for nothing. Needless to say, knowing I wouldn’t have to deal with that made my day.
The other thing I worried about was the dreaded “bed rest” after the ablation. They want you to lie still for six hours after an ablation so the two holes in your groin where the catheters are inserted don’t open up and bleed. This turned out to be a complete non issue. For starters, I was so tired that all I wanted to do was rest anyway. I had no desire to move. I would have lied there all day.
I also found out that while they want you to lie still, you can still move your upper body. It’s not like you’re lying flat on your back looking up at the ceiling with your hands to your sides for six hours, which is what I had imagined. They just don’t want you moving your legs or doing any twisting or turning. Like I said, it was a total non-issue as I just lied there and watched TV and occasionally drifted in and out of sleep. The six hours flew by.
The only discomfort I had during the bed rest was my throat was incredibly dry, scratchy, and sore. They said that was from the breathing tube they put down your throat during the procedure. I’ve never sucked on so much ice before and Popsicles never tasted so good!
A Temporary Set Back
Just as the mandatory bed rest ended, something came over me. I was partially sleeping when all of the sudden I felt nauseous and light headed. My blood pressure dropped dramatically as well. The nurses came in and gave me some medication through my IV to help with nausea and something else for inflammation. During this whole ordeal I had to go to the bathroom really bad as well so my wife had to help me out. I swear I filled the entire jug they gave me to pee in. It was a total Austin Powers moment.
The nurses also called Dr. Natale to come by and check on me. By the time he arrived, which was only about 10 minutes later, I was already feeling better. He looked me over briefly and said everything was just fine. He assured me not to worry. Ten minutes after he left I felt totally fine again. This whole thing only lasted about 20 minutes.
The Elephant on My Chest
For the next several hours I felt great – aside from the dry scratchy throat. It wasn’t until the late-night hours that things started taking a turn for the worse. I’d say around 11 p.m. I started having some noticeable chest discomfort. It felt like someone had a belt tied around my chest and was pulling it tight. And yet at other times it felt like there was a balloon in my chest and someone was blowing it up really big. Eventually it just felt like an elephant was sitting on my chest. There was no pain whatsoever. It was just a major annoyance and because it was so uncomfortable I couldn’t sleep at all.
The nurse on duty was giving me medications for inflammation and at 4 a.m. she had me get up so she could weigh me. I was five pounds heavier than I was prior to the ablation (183 lbs. vs. 178 lbs.). Obviously I was experiencing some fluid build up which is totally normally after this procedure. The nurse gave me Lasix and potassium at this point.
By 6 a.m. I finally started feeling a little better and was able to drift off to sleep for an hour and a half. At 7:30 a.m. there was a nurse shift change where I was given another round of medication and my vitals were checked. Shortly after Dr. Natale stopped by to do a final check up and to essentially say good bye.
I was originally scheduled to be discharged at noon but the staff was way ahead of schedule. Had my wife been there to take me home I could have left as early as 9:30 a.m. My wife and kids arrived at the hospital at 10 a.m. and we officially got discharged around 11 a.m.
Overall Impressions of My Experience
All-in-all the ablation was far easier than anything I had imagined. I worried about so many stupid things – mainly things about pain. I didn’t want to have ANY pain and I didn’t. I’m still shocked that you can have a heart procedure like this and not have an ounce of pain. Sure I had a sore throat and some chest discomfort but even a wimp like me can handle that. If I have to have another ablation I won’t have a worry or concern in the world.
I also want to say my experience at the Texas Cardiac Arrhythmia Institute at St. David’s was nothing short of amazing. Every hospital and clinic (and every business for that matter) should take a lesson or two from them. Every single staff person I came into contact with was super friendly and helpful. They were all genuinely concerned about me. My every need was met and then some.
And of course my experience at St. Davids wouldn’t be complete without talking about the maestro himself, Dr. Natale. He was kind, gracious, and just a genuinely nice guy. And the fact that he told me I had a very good chance of being an “one and done” candidate only makes my opinion of him higher than it already was!
What About My Atrial Fibrillation?
As someone with paroxysmal atrial fibrillation I wasn’t always in afib. As luck would have it, my last episode prior to my ablation was on February 3rd. As a result, I was in total NSR the day of my ablation. I was in NSR immediately after the ablation and continue to be so as I write this post. I didn’t even have a single heart palpitation after the procedure nor have I felt one yet. My heart’s performance felt exactly the same after the ablation as it did before – nothing but solid NSR!
The true test for me won’t be until June when the 3-month blanking period ends, the time it takes for your heart to fully heal after this procedure. I suspect I’ll have occasional runs of a rapid heart beat or even some quick bouts of afib during the blanking period as that’s totally normal. I won’t really know, however, if the ablation “cured” me until the year unfolds. Prior to the ablation I was experiencing afib every 2-4 weeks. We’ll see what happens after the blanking period ends.
The only difference in terms of my heart’s performance after the ablation is the rate at which it beats. Prior to the ablation I had a resting heart rate of 52 beats per minute. Immediately after the procedure my new resting heart rate fluctuated between 80-90 beats per minute. That might sound like a dramatic increase, and it is, but I didn’t notice ANY difference at all. I was actually shocked to see my new resting heart rate was so high because I felt exactly the same as I did when it was 52 beats per minute.
I’ve been told this will decrease over time but I will likely always have a slightly higher resting heart rate after the procedure. This is actually good news for people like me who have bradycardia. While I never had issues with such a low heart rate, I was never comfortable with it. If my new resting heart rate settles in the 60’s I’ll be perfectly happy with that!
What About Drugs?
Most people that have an ablation need to be on a daily anti arrhythmic drug such as Flecainide to help keep their heart in NSR during the blanking period. However, since I was taking Flecainide only “as needed” (i.e. pill in the pocket) prior to the ablation, I didn’t need to take it daily after the procedure. Of course if for some reason my heart starts misbehaving during the blanking period, there is a chance I may have to take Flecainide daily but for now I don’t have to.
The only daily medication I’m on right now is my anticoagulant, Eliquis. I’ll be able to stop taking that after the blanking period if my heart has been in NSR for the most part during the blanking period.
Hi Travis. You’re such a kind soul to keep up this blog and help so many people! I never thought I would consider an ablation, but now I am thinking about it. My afib has gone from a few episodes a month to nearly every day, and sometimes several times a day. I have a few questions.
1. Did you have to take antibiotics after the procedure? (I have a history of c-diff and am not allowed to take them.
2. How long did you stay in Texas after your procedure and how soon after an ablation are you allowed to fly?
3. I literally have no family and would need to fly from NY to Texas. Can I have this procedure with no one there to watch me after discharge? That’s the scariest part for me. Any ideas what I can do?
4. Are you still taking anti-coagulants?
5. Which anti-coagulant did Dr. Natale put you on prior to your ablation?
6. One last silly question… you have to lie still for six hours after the ablation. What if you have to pee??? I’m female and can’t just pee in a cup… guessing I’ll have to have a catheter?
Sue,
If I may offer some thoughts on your questions while we wait for Tarvis to chime in, first thing I would suggest is for you to seek out a local EP surgeon in your area. I have no doubt that Dr Natale is every bit as wonderful as Travis says he is, but there are hundreds, if not thousands of highly qualified doctored across the country, there must be one in your area. I like my Dr every bit as much as Travis likes his, there are lots of good one out there.
The inconvenience and expense to need to fly across county to have the procedure would be staggering. A round trip air fair, rental car for at least several days, hotel room for at the very least several days, etc. You would need a room a couple days in advance, the lab work is usually done the day prior, and the day of the procedure you have to show up three hours before the procedure.
You would be released the following day and would need someone to drive you back to your room, you won’t be allowed to drive for 24 hours after the procedure. Then you will need a follow up appointment two to three weeks after the procedure. Are you going to stay there that long, or fly home and back again? What if you need follow up procedure as I did? On my follow up appointment it was discover that I needed a cardiac aversion, a fairly simply out patient procedure which was schedule for a week later. Then you would again need someone to drive you, you still can’t drive for 24 hours. I had my procedure on Sept 30th, the second procedure on Oct 22nd, and it’s now Nov 4th, and I have my next follow up this Friday, Nov 8th. I’m still not done making follow up visits. No big deal for me, but I would hate to be commuting across country for all of those visits.
I live in So Calif, my doctor is Dr Kim at Riverside Community Hospital, a 20 minute drive, no airfare, no hotel, no rental car, and I can visit him any time with a short drive. You’re in the NYC area, there must me a large number of qualified EP doctors in your area. Save yourself a lot of hassle and a lot of money and investigate a local Dr., some one you can see for your future visits.
As far as a bathroom visit after the procedure, I was in a recovery room with two beds and a bathroom right in the room. The nurse will help you up and guide you to the bathroom ten feet away, and your home free.
Good luck…
Don:
Thanks for all your updates and thanks for replying to Sue. How are you doing now a few weeks past your ablation? Great I hope!
I just want to reply to your comments so people have the full picture here. While there are indeed many great local EP’s, there are only a handful that truly have the skills and experience to provide a long-lasting, durable ablation. I am living proof of that. I have been 100% afib free without any drugs for well over 4 1/2 years now. I should also point out that I live a totally “normal” life. I don’t eat any kind of special “heart healthy diet” or anything like that.
I can provide similar testimonials from others that have been ablated by these rare elite-level EP’s. Unfortunately, it is extremely difficult to ablate afib. It’s not like having your tonsils taken out where any surgeon in your local hospital can do it with ease. Successfully ablating for afib is more akin to neurosurgery. It takes a special skill set and extensive experience.
I encourage anyone considering an ablation to read this post:
https://www.livingwithatrialfibrillation.com/1980/considering-an-ablation-to-treat-your-afib/
Having said all this, that doesn’t mean you can’t have success with a local EP. It just means that you have a far less likely chance of nipping afib in the bud after one ablation rolling the dice with a local EP. I get dozens of emails every month from people who have had failed first ablations because they settled with just any local EP. And by fail I mean they are back in afib just months after their ablation and are looking at a second ablation so soon. Again, I encourage everyone to read the post I have linked to here in my comments. It puts everything I’m talking about here in perspective.
If you can travel to be treated by the best, then you should do it. But if your circumstance doesn’t allow that for whatever reason, then just make sure that your local EP is the absolute best one you can find! And by “best” I mean someone that has at least 1,000 ablations under their belt and that’s even below the bare minimum that I would look for myself. Personally, I’d want my EP to have at least 2,000 or more ablations under their belt with most of those being for complex cases of afib.
Travis
Hello Travis and the rest of you ‘fibbers….
I just celebrated my one year anniversary on Sept 30 and I’m happy to report everything is going great. On my first check up after surgery I was informed that I was in NSR for two weeks and then I had an episode of afib again so I went back in for a cardio version, which was successful and I’ve had no problems since. My last check up the doc said the condition of my heart had improved, it had actually gotten better. I was cleared to resume all activities.
I am back to my former ADHD lifestyle of old with boundless energy, constantly on the go and no running out of breath. I was up at 5am this morning, washing and detailing the car before the sun came up and then took the dog for a walk. Not too bad for a give out old guy..! I still can’t believe the different the surgery made in my life. Hopefully things continue this great for a long time to come.
My last trip to the Dr. I gave his nurse the address to this web site in case any patients scheduled for ablatsion might want to see what others have experienced. I know I wish I has seen it before my procedure.
Thanks for the great, informative forum and good luck to everyone here.
Great doctor in NYC at Mt Sinai..Dr Reddy..one of the tops in the country… no need to go to Texas.
You’ll be on Amiodarone of about 3 months after ablation..get off as soon as you can… bad drug.
They may want you to be on anti coagulant for extended amount of time, but I made them stop after 2-3 months…Eliqus is the drug of choice for me it was.
I made them take the catheter out immediately after I knew it was in, I mean moments after I awoke from ablation… I laid in bed about 4 hours maybe 6 not sure… I didn’t need to urinate till I got out of bed, but keeping the catheter in is recommended.
Sue:
Thanks for your comments. Here are my answers to your questions…
1. I wasn’t on any antibiotics before or after my ablation.
2. I stayed in Texas for a full week “just in case” but I could have flown home a couple days after my ablation. I don’t know what Natale’s “official stance” is on this but I think he’d tell you to plan on being down there for at least 2 full days after your procedure. I planned for a worse case scenario so I literally stayed an entire week after my ablation. I also made it a mini vacation of sorts as I took the family with me so it wasn’t strictly a “medical trip.”
3. That is entirely up to your comfort level. It would ideally be best to have someone there with you. Having said that, if you have no other options you could do it as you could always call for a taxi or an Uber if you needed to get to the hospital for anything. I think it would be a bit stressful and anxiety driven if you went alone. I probably would NOT recommend you go it alone. You mentioned you were in New York. I’ve got a recommendation for you following the answers to your questions (see below).
4. I stopped taking anticoagulants 2 months after my ablation. I haven’t been on them since.
5. Eliquis
6. Natale’s practice now uses collagen plugs. What that means is they inject collagen in the insertion points in your groin area where the catheters go. You only have to lie there for about 2 hours now so no foley catheter is required!
My NY recommendation: Since you are in NY, you might want to consider seeing Dr. DiBiase. He was trained by Natale and they work together to this day. You might find this post inspirational (a woman from New York was successfully ablated by DiBiase and Natale):
https://www.livingwithatrialfibrillation.com/3168/ilonas-afib-ablation-experience/
If you’d like to make an appointment with DiBiase let me know. Please contact me privately via my contact page. I can put you in touch with someone that can get you in. Best of luck to you!!
Travis
P.S. Please see my reply to Don’s comments to your questions. I want to be sure you have the full picture here:)
Caffeine or not? My cardiologist said no caffeine, dr to do catheter ablation said, Go ahead and drink caffeine. Just don’t overdo it. I take Eloquis, 150 mg. of metropolol succinate, and isoscibe monontrate daily.
does anyone know the answer to this?
I was told that caffeine, chocolate, and cola could be a trigger to afib. I just gave it all up although once in awhile indulge in some chocolate and recently read that milk chocolate is better that dark chocolate for afib patients
I wish I would have discovered this site a few weeks ago. I’m scheduled to go in for ablation in two days and being a devout coward, I’m looking foreword to having it behind me.
I have had AFib for about 5-6 years, I guess? Had a pacemaker installed five years ago.
Why did I say 5-6 years I guess? Because I have never had an AFib episode to my knowledge. I’m told I’m having them, just never had a symptom so I never knew it.
Many of the stories I’m reading in here, people talk about how the person experiences AFib. Everyone seems to know when they occur but I don’t?
Because of a recent move, I have changed cardiologists 3 times in the last 5 years. The first guy I thought the world of, but now with more knowledge, I’m not so sure about him. He was the one who installed the pacemaker. The second guy was only used for a few months after the move and before I was established. The latest guy I like very much, he’s young and very knowledgeable. He has all of the equipment. Most Dr’s send you to a lab for different tests, he has it all in his office. He requires an EKG on every patient on every visit before he sees you. He wants up to the minute information.
The first visit he hooked me up and informed me that I was having an episode right then. That was news to me, as I stated earlier I have never had and symptom or knowledge of AFib taking place?
Next came the 24 hour monitor, after which he informed me that I was in AFib 50% 0f the time? He also stated that if he had been my Dr 5 years ago when the pacemaker was installed, It would have never have been installed.
So he gave me the option of trying different drugs, but I didn’t want to waste months experimenting and went straight to ablation, even though I’m not thrilled with the idea of what the procedure entails.
So, bottom line, my question is, why does everyone but me know they are in AFib? Is that unusual or is the DR just behind on his Ferrari payments?
Thank you and, great forum….
Don:
How did your ablation go and how is your recovery going? Regarding your question, there are a percentage of afibbers that don’t feel it. It’s called “silent afib.” My dad had it. It’s not uncommon. I hope you’re doing well!
Travis
Tomorrow will be two weeks since I underwent the procedure, so I’m well on the road back to normal. All of the fear and worry were for nothing, but I sure hope that was the first and last time I get to do it. I read in here some have had it done several times and I’m hoping I’m not one of them that requires several trips.
The doc came by to visit while I was getting prepped and told me again exactly what they were going to do. I asked him how long ti takes and he said his part was only about an hour, but that it would be about 6 hours total with prep, the procedure, and recovery time.
I went under about noon and the next thing I knew my wife was shoving a juice box straw in my mouth about 4pm.
I felt great the rest of the day, and the next day I was ready to take on the world, no effects at all from the procedure. The doc came by about 6:30am the next morning and I told him I felt so good that I was convinced that he hadn’t even shown up the previous day. I was released about noon the second day.
The next day I woke up and wondered if anyone had written down the license number of the truck that ran over me, I was really hurting big time.
With the help of some pain pills I got the pain down from a 10 to just being uncomfortable by that evening. since then I have had some minor chest pain, burning sensation, not really painful but uncomfortable. That has now gone away and I’m feeling good. My wife is a drill sergeant, won’t let me do anything, can’t wait to see the Dr and have him call her off..!
I go back to see the Dr in a few days and see what he has to say and find out how I’m doing. I do think I’m not experiencing the shortness of breath I was before, but I’m been taking it pretty easy so haven’t done too much that would cause shortness.
Wife asked me if I noticed less shortness of breath and I told her, if you have shortness of breath, you notice it. If you don’t have shortness of breath, you don’t notice it..! If something hurts, you notice it, if nothing hurts, you don’t notice it, so I guess at this point, it’s all good.
I’ll give another update after I visit the Dr. I’m going to give his nurse the address to this web site, something I think his future patients might wish to read to calm them.. Facts from those that have been there is a good thing….
gb
This is a really good article, especially since it focuses on “silly” things like pain management, Foley catheters, etc.
I’m going in for my ablation on August 7, 2019. I’ve already had three (yes, that’s right, three!!) ICD implantations for V-fib, which is a whole lot worse than A-fib, so I’m not a wuss, but the ablation still makes me nervous.
Like many people here, I’ve had many episodes of A-fib, sometimes for days. And now that I’ve schedule the procedure, of course the A-fib episodes have stopped! I’ve come close to cancelling so many times but all the doctors said that A-fib never goes away, it just comes back so much worse.
Besides hoping that I make it through the surgery, I’m terrified of laying on my back for so many hours with a catheter in my groin. And I’ve had the bladder cancer tests before where they put the camera inside your you-know-what, and that’s a pretty bad experience. So I hope I don’t need that catheter too, or at least I hope they do while I’m knocked out.
I wish this whole thing was behind me already. But thanks for your story; it helped calm my fears.
David:
You are one tough guy! I totally understand your fear of the dreaded foley catheter. They are man’s worst nightmare…lol. You might want to check with your doctor and ask if they are using collagen plugs by chance.
The top EP centers are now using collagen plugs so the foley catheter is no longer needed! Furthermore, the plugs allow you to get up and move around just a couple hours after your procedure. They basically put collagen in the catheter insertion points after the procedure which allows you to get up and move around so quickly.
Even if your hospital isn’t using collagen plugs, the whole “6 hour wait” is not a big deal at all. You won’t even notice it. I was very concerned about it as well but it was a total non-factor. For starters, for the first couple hours after your procedure you’ll be so tired that all you’ll want to do is rest.
Second, you don’t have to lie totally still like a man in a coffin, which is what I thought was the case. You just can’t bend your legs so you can still move your upper torso up and down with the aid of your bed controller.
Finally, the 6 hours goes by so fast that you won’t even notice it. Like I said already, the first couple hours you’re so tired and “out of it” that all you want to do is rest anyway. Then the remaining time you’re just lying there watching TV or resting more visiting with friends and family.
I wish you a successful ablation. Please keep in touch!
Travis
Travis, thank you so much for responding so quickly. I already printed out your suggestion about the collagen plugs. I hope they can use the procedure.
My surgeon is one of the top EPs in New York City so I think I’m in good hands. And I’ve always come out of all my surgeries feeling much better than I originally dreaded. After the first one in 2000, I was so drugged-up that I thought I was on vacation!! And believe it or not, the ICDs didn’t hurt. I just felt like I was on the losing end of a fight, but no sharp pain or anything.
I had knee surgery a few years ago and the doctor gave me opioids to control the pain. But I didn’t have any pain! I took a Tylenol and that was that. If you saw a picture of me, you’d be surprised that I have any health problems at all. People always say, “You look like the picture of health. Are you sure you have a heart issue?!”
David:
Terrific! Given your history of successful surgeries, this ablation should be a walk in the park for you. Keep us posted and I wish you a quick and speedy recovery…and no Afib afterwards!!
Travis
Dear Travis, it’s almost two months since my ablation. I’m feeling about 90% better, occasional A-fib episodes. My doctor said that it’s common during the blanking period. Unfortunately, I had a pretty rough time for the first two weeks after surgery. Quite a bit worse than I hoped or expected. The procedure lasted nearly five hours, and I had a bad time with the anesthesia. The doctor is very optimistic that the procedure was completely successful. I’m glad it’s all behind me.
I noticed that there’s been activity on your blog, so I thought I’d chime in! It is now three months since my ablation, and I feel great. I haven’t had any a-fib episodes for a month, and it’s almost like nothing happened. As I mentioned previously, the first week after surgery was pretty rough, but now I can barely remember. I was on Xarelto for three months. Other than baby aspirin, no more anticoagulants. One of the commentators on your blog mentioned New York City; my surgery was done at Montefiore Hospital in NYC (the Bronx, to be exact) by the Chief Electro Physician, Daniel Wang MD. He is really great, takes his time, good bedside manner. Thanks again for this forum.
I have persistent AFib. I never knew I had it until I had a stroke. I was very fortunate as I was administered TPA soon after and all my paralysis was gone. It was then they found I had Afib.
While in the hospital they realized my heart was beating too low at night so I had a pacemaker put in. It has been 5 years since I was diagnosed and have had 6 cardioversions and two ablations, and after the last ablation I was only in sinus rhythm for 6 weeks.
I am now waiting to hear what is the game plan as I was told no more ablations. I think it is medications but have taken Tikosyn which stopped working and now I’m on Amiodarone and Diatiazem but I know it is not a good long-term medicine. I also take Warfarin for my blood thinner. Any suggestions?
Vonna:
Sorry to hear about your struggles with afib. Glad to hear you recovered from your stroke!
Given your history I HIGHLY recommend you consult with the very best EPs you can find. If you’re willing to travel to be treated, contact me via my Contact page and I’ll give you some names.
There is no reason you can’t have another ablation but the key thing is that you have your next ablation done by a true elite-level EP. There are only a handful of these types of EPs so it will require you be willing to travel to another state (most likely).
Travis
Hi Travis thank you for all your great information. Although it’s been a few years since you had your ablation I was just wondering how you are feeling these days. I am scheduled to go for my first ablation in January 2019. I have paroxysmal A-fib and right now I get an event maybe once a month which does respond to my meds. The problem is you just don’t know when it’s going to pop up. When I’m in afib I’m ready to go for the ablation.
And now that it’s been silent for a while I’m getting cold feet. My question is, has anyone come out with additional problems after their ablation? My fear is coming out with worse situation than I’m going in with.
I do have an excellent EP doctor on Long Island at Saint Francis Hospital. I guess I am just second-guessing myself. I do live a fairly normal life dealing with this AFib but would like it of course to go away forever. I guess that’s everybody’s ultimate goal. I know I will be anxious before and after the procedure and I’m concerned about the pressure on the chest feeling?
I would think I was getting a heart attack if I start feeling that tightness and pressure on the chest. Hopefully it won’t be too bad. I know I am overthinking this… trying to keep busy with the holidays I’m trying to put the ablation out of my mind for now. Thank you for your honest support.
Chris:
I completely understand what you’re going through right now. It’s extremely common. I went through the same thing – always second-guessing my decision to have the ablation. Like you, my afib went silent after I made the appointment to have an ablation. It seems to work that way. You make the appointment and then suddenly the afib goes away. Don’t let the beast fool you, however!
I almost made the mistake of cancelling my ablation. About three weeks before my ablation I was going to cancel it. Fortunately, a good friend of mine convinced me otherwise. If I would have cancelled my appointment that would have been the biggest mistake. I’ve been afib free now for over 3 1/2 years now – and no meds either! Aside from my battle with PVCs and PACs, which have been gone now for over a year, I didn’t experience any negative “side effects” from the ablation.
You need to remain confident in your decision and just plow forward. Trust in your doctor and your decision! If you cancel your ablation I can almost guarantee you your afib will return:( You’re doing the right thing.
Travis
Travis, are you still in NSR in 2019 and do you still experience those pains – I believe they were PVCs and PACs? My husband has persistent, long-standing a-fib but had one catheter ablation over 2 years ago which was 100% successful with no meds. He just went back into afib. He is 50 and is awaiting the prior specialist in Calgary that he saw (very skilled). They say that a second ablation can take care of this once and for all. I hope the afib clinic is right! TY!
Mary:
I am still in NSR. It’s been over 3 1/2 years now (knock on wood). I haven’t had PVCs or PACs for the past year. However, I have had some battles with PACs in the past couple weeks but that’s because I’m on a calorie restricted diet in my effort to lose weight. Whenever I don’t eat enough over a long period of time my heart gets “jumpy.”
I wish your husband well and I hope his second ablation puts the beast to rest for good!
God Bless,
Travis
I had my ablation in January 2018. I went back into A-fib 10 days ago. My choices are another ablation, cardioversion, or meds. I have to speak with the doctor who did the ablation. I’m back on Eliquis and Digoxin until a decision is made. I’m confused.
Stewart:
Sorry to hear you’re back in afib. I’m bias given the success of my ablation but I would definitely have another ablation before I’d rely on drugs the rest of your life. Just be sure if you go down that route you go with a highly experienced EP! If you’re willing to travel, you should see Natale down in Austin, TX. He’s the best EP you’ll find. I flew across the country to be treated by him.
I wish you well.
Travis
Thanks Travis…I’m seeing the EP tomorrow morning… will make a decision soon… Think I want the cardio version first… if that doesn’t work, then I’ll do another ablation…Thanks for heads up referring to Natale… I may consider it in the future if CV is not successful…Thanks Stewart
Wow happy I found this site! I have been thinking gee I wish there was a site or support group for afib people. Talking to non AFIB people they don’t get it in my opinion. I am having my second ablation April 16th in Minneapolis, MN. My first one was done in June 2017. I have been on the AFIB journey since 2014. However, I have experienced premature beats and bothersome flutters since 2008 and was treated with Metoprolol.
During my journey I had a cardioversion and then went to pill-in-pocket with Flecainide. As time went on I developed horrible side effects. I felt so great after the ablation and it was with tears in my eyes I drove to my EP appointment (two hour drive) as a follow up to the E.R. and overnight stay last week. I wanted to have a cardioversion and they wouldn’t do it and instead tried to lower my heart rate with diltiazem.
E.R. visits are the worst because they ask questions about triggers like are you stressed, etc. I teach yoga, Pilates, do meditation, watch my caffeine and none of it makes a difference but after reading about magnesium and potassium I learned I should supplement more. I also need to reread about the different ablations that can be done. I got kinda lost. I now get a lot of PACs and prior to the AFIB I had atrial flutter (that’s what the doctor said).
I get anxiety after my episodes and PACs are driving me crazy. While I don’t like the thought of another ablation, I look forward to the calmness. I am back on Flecainide with bad side effects – headache, “cotton mouth,” overall sluggishness, and more anxiety. I use essential oils and am grateful for their help but I’m looking forward to the ablation.
Violet:
I don’t know if you know this but I live in the Twin Cities. Can I ask you where you had your first ablation and where you’re having your second ablation?
I hear you about the E.R. It’s NEVER fun going to the E.R.
You mentioned that essential oils help you. Can I ask you how they help you and what specific essential oils you use?
I wish you a successful second ablation!! Hang in there. It can only get better, right?
God Bless.
Travis
Hey Travis,
Great blog! My experience was similar to yours. I had mine done 5 weeks ago. I had a checkup 2 weeks ago and everything so far is fine. I have to go back in 4 weeks from now. I am on Eliquis and Amiodarone 200mg per day. I started off with 800mg per day and was feeling highly agitated so the dose was reduced. If at my appointment I am still in NSR I will be taken off the amiodarone.
Yes, the laying in bed for 5-6 hours is a little uncomfortable, especially a guy like me who always has an itch to scratch. The most annoying part for me was that I was catheterized. When I woke up from the procedure, the first thing I said was I have to pee. They said, “Don’t worry about it. We have that covered.” He showed me a jug with a string attached. I said, “I have a catheter in me?” I begged them to take it out as that is a fear I’ve had for many years. They took it out immediately.
I tell you the truth, if I knew they were going to do that I would have never gone through with the surgery. I wish I would have read your blog prior to my procedure because I would have demanded no catheter. The first pee was quite painful and long. For the next few days I was peeing every hour for 24 hours a day. Now sometimes I pee normally like every 5-6 hours or it can be some days again every 2 hours. This was the most upsetting part of the whole ablation. I will be going to my urologist next week to see what is causing this unusual urinating cycle.
P.S. I am also treated for PVC’s and I am on Atenolol 25mg per day. Thanks again for your blog!
Stewart:
Glad to hear things are going well so far after your ablation. I’ve got some good news regarding the urinary catheter and the whole lying still for 6 hours ordeal. One busy afib center is currently testing collagen plugs. These are plugs they insert where the catheters go in. They are made of collagen so they “absorb” into your skin. They don’t need to be removed. They allow you to get up and walk around just 2 hours after your ablation! More importantly, they allow you to skip having a urinary catheter. So far the testing has been going really well and will be available to all patients at this center likely as soon as this summer. When that happens, I suspect afib centers across the country will slowly start to use them. Within a couple years they will be standard (I’m guessing).
Travis
I had a plug put in when I had an angiogram in 2012. It made my abdomen cramp for awhile, but other than that it was okay. I think I would rather lie still though if I had a choice.
I am so impressed with your blog. After so much pointless searching through articles that were written so long ago, they are barely true…finally, a blog that breaks it all down in a common but educated language. I love reading your posts. They truly calm me down. I was wondering how long it’s been since your ablation and how you are feeling now?
Thanks for your kind words! I had my ablation in March 2015. It’s been just a little over 2 1/2 years now. I haven’t had a single episode of afib since:) Other than my off and on battles with PVCs and PACs, I feel awesome! In your other comment you mentioned you have an appointment with Natale. Your outcome could be the same as mine so chin up! Have a great day and God Bless!
Travis
I had my ablation at Duke Medical Center and was very impressed with everyone I met at Duke. My ablation was successful and I felt great for about 8 months when my afib came back. I was a little disappointed but my doctor had told me that more than one ablation is not unusual.
I had no pain from the procedure and went home the next day. My doctor was Dr. Bahnson who has been preforming this procedure for many years. I highly recommend Duke because of their quality of care and professionalism. I am planning on a second ablation in the spring.
I’m new to AFib (4/28/17). It was discovered when I was at the clinic for a cough/respiratory situation. What has me concerned is that the cardiologist immediately wants to do a cardioversion with a pacemaker looming in the not too distant future. I’m a member of Kaiser Permanente in So California. I declined the above treatment after doing some research on my own and discovering that the suggested treatment is somewhat the last resort – not the first.
Question is: Can anyone enlighten me on what to expect – alternative treatment, supplements, etc?
Frankiez:
A cardioversion makes sense as a short-term fix. If it works, it will reset your heart and get you back into normal sinus rhythm. How long you’ll stay in normal rhythm is unknown. The key thing to know is that a cardioversion is only a short-term fix. I’ve had 4 myself over the years.
A pacemaker to control your afib is the absolute last resort option! You may be able to control your afib or at least manage it for a while with drugs but if you want a long-term fix, an ablation is the best option.
Don’t let any doctor tell you that you’re too old for an ablation! An experienced EP can do ablations on people as old as 90. You have the best ablation doctor in the world in your state – Dr. Natale. He practices in San Francisco.
If you were m dad, I’d tell you to see Dr. Natale and have an ablation.
I wish you well!
Travis
P.S. Supplements can help manage afib (specifically magnesium) but they will not cure you of your afib.
Travis,
I found your site when I was preparing for my ablation and I cannot thank you enough of the information on here. It certainly made the procedure more tolerable knowing what was going to happen.
I have had persistent afib treated with drugs for quite some time; the last 5 years on Tikosyn. Recently it stopped being effective and I actually had a scare in the middle of the night where I passed out so we could not mess around any more. My ablation was scheduled for this past Monday and all indications are that it went well.
I was in the hospital overnight and went home yesterday by 9:30 am. My experience was similar to yours in that there were few issues and my biggest concern was actually urinating on my own after being catheterized. I was treated for Afib and Atrial Flutter so my operation was 6 hours so they had to catheterize me.
I hope this ablation did the trick but I would not hesitate to do again if necessary. Once again your blog was really helpful for me personally and I wanted to thank you for helping people with this information. All the best. Don
Don:
Thanks for your kind words. I appreciate it. I’m glad you found my website helpful.
I’m praying that your ablation was a success! Keep in touch and I wish you the best!
Travis
So far, so good. I went for my 3-month checkup and I’m still in sinus rhythm and feeling good. Back to all physical activity I was doing before the ablation. Dr. approved me going off of Pradaxa but I have to check my pulse every day but I was doing that anyway.
What does your research or experience tell you about keeping in sinus rhythm if the ablation was a “success” over the long-term?
Don:
Great to hear from you! And great to hear you’re doing so well after your ablation. That’s awesome!
I’m not sure I fully understand your question. Technically, success is defined as having no afib episodes without drugs for one year after the 3-month blanking period. That’s a very low threshold, obviously, as we all hope to get more than just one year of afib-freedom!
Individual success rates vary greatly. Your ultimate long-term success will be the direct result of the experience of the EP doing the procedure. If he/she is good, you could go many years without afib after your ablation. If your EP isn’t that good and/or you have a difficult case of afib, it may return within months of the ablation.
If this doesn’t answer your question, let me know!
I wish you continued NSR!
Travis
That was exactly what I wanted to know; is this a time out or a potential answer. As they say “time will tell” I guess. Thanks for the help and quick answer. All the best and continued NSR for you as well. Don
Doesn’t the Afib procedure last for good? That scares me if it doesn’t. I’ve had 11 surgeries and don’t want more. But, with my family’s stroke history (both my parents died from strokes), I guess I should get it done. Does the average person have the Afib return?
Mary:
For some, the ablation procedure “lasts for good.” Unfortunately, that is not the norm. The majority of people with afib will need two procedure to be “done” with afib. The good news is, if you go to an experienced EP, ablations are very safe and the recovery is quick.
Travis
thank you, Travis! Is pulse different from resting heart rate? I never had any heart problems what so ever, until I took 5 months of chemo. the doctors said that is what caused the problems. I take Eloquis, isosorbidemonontrate, and150 mg. of metropholsuccinate daily. besides afib, I also have high blood pressure. I feel some episodes, it is the ones I don’t that scare me. When I wore a monitor, I had one that was 144 minutes long! maybe a dumb question, but, does high blood pressure and afib go together always?
thank you! I hope the doctor is good! I was sent to him by my cardiologist and I’ve met with him. seems to know what he’s doing. I hope! lol
Hey Travis I have been in NSR since I last wrote you back at the end of 2017. Now for some reason my heart is racing up around 90BPM and there doesn’t seem to be much I can do about it. I see my cardiologist on Monday after over a year and not sure what he will say to do. Does this seem strange after almost 3 years of NSR? Lots has changed since we last spoke I lost my wife of 37 years to Ovarian Cancer 2 years ago and so still trying to figure out what to do. She was my partner in crime and helped me through the ablation and without her I am not as confident.
Don:
I’m so sorry for your loss. And sorry to hear about your recent heart issue. While ablations are the best treatment option for afib (in my humble opinion), there is no guarantee you won’t have heart issues again. Steve Ryan, of a-fib.com, had an ablation 20 years ago and his afib just returned. He has since had a successful 2nd ablation.
I’m not saying you have afib, by the way. I’m just saying that just because you’ve been in NSR for so long doesn’t mean it can’t return – especially after just one ablation. Most afibbers will need 2 or more ablations over the course of their life time.
My guess is your doctor will want to put you on a heart monitor for a period of time if he can’t see anything during your appointment. If he doesn’t, you might want to ask for one. Only a heart monitor will be able to tell you and your doctor what is going on. Then once you have some answers you can come up with a game plan!
I wish you the very best and I hope you have a positive doctor’s appointment. Please keep in touch!
Travis
Frankiez,
I just saw your post. I’m also a member of Kaiser in So California. I had an ablation there in April of 2015.
I’ll be happy to discuss it with you if you want.
I have never heard that this treatment described above is the last resort. As far as I read and heard from other patients, the treatment is right on target. I preferred medication to ablation, and wished I had agreed to the ablation. It could have made a big difference in my lifestyle.
Four years ago I had an ablation to treat WPW causing afib and it’s really something seeing how so many people had experiences like this with the procedure. Perhaps it’s because I had grown up with so many health problems, but I was up after the 6 period rest time functioning almost entirely normally besides stiffness. Maybe it’s because it was only local anesthesia rather than general? I woke up during the procedure and the doctors pressing on the artery to stop the bleeding was the worst pain I felt the whole time, but besides that it went well.
Anyway, the heart symptoms appear to have returned and I may have to have another ablation. I was just wondering how different the newer procedures are from the older ones.
Ty:
Am I reading your age correctly – that you’re only 17? If so, that’s awfully young to have to deal with this stuff!
The ablation procedure hasn’t changed dramatically in the past 4 years. The experience you’ll have is 100% dependent on the EP doing the ablation himself and his support team.
When I had my ablation I was totally under so I didn’t feel anything. After my resting period I was up and walking around as well but I had to spend the night for observation. That’s standard protocol where I went. Again, your EP center may vary.
Sorry to hear you need another procedure. Hopefully the second will put the beast to bed for good! I wish you well!
Travis
Hi Travis,
How do you handle going back to your hometown EP and telling him/her that you chose to go to Dr. Natale instead? I know this shouldn’t be a factor, but it feels awkward, nevertheless. I am assuming that I can self-refer to Dr. Natale.
Ann:
Great question! My original local EP was fine with it but the way he talked about Natale didn’t settle well with me. On one hand he was fine that I had another EP do my ablation but his words and body language indicated he wasn’t totally fine with it. Long story short, I “fired” him and found another local EP.
My new local EP was 100% supportive. His reaction was night and day. He said he was happy I found an EP I was comfortable with working on my heart. He said he would be willing to play whatever role I needed him to play in my care. He was more than happy to work with Natale’s team.
Then he said something I’ll never forget. He said if any doctor isn’t willing to partner and work with other doctors, RUN don’t walk out of their office. He said our role as doctors are to support the care of our patients so if we have to work with doctors then so be it. How awesome of a response was that?
The point is this, there is a good chance your local EP is going to be a littled miffed. After all, doctors are human. If that’s the case, find another doctor! You will be able to find one that will support your care no matter what the situation is.
What you’ll want to do, however, is get this out of the way before your ablation with Natale. I’d meet with your local EP and tell him that you have decided to work with Natale for your ablation. Then ask him if he’s o.k. with that. Specifically, will he be willing to do any follow up after the ablation. If he’s reluctant or unwilling, then find another EP to work with.
Travis
Good blog and I am glad I found it. I am having the procedure done on 4/6/17. I have been dealing with AFIB with RVR for 2 years off and on. I have been in AFIB now for months and did realize it until I was at the hospital for back surgery a few weeks ago. Medication has brought my heart rate down from 150 but the rhythm is still not right. If I don’t take the medication on time, my resting heart rate goes back over 100.
How long after your procedure were you able to go back to work? I have a stressful office job, but nothing physical. My doctor said they would like me to take the week following the procedure off but I could go back earlier if I want. I imagine I would be tired for a little while.
Rick:
Everyone’s recovery is going to be different but mine was about as smooth as it could have been. I went out to eat for dinner with my family the day after my procedure! I took a week off as well but if push came to shove I could have easily gone back to Minneapolis (I flew to Austin, TX for my procedure) within 3-4 days of my procedure.
If you really want to know what my recovery entailed, read my ablation recovery posts found here.
I wish you a successful ablation and a speedy recovery!
Travis
Travis,
I feel so much better after reading your experience with the ablation. My biggest worry was how I was going to lay still for all of that time after! And too pictured myself not being able to move at all.
I am having the ablation some time next month. My Electrophysiologist told me yesterday that I am a great candidate since I have no other heart issues. I have had 4 episodes in the past year and cannot take any medication.
Thank you!
Cindy:
Congrats on your upcoming ablation! I’m sure you’ll have success!
Ya, the lying still for “hours” is a piece of cake. They basically just want you to lie in bed for 6 hours. You can still move your upper body. They just don’t want you moving around a lot from the waist down while your catheter insertion points heal. It’s absolutely nothing to worry about.
Keep us posted on how your ablation goes!
Travis
Hi I’m 17 and have to have a catheter ablation for WPW. Your post gave me hope but I am still a Lil nervous. The only problem I think I will have is having to lie still for a few hours.
Hey Olivia. 17 and with afib? You are way too young to have to deal with an arrhythmia and a consequent ablation. The good news is you’ll likely bounce back much quicker than us older folks:) And don’t worry about lying still for a few hours. It’s not a big deal at all. They just don’t want you walking around, bending, etc. You’ll be lying in bed like normal. I was freaked out about that part as well but it turned out to be nothing to worry about. I was tired after my ablation so it felt great to just rest anyway.
I wish you well. Stop by and leave us an update when you get a chance.
Travis
WPW = Wolf Parkinson White, another arrythmia caused by an electrical problem. So what was your end evaluation of the ablation?
Hi Travis,
Reading your account of the day of your ablation was really informative. Pleased that the ablation went as it did.
I’m due to have catheter ablation on 15th July and whilst not overly apprehensive, yet, it is still a very daunting thought as to what is going to happen.
Thanks for sharing your experience, it helped to read of what took place on the day of your ablation.
Pete:
Glad to hear you found this post helpful. I wish you the best with your ablation as well. You’re pretty young – 35 – and you’re having your procedure done sooner than later (I waited 9 years) so you have a lot going for you! I’m sure it will be a success. Be sure to stop by with an update after you’ve had the procedure.
Best Wishes,
Travis
Hi Travis,
Thank you so much for sharing the details. An ablation is imminent for me and your words, good and bad, are very helpful. I hope you don’t mind two questions.
I just attended an afib patient conference (stopafib.org) where Dr. Natale spoke. He was quite technical, like he was speaking to colleagues, but fascinating just the same. Was it hard to line him up for your procedure?
I also learned of other ablation types at the conference (cryo-balloon, FIRM, surgical). Did your EP recommend RF over the others (i.e. who picks the right one for the patient)?
From what I learned at the conference, one-and-done is certainly a possibility for some.
MD:
Good to hear you were able to attend StopAfib.org’s patient conference. I would have attended but I was just down in Austin, TX for my ablation with Dr. Natale so I figured I would pass on attending. I will likely attend next year.
Dr. Natale can be difficult to understand. One, he has a slight Italian accent and tends to talk very fast. Two, he is very soft spoken so he can be difficult to physically hear. Three, he does tend to be very technical. Had I not done as much research as I had done prior to meeting with him, I probably would have been frustrated with him if I’m being honest. Luckily, I was well prepared ahead of time so when I met with him it was mainly a formality.
It wasn’t hard at all to get an appointment with him. I had to wait 3 months for my initial consult. After that I could have had an ablation with him within a month but it didn’t work with my schedule. I scheduled my ablation 2 months after my initial consult but had to reschedule that too but was able to easily find a time a month later. All told, I was able to get my ablation done within 3 months of my initial consultation.
My local EP does cryoballon. However, Dr. Natale only does RF. RF is still the gold standard of ablations. Dr. Natale has done over 8,000 ablations – all with RF. There is a reason for that! If there was a better technology, Dr. Natale would be using it.
The type of ablation – RF, cryoballon, FIRM, etc. will be determined by the EP doing the ablation. In other words, an EP will usually do one type and one type only. An EP isn’t going to say, “I think RF is best for you so I’ll do RF.” RF vs. cryoballon is just a different way to achieve the same thing. At the end of the day, both technologies do the same thing – burn areas of the heart where the electrical misfires are occurring. Some EPs prefer cryoballon and others prefer RF.
The main thing when it comes to ablations is the experience of the EP – not the method he uses. I could care less whether or not Dr. Natale uses RF or cryoballon. I’m more concerned about his experience, which he has plenty of!
Best of luck to you and please stay in touch!
Travis
Excellent information Travis, extremely helpful! I didn’t know about Dr. Natale’s “gliding” technique either – thought they were all the same. Wow.
Thank you very much. I will keep in touch.
MD
Hi Travis,
Excellent blog – I’m learning a ton!
The reader questions and your replies to them have been very helpful as well.
I have a few comments and questions:
1) I’ve heard such nice things about Dr. Natale. But was a bit worried because when I watched one of his videos, I actually had the exact same impression you described:
“Dr. Natale can be difficult to understand. One, he has a slight Italian accent and tends to talk very fast. Two, he is very soft spoken so he can be difficult to physically hear. Had I not done as much research as I had done prior to meeting with him, I probably would have been frustrated with him if I’m being honest. ”
I’m very glad to hear (pun not intended) that I’m not the only one with that impression of Dr. Natale. And it’s very reassuring to know that that’s how he always speaks. Otherwise I would’ve thought that maybe I’d shown up on a bad day (perhaps Dr. Natale was overworked and it was catching up with him), and been tempted to reschedule my ablation.
On that note, an MD friend of mine, who had cataract surgery recently, told me her story: when her cataract surgeon walked into the OR and asked her if she’d had a good night’s sleep beforehand, her reply was, ‘Yes, but that’s not important. What’s important is… did *you* have a good night’s sleep? Or are you feeling a bit hungry? It’s perfectly okay with me if you want to go eat a sandwich before the operation. I can wait, or reschedule – it’s no problem!”
2) Thanks for pointing out that you had two *separate* face-to-face visits with Dr. Natale (initial consult, then separate visit for ablation), and the appointment timing details. I was under the impression that since many people fly in from out of state, that a Dr. Natale ablation was a 1-visit process (ie, he ablates the day after he meets the patient for the first time). Was the separation into 2 visits mandatory or required? In particular, I’m wondering if after the first visit, Dr. Natale said “you know, since we have a month before the ablation, if you could send us a copy of your XYZ medical record, it would be really helpful”… ?
3) What aspect of your medical data/history did Dr. Natale (and/or his staff) seem to find the most valuable? For example, if you’d had an echo done before your visit to Austin, did they want just the echo report, or a copy of the actual imaging (CD)? Did they seem interested in TSH, etc. results to rule out other root causes for afib?
Also, did they want a detailed account of what seemed to be your afib triggers, the duration of each afib episode, etc? Or is that level of detail irrelevant? (Perhaps they typically get all the info they need in the EP lab, by imaging and studying the voltages, etc? And the patient records/anecdotes are largely irrelevant?)
I’m trying to avoid a scenario where I forget to mention that “this one time” I had afib triggered by walking into a cold room (or whatever), and later find out that if I’d reported that to Dr. Natale, that he’d have ablated differently… Or I forget to bring a copy of my XYZ medical record, which Dr. Natale would’ve found relevant to his EP strategy for me.
4) Regarding this statement:
“The type of ablation – RF, cryoballoon, FIRM, etc. will be determined by the EP doing the ablation. In other words, an EP will usually do one type and one type only. ”
I’ve found that in some cases, there’s actually a bit of a middle ground. For example, my local EP mentioned that her preference is to try cryoballoon ablation, but if my PV anatomy is not a good fit for the cryoballoon, then she’d extract the cryoballoon and instead use an RF catheter.
Cheers,
-Ted
Ted:
In terms of your medical history and things of that nature, to be honest the specific details of my afib episodes didn’t really come into play at all. When I made the initial consultation with Dr. Natale’s office they wanted me to fill out a “new patient packet” and send them copies of all my medical records.
When I met with Dr. Natale I basically told him I had paroxysmal afib and that I was having more and more episodes.
Without much hesitation he said I would be a good candidate for an ablation and that was about it. He said I could certainly try to keep it at bay with drugs for now but given my young age, I would likely need an ablation down the road anyway.
We honestly didn’t have any conversation about triggers or the specifics of my afib. You have to keep in mind that with experienced doctors like Dr. Natale, they have seen and heard everything and at the end of the day all they need to know is if you have paroxysmal or persistent afib and if there are any other underlying health issues they should know about. They don’t really care about your triggers or even the details of your specific episodes.
It’s kind of like taking your car to an auto body shop after a car accident. The auto body guy doesn’t really care how the car got wrecked – or at least doesn’t really need to know those details to fix your car. All he sees is a wrecked car so he just needs to know what the specific damage is and what its going to take to fix it.
I wouldn’t get too worried about not giving enough details or forgetting this or that detail about this or that episode. At the end of the day all Dr. Natale wants to know is what your overall health is, what kind of afib you have, and how long you’ve had it. Of course he’ll want to know about any prescription drugs you’re taking or any past procedure you might have had done (i.e. previous ablations).
Regarding my comment about the types of ablations EPs do, you are right. Some doctors may do both (cryoballon and RF) but as I originally stated, “most” do only one or the other.
Travis
Have you seen recent articles on “Lone Afib”? There’s one in particular in http://www.jafib.com
that questions the whole notion. They suggest that there’s a cause/causes for each case of afib and that for “Lone”, physicians just didn’t look far enough.
To me the idea of a trigger is beside the point – the point being that afib is established and waiting to manifest. That means that you might have hidden hypertension, sleep apnea, diabetes, atherosclerosis, too high or too low a level of thyroid function, genetic predisposition, obesity, autonomic dysfunction, endothelial dysfunction, or any combination.
The point further being that if the ultimate underlying cause/s can be discovered and addressed, the progressive nature of the disease afib might be stopped in its tracks – maybe even regressed. Too many successful ablations fail after a few good years. Is that because Causes were not addressed? A simple med or two for an overlooked condition or perhaps a simple (Yet sometimes difficult!) lifestyle change might forestall further grief. The squeaky wheel gets the oil. Proactive patients take their lives in their own hands and don’t take “Meh” for the answer to “Why?!”.
Jeff:
I hadn’t seen their recent articles but that’s a good resource so thanks for sharing it! The point of the article you have pointed out is spot on (finding the true cause) but that’s the problem…nobody has been able to figure out what the cause is! Until then, managing the burden of afib through drugs or an ablation is as good as it gets. Granted, you can try to figure out what the cause might be and try to address it (i.e. diet, mineral deficiencies, etc.) but you’re just shooting in the dark.
For me, there is a strong genetic component as my dad had it and several other members of my extended family have it. What do you do then?
Travis
My guess is that diet and deficiencies might act simply as triggers in someone who already has the afib “substrate” – in your case and in mine, from our Dad.
In my case, I had a daughter and a son growing up by the time I realized there might be a genetic legacy. So I didn’t have to think about it. Sadly, My children can’t help but contemplate the prospect of passing it along yet again.
A new distress that our sophisticated medical technology has brought us. For myself: Thank you, Technology! For my kids: It’s equivocal. The genetics of afib is in its infancy. Here’s hoping it grows up fast.
I had my ablation on October 3rd 2015. I had some mild episodes up until a week after the procedure and have been episode free since. The past 5 months have been the best that I’ve had in years. I feel like I have my life back. Thanks for sharing your story Travis, I’m so grateful to have found a successful solution for my own Afib. For years there wasn’t an hour that went by that I wouldn’t think about when my next episode would take place. Every moment of my life was overshadowed by Afib.
Your ablation experience seems almost identical to mine. I had mine done at NYU Medical Center in NYC, and before the procedure I was terrified. Looking back it was a very small price to pay for what has been the ultimate reward. I could go on and on, but I don’t want to bore everybody with my story, we all have them. JD
John:
Looking at your bio, we’re a lot alike – both guys in our 40’s who have been battling the beast for almost a decade. I totally understand what you mean about spending every waking hour thinking about afib. Do you find yourself still thinking about it even after the ablation? I know I do. I still constantly “worry” about having an afib episode. In fact now all I keep thinking is, “will this ablation stick or will I have afib and need a second procedure?” And I think even after the blanking period I’ll still worry about afib. After spending every waking hour thinking about it for almost a decade it’s hard to break the habit. I suppose if I can go a couple years without an episode I’ll get over it but I suspect that cloud will always be over me to some degree.
Good to hear you too had a good ablation experience and that you’re afib free so far. That is so awesome and I’m truly happy for you…but by all means feel free to spill your guts. My whole website is probably a bore for most people…lol. I just figure the more I can share, the more others can learn so if you’re so inclined, feel free to leave more details about your story in a comment here or shoot me an email via my contact page and I’ll post your story as a separate blog post.
Take care and I wish you many years of NSR!
Travis
Yes, it’s very hard to break the habit of hanging on each and every beat. It’s been 5 months and 9 days since my last episode and I definitely think about it less, but its not forgotten. There’s no more constantly checking my pulse, and now I can go an entire day without thinking about it. There will always be something that reminds you of your Afib. My life is so much better though, I have a 16 year old son and a 12 year old daughter and they have been so great about this whole thing. We live in Shanghai so I had to spend quite a few days away from them after the ablation.
I remember having an episode at 40,000 feet on my way from Newark to Shanghai, so it still weighs heavy on me before, during and after flights. Anyway, everything in my life has improved as a result of the ablation I decided to have. I saw one of Matthew McConaughey’s Lincoln commercials a while back, and he said, “when you take care of yourself, you take care of more than just yourself.” I find that to be very true. JD
Jeff:
That was always my biggest fear – having an episode during a flight – or having one while on vacation. My worry would skyrocket during those times!
I have a 10 year-old and an 8 year-old and they’ve been great about it as well. I wrote about that here: https://www.livingwithatrialfibrillation.com/1397/talking-atrial-fibrillation-with-kids/
It’s so much easier when you have family to support you as you go through this crap!
Take care!
Travis
P.S. My niece lives in Shanghai. She’s attending the NYU college they just opened there this year.
Can you tell me who did your ablation at NYU?
It was done by Dr. Larry Chinitz. I was very pleased with my results. Let me know if I can provide you with any helpful info. JD
Hi, Travis:
Thanks for creating this blog, Travis. I am in your previous situation. Paroxysmal for three years, symptoms are palpitations and sometimes the incredible urge to urinate while in A-Fib for a while. Usually attacks don’t last longer than eight hours…sometimes they are very short.
Three weeks pre-ablation and the heart is very quiet.
Getting cold feet now reading more about the procedure and some of the bad experiences people have had. It’s like reading a book review on Amazon…100 good reviews and one bad one…we concentrate on the bad one.
How are you feeling now?
Greg:
Having cold feet is totally natural. I was in the same exact boat as I had ZERO palpitations and no afib the 5 weeks prior to my ablation! You can read about that in this post:
https://www.livingwithatrialfibrillation.com/1418/leading-up-to-my-catheter-ablation/
(second section in the post I talk about how I had no afib episodes)
Because my heart was so quiet leading up to the ablation, I found myself second guessing what I was doing all the time but I knew deep down I was doing the right thing. You are too so hang in there. Don’t look back and don’t focus on those negative reviews!
Where are you having your procedure done?
Travis
P.S. I’m only 10 days post the ablation but so far it’s been awesome. I haven’t had a single episode of afib or even a palpitation. It’s way too early, however. I hope things continue to go smoothly but I’m keeping an open mind given the 3 month blanking period. I won’t declare victory then until June 5th:)
Hi, Travis:
Thanks for the response. I’m in Southern California and am having the ablation at Kaiser Permanente, since I am a Kaiser member. Don’t have any other choice. I hear they have a very new EP lab and the PA has been very good at answering questions. All of the Kaiser EP studies are done at the main Kaiser hospital. The EP who will do the procedure is the head of the department. I’ve spoken with him and will speak with him again next week.
Your site is a great help and I can relate to the anxiety. While in NSR most of the time I think it will always stay that way…then….bam…it hits. Sometime a bad dream in the middle of the night will set it off.
it’s hard to explain to the doctors the anxiety it causes. The cardiologist would just tell me…”It’s totally benign.” I remember telling her about he constant urination during extended episodes and she would say “Just a coincidence…”
I spent three days in the hospital (first time in my 59 years) last Oct. because Flecaniade as a pill-in-the pocket threw me into A-Flutter. I had to stay for three days to be observed on Sotalol. I was lucky to have an EP attend me to me and he knew so much more than the cardiologist. Not many side effect from the medication, just a very slow heart rate (40 or so) so they couldn’t give me a therapeutic amount.
Have you noticed any of the following that many people mention they have after ablations?
1. Sore throat
2. Head aches (migraines)
3. Trouble breathing
4. Increased heart rate
Thanks again for setting up this blog. It helps to hear others’ experiences.
Gregg
It’s not a coincidence, Greg.
Jeff Patten here. I had a couple of years of very symptomatic AF before my Pulmonary Vein Isolation in 2012. One symptom, in the words of an ER nurse was, “You’re peeing like a race horse!”
When in fibrillation, the atria – particularly the left atrial appendage – release atrial natriuretic peptide. It’s the body’s attempt to normalize blood pressure by reducing volume. It took a lot of questioning before they explained this… as if I wouldn’t be able to handle it? They don’t seem to realize that information helps; keeping it a mystery does not. You must advocate for yourself to get the best info and the best treatment.
At the worst I would pee a liter every half hour.
Doesn’t happen any more since my ablation!
Travis:
I reread your blogs and you answered most of the questions I posed to you. Thanks.
Any experience with headaches?
Gregg
Greg:
Ya, most cardiologists are completely clueless when it comes to afib. That’s why it’s imperative to work with an EP as soon as you know you have afib. I did not have any headaches at all after the ablation…but I rarely have headaches to begin with. Keep us posted on how the ablation goes. You’ll do just fine. You made the right decision so don’t look back!
Travis
Thanks, Travis:
I’m trying to keep busy so I don’t think about it much. Next week is the CT heart scan.
Your site is very user friendly and has been a great comfort so far.
Gregg
Good luck with the CT scan. And thanks for your compliments. I’m glad you like the site.
Travis
1. Sore throat
2. Head aches (migraines)
3. Trouble breathing
4. Increased heart rate
Greg, I have experience with each of these from my 2012 ablation.
The sore throat is likely. It would be from a combination of the trans-esophageal echocardiogram device and a breathing tube. No worry. Just a sore throat that goes away.
Do you get headaches/migraines now? I had chronic migraines for decades. They’re gone now. It seems that ablation might actually be a cure.
http://blog.themigrainereliefcenter.com/radio-frequency-ablation-1-option-that-may-cure-your-migraines
My ablation was by Cryo. There’s a tendency to frost the phrenic nerve that controls your diaphragm with this technique. I was short of breath for a few months till the nerve woke up again. No worry, they’re getting better at avoiding it. Worth it anyway, to be rid of AF!
There are ganglia of the autonomic nervous system in the area of the pulmonary veins that influence resting heart rate. It’s usual that they’re effected by ablation. As a matter of fact, increased heart rate is an indication that the ablation worked. It’ll slow down somewhat over months. Again, no worry!
Thanks, Jeffrey…
I don’t get many headaches.
My resting heart rate is in the 40s anyway…eespecially with the Sotalol. Just can’t wait for the entire thing to be over. Don’t think they will do cryo since they want to hit the flutter also.
Did any of this affect your blood pressure?
Gregg
Well, I was nervous going in also, so I’m sure my BP was up then. But then, such relief to be out – with no AF! No after-effects on my BP one way or the other. I’d been flirting with 140/90 a few years before (Risk factor for AF?), so I just continued on the same small doses of valsartan and verapamil. 119/68 before and after ablation.
Sometimes they have you continue on an antiarrhythmic during the blanking period, sometimes not – if the EP is confident. Ask about that.
Hi Travis,
Your link to your ablation report is not working. I have read about the new technique developed by Dr Natale here (link removed). On Jan 13, I had my ablation for AF here in Brazil and currently I m keeping my fingers crossed, hoping that they have fixed my arrhythmia. (I wish the same for you).
Hey Christian! I had to take that page down about my ablation report temporarily as I am preparing notes to go along with the it. I forgot to take down the link to the page when I took it down so thanks for letting me know about the broken link.
So glad to hear you’re doing well after your ablation. If you had the procedure on January 13th, then you just past the 3-month blanking period. If you’ve been afib-free since January 13th then you’re likely in the clear for a while at least. I say “a while” because it’s not uncommon to need a second procedure for a touch up. “A while” could be a few years or many years so just enjoy the NSR and try not to worry about it.
Thanks for the positive wishes for my own ablation success!
Travis
P.S. I removed the link you provided because it was already provided in an earlier comment (scroll down the comments to see the link).
First off, you are looking skinny in your picture. Nice work! You said you’ve been eating better and exercising but wow! I need to learn some of your fitness tips to slim down before my wedding.
Second, you are SUPER lucky you didn’t have a urinary catheter. I had one of these after I had my appendix taken out and it went something like this.
‘If you can’t use the bathroom in the next 10 minutes we’ll have to give you a urinary catheter. ‘ I literally couldn’t go so 10 mins later it was the WORSE PAIN ever and I was on a morphine drip. lol. Oh and it hurt like hell too when they had to take it out.
Anyways, glad to hear everything went well. Sounds like the next few months will be key. Looking forward to more updates!
James:
Hey James! Thanks for stopping by and leaving a comment. Ya, losing weight was a battle. I did it the smart way though. I changed my lifestyle. I didn’t just go on a diet. I lost 37 pounds over a 6 month period in preparation of this ablation.
Your urinary catheter story is exactly why I was dreading it so much. You can see why I was so thrilled when I didn’t have to deal with it!
Travis
I fell off my icy roof a few Christmas mornings ago. (Don’t ask. This is New England.) The two broken ribs resulting was my number ten on the pain scale. Then I had a hasty application of a urinary catheter after my second ablation. The ribs are now an 8.
I learned that there’s an easy fix that the nurses seem shy of for some reason. Ask for the plastic syringe of Lidocaine lubricating gel. It goes in before the catheter goes in. No, really! You never feel a thing. You have to know these things.
Jeff:
“Ask for the plastic syringe of Lidocaine lubricating gel.” Thanks for the tip!! I’ll definitely remember that if I ever need a urinary catheter.
Hey Jeff, I just posted my official albation report if you’re interested:
https://www.livingwithatrialfibrillation.com/1451/official-catheter-ablation-report/
Travis
Hey Travis great news that everything went well! Looks like it was a really successful game plan that went off without any major hitches which is awesome. Like you said the 3 month blanking period I have read many people get the odd off beat but usually once over that period it’s smooth sailing from there. Keep us all posted on your progress and how your feeling!