On my last update on June 14th I talked about the pocket ECG monitor I had to wear for a week to confirm I wasn’t having any afib episodes. I wore the monitor for seven days as instructed and then waited to hear from Dr. Natale’s office to see what they saw during the monitoring period.
For whatever reason, it took a long time for them to get back to me – almost three weeks. In the meantime, my heart monitor sat on the counter collecting dust as I wasn’t sure if I was supposed to return it or continue to wear it. They finally got back to me in a very brief email that all was good. I was in NSR the whole time and the only thing they saw were a few PVCs and PACs but nothing to worry about.
In short, I was “good to go” and the ablation recovery process was officially over!
The Calm Before the Storm
I wore the pocket EKG from June 14th to June 21st. Ironically, the day after I took off the monitor for the last time I started feeling some weird palpitations periodically throughout the day. I knew it wasn’t afib but it was “something.” I told Shirley, one of Dr. Natale’s nurses and my primary contact there, that I was feeling some weird palpitations. I asked her if I should put the pocket ECG back on for a few more days so they could see what was going on.
Shirley didn’t think that was necessary and said that what I was experiencing was just PVCs and PACs. It was nothing to worry about.
At that time I wasn’t having these PVCs and PACs continuously. I’d say I was experiencing them maybe 5% of the time. It really wasn’t a big deal.
The PVC Storm Hits (After My Dad Dies)
Then my world as I knew it crashed. My dad was admitted to the emergency room and then immediately to ICU early Saturday morning on June 27th. It’s a very tragic story and you can read about it here, but he died the following day. He was only 61 years old.
I was extremely close to my dad so it was a very tough loss for me. He also suffered from atrial fibrillation and had total right side heart failure when he was admitted that Saturday morning. As a hypochondriac to begin with, you can imagine how freaked out I was as I was witnessing my dad go through all of this. All I could think about (and still think about) is, “Will this be me in 10 or 20 years?”
At any rate, I was with my dad that Saturday night in the ICU and of course I didn’t sleep at all. On early Sunday morning I felt my heart pounding out of my chest. I started freaking out because I thought I was in afib or I was about to go into afib. I had my AliveCor monitor with me so I took a reading and while I wasn’t in afib, I was in tachycardia with a heartbeat of about 115 beats a minute – sometimes hitting 120 beats per minute. My average heart rate right is around 75 beats per minute.
I attributed the tachycardia to the incredible stress I was under and the fact I was going 24+ hours without any sleep. Quite honestly, I was surprised I didn’t go into afib. That was probably the first real test of my ablation. While my heart may have been ticking faster, it was nothing but solid NSR throughout the whole ordeal.
Ever since my dad’s death, however, I have had nothing but constant PVCs. I went from having them 5% of the time to 90% of the time. Even as I write this post I’m experiencing them.
I mostly get them around noon and then they last until I go to sleep. Fortunately, they seem to subside almost completely when I go to bed for the night. I also never have them when I first wake up or anytime in the morning. It’s always in the afternoon and they don’t stop until I go to bed.
I returned the pocket EKG because I was told I was officially “in the clear” and continuous monitoring wasn’t necessary. I was allowed to keep the event monitor for a couple more months. What I’ve been doing now is trying to capture the worst of these PVC events and send those to the monitoring company so Dr. Natale’s office can review them.
So far they keep telling me I’m just having PVCs and that it’s nothing to worry about. While that might be true, these PVCs really suck. They don’t really affect me in any way other than I can feel every one of them. Each PVC feels like an extra pronounced heart beat and at times it feels like I have to catch my breath – sort of. It’s hard to explain if you haven’t experienced them but they are just super annoying.
I’m in constant contact with my good friend and “afib mentor,” Shannon Dickson of Afibbers.org. He’s been helping me get through these damn things. He says that it’s perfectly normally to experience PVCs and PACs for a period of time after an ablation. As he put it, they can “come and go” for as long as a year after an ablation. It’s all a part of the recovery process.
Another thing he told me was that it’s very possible the death of my dad threw my body chemistry out of whack and that’s what triggered the onslaught of PVCs. And it’s possible I’m still stressed over his passing (even though I don’t really feel stressed) and that’s causing the PVCs.
Either way, I want them stopped! I’m in the process right now of trying to find a good local EP I can work with in case shit hits the fan and my heart starts doing crazy things. While I won’t let anyone touch my heart except Dr. Natale, I want a local EP I can work with for any tests or exams that might be necessary in the future – or if I have any “emergency events.”
I’m finding it very difficult to find highly qualified local EPs. I asked Dr. Natale’s office for recommendations but it’s been nothing but crickets so far. I know they are super busy so I’ll cut them some slack but it would be nice if they could give me some recommendations. I also reached out to Shannon but he hasn’t really been able to help either. He gave me a couple names of doctors at Mayo Clinic down in Rochester but that’s 2 hours away. Granted, that’s not a long haul in the scheme of things but I’d like to find a doctor that’s close – like within 30-45 minutes of my home.
I talked to Shannon about how hard it is to find “good” local EPs and he agreed. I told him I want to build a directory of the best EPs in the country and he thought it was a great idea as he’s been thinking about doing the same thing. We agreed to work on a directory together as soon as we re-launch Afibbers.org, which will be in the fall. Until then, I need to find a local EP I can work with so I’ll keep you posted. I don’t know if I’ll just end up going to Mayo or settling for someone more local.
For now I’ll continue to send in periodic recordings to MediLynx for Dr. Natale’s office to review and I’ll try to figure out a way to put these PVCs to rest. Hopefully I’ll get lucky and they’ll settle down on their own (hopefully sooner than later). I guess the silver lining in all of this is my ablation has held strong during all of this. Despite the temporary tachycardia and the constant PVCs and PACs, I continue to stay in NSR through all of this!
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Click Here for My Catheter Ablation Experience
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I just found your site, and i want to commend you on the effort you put forth to educate, and counsel people dealing with Afib. Discovered I had Afib about 7 years ago, or should i say diagnosed with it officially 7 years ago…. Spent the 2 years prior going to ER’s, & doctors who told me i was stressed out & suggested counseling. I was in a bad place, no one would believe me. I did echos, and stress tests, but no one cared enough to do an event monitor…
Finally after 2 years, i found a doctor who truly saved my life. She took the time, ran all the tests, and explained that i was not gonna drop dead at any minute, but had an irregular rhythm that could be corrected. I have had 2 ablations, the first one did not “take”, 18 mos later went through the procedure again, and i can say i have been feeling well ever since… Except for the dreaded PVC/PAC… i really think these are a side effect of the surgery, like yourseld, I never had them before surgery. And they truly are hell. I get them it seems like every 3-4 months and they stay for weeks at a time. some days bad, some days good. I have gone back to my doctor, and they always come back as benign. Have my annual physical this week, and will ask the doctor to run a full check of my body chemistry, i am hoping that there is something causing them, dehydration, thyroid, i just want an answer besides it is benign….I do not regret having the ablation, but as i am very discouraged thinking PVC/PACs are something i will deal with forever. but hey it is better than having full blown Afib. Honestly, it is just the anxiety, of feeling your heart skip a beat that most people do not understand.
My wife used to be a nurse, and tells me all the time, i am a hypochondriac, and encourages me to be positive. And i love her for that, but as i stated above, until you feel the flip flop of the heart, you just dont get how it can stay on your mind. You find yourself reading every article online, taking your pulse constantly, and contemplating a ride to the ER just for an ECG to rule out Afib.
Anyways, i have found your site, and will continue to follow it. It just feels good to know that other people are out here have the same feelings & anxieties. I really needed to vent, and i hope i do not come off as complaining. again thanks, this site is a great resource, and reassuring.
Just found your site, excellent!. My story, 59 yo male, 5’7″ 295 and losing. Aflutter 2012 ablated successfully, stroke in 2012, luckily no permanent damage that I can tell, then 1/1/2016 Afib. And about 55 days ago I had the Watchman device implanted in my LAA so I can get off blood thinners.
Aflutter ablation went well, but I would get the occasional to frequent PVC and PAC, confirmed with a Holter monitor, doctors say its not a problem.
Afib, what a way to start the new year. PVI Ablation in mid March, heart was very quiet for the first couple months, but now the PACs and PVCs are picking up. Not too bothersome but I wish they would go away! My Ep wanted me to stay on sotalol till after the Watchman Device was implanted. I just saw her and she said that I can come off the sotalol if I want. But, I guess it’s my crutch right now. I don’t want to go off the beta blocker sotalol and go into Afib. Since the ablation I have been in NSR except for the occasional rapid b b b pause or b b b b pause and NSR.
I guess that’s about it now, I have more, but its nice to find someone who knows what its like.
Hey Les! So glad to hear you didn’t suffer any permanent damage from the stroke. And you’re the first person I’ve communicated with who has had the Watchman device implanted. I’d love to follow up with you directly to see if you’d be interested in doing an email interview about your experience. If you are, please contact me here:
Regarding your PVCs and PACs…they are nasty buggers for sure. If you’ve read any of my posts here you know I’ve been battling them for over a year now. But here’s the great news…about two weeks ago they just stopped. It was literally like a light switch. One day I had them and the next day I didn’t! Today marks my 15th straight day of ZERO PVCs and PACs. I’m praying the trend continues.
So why am I telling you this? Well, there is hope, my friend. If you stay positive and have faith (literal faith as in leaning on God), I’m confident your PVCs and PACs will go away as well. It might take a while but your time of healing will come!
Regarding your “sotalol” crutch…I completely understand. Unfortunately, the answer isn’t an easy one. You’ll just have to take a leap of faith again and just try going off of them and see what happens. It’s not going to be easy but it’s a step you’ll probably have to take as you don’t want to be on this drug forever. It’s possible that the sotalol is contributing to your PVCs and PACs so keep that in mind as well.
If you go off the sotalol and you go into afib, then you’ll likely need a second ablation. I know that’s not what you want to hear but here’s the good news. IF you do end up needing a second procedure, there is a very good chance you’ll be done with all of this crap – including the drugs!
I wish you well!
P.S. If you do end up needing a second procedure, please contact me as I have some important information for you that will help ensure that the second procedure is successful.
My gosh. Exactly what I am experiencing. No afib 14 days after my ablation but consistent PVCs in late morning until afternoon
Ectopy such as PVCs and PACs are to be expected during the 3-month blanking period. And in cases like mine, it’s not even uncommon to battle them for up to a year or more after an ablation.
Thankfully, two years out from my ablation mine have settled down dramatically. Hang in there. It will get better!
Great info, and thanks everyone for sharing your thoughts as well. The world of PVCs is a strange one. For what it’s worth, I have basically cured my PVCs. You can read about it on my website, http://www.howtocurepvcs.com/
Thanks for providing a link to your site. I find it interesting that you drink 3-4 cocktails/beers a day and it has had no affect on your PVCs. It seems everything you read online indicates drinking is a big no-no for people battling PVCs. Personally, I’m not convinced. Alcohol seems to have no affect on my PVCs. I have them whether I drink or not:( And interestingly enough, when I occasionally have more than a cocktail or two in a day, my PVCs seem to be less severe. Go figure.
Hi Travis! & greetings from Canada!! I am so glad I found your website! My husband just got diagnosed with Afib at 47 years old. It was quite a shock, and I know you can identify with this. Thank you for hosting such a truly informative site intertwined with your encouraging personality! :)) I am so sorry to hear of your Dad’s passing. I am sure that from his new vantage point, he is relieved for his son’s successful ablation!
My husband’s doctor put him on blood thinners (low dose) and a Beta Blocker about a month ago. Today he went in for a follow-up and unfortunately, he has been diagnosed with persistent afib, to which the cardiologist said weakens the heart over time/tires it out. *He did not speak of ablation whatsoever, but is going to do a cardioversion on him in 3 weeks, although he said they are not usually successful permanently.
I have been researching ablation and found a Dr. John Sirak who developed the “5 box maze” technique with another colleague (an extensive in-camera video was featured on youtube with Dr. Sirak narrating the entire procedure). Did you ever hear about this procedure and if so, do you know if this Ablation technique would also have to be repeated two or three times in a lifetime?
Also, how much do these procedures cost in the US? Presently, I am not even sure if this 5 box maze technique is practiced in Canada. I am just beginning the journey into research even as Peter’s doctor has not even mentioned ablation as an option thus far. Thank you for all that you do, Travis! Sincerely and keep up the wonderful health!
Sorry to hear of your husband’s recent diagnosis. I hope he’s doing o.k.
As for the box maze, I’m not too familiar with it other than I know it’s usually reserved for the toughest cases of afib and is usually best for people that are obese. As far as repeat procedure, as far as I know the maze procedure is a one and done procedure (meaning whether it works or not it’s only done once). I’ve never heard of anyone having multiple maze procedures.
Given your husband’s age (relatively young), I would definitely focus on at least having an ablation. The longer he is in persistent afib, the harder it will become to treat. Do not be fooled by the medications. Even if he responds well to them, the afib will continue to progress. My guess is his doctor will tell him to “try the medications for a while first.” That’s fine – take the medications until you can find a competent EP to do an ablation. The sooner he has a procedure the better.
I can’t speak to the costs of the maze procedure but ablations are anywhere between $100,000 – $110,000 here in the U.S. If you pay with cash, you can have them done for less than half – about $40,000. They aren’t cheap. I would imagine the maze procedure would be at least as expensive as an ablation as it is a more complex procedure.
I wish your husband the best!
I’m truly sorry for the loss of your father. I can’t find the original post I send you a while back which you replied to but I felt like sharing an update. I had my first “attack” January 29 of this year and have had 7 Afib episodes in the first 5 months. 3 lasted under around the 2 hour mark in which I self converted, 2 lasted more than 12 hours (One was electro cardioverted), and 2 more lasted more than 2 hours but less than 8 and they self converted as well. I live in Alberta Canada (Edmonton) and met with a cardiologist (said plumbing was fine) within 1 month of diagnosis and he referred me to a Physiologist which I met in June.
Before I continue with the Physiologist I just want to add that since I was 22 I have been plagued by PVCs/PACs. I was hitting the Gym hard at that age and had MANY PVCs/PAC’s which led me to see a cardiologist about it at 26. After tests including a stress test he concluded this was normal and I continued on my journey. I was always scared to perform cardiovascular challenging exercises other than just vigorous weight lifting since they would aggravate my PVCs/PACs. When I turned 30 I put my foot on the gas and said the hell with it and began mixed martial arts, cross-fit, rowing sports. Around 35 years my PVCs/PACs changed in symptoms. They went from the usual extra beat or missed a beat type feeling with the slight usual pause to a 1-3 second heart “quiver”. I saw my GP who sent me for an echo, once he received the results he dismissed it has the pluming was fine so you have nothing to worry about. By the time I followed up with a second opinion 2 years later I walked into my house from the doctor’s visit, sat down on the living room rug with my daughter and had my first Afib episode. I had a normal PVC/PAC on the rug and the heart never recovered to a NSR and broke into AFIB. It took 3 Adavans to get me to sit down for the paramedics when the ambulance came to the house…yadda yadda you guys all know what I’m talking about. 3 of my 7 Afib episodes came directly after a PVC/PAC.
I did a sleep study in May. The results indicated that I had “Mild” sleep apnea. When I say Mild, I mean almost in the normal range but enough to get a prescription if I want. My wife said I started snoring in January, something I had never done in the past. None of my doctors thought to look at other factors which may have contributed to my Afib. The supplements I take, sleep study etc. came from my personal quest to understand my condition and picking up a few tips along the way (Thanks to your website, it helped tons). I bought a CPAP and started using it even though I was almost normal for Apnea risk because I read through my research that even a very mild risk of Apnea can be associated with Afib. Believe it or not I have been Afib free since May 27, since I brought the CPAP home and started sleeping with it. 7 episodes in 5 months, none since May 27.
Now to get back to the Physiologist. I read “Beat your Afib” and when I walked in to see Tomasz W. C MScE, MD, FRCPC at the Manzankowski Alberta Heart Institute I wanted to walk out at all cost with an appointment for ablation. I had an excel chart printed of my Afib episodes and delivered what I thought was a strong case in regards to the escalation of my episodes and the chemical risk vs ablation treatments for management of the symptoms. I seriously felt like an idiot sitting in front of this guy discussing with him my research and opinions based on what I read and researched and talking to ER doctors while in hospitals. What became instantly clear is that this was the expert and most of the details I received from other doctors were incorrect and mostly out of left field. He explained to me essentially the facts…no sugar coating. There is no known cure for my condition, there are risks to ablation including further aggravation of the condition although rare. He essentially explained to me all the reasons why I should not consider the ablation as the “holy grail” for curing Afib. I sunk in my seat hearing him talk about it. Most importantly he asked me why I wanted ablation. I told him I wanted to compete in rowing sports and that I wasn’t done climbing my way through life at my leisure, let alone I didn’t want to be on medication for the rest of my life which in itself will create additional risks from longterm use. He asked me why I thought I couldn’t do this now (pushing the envelope at sports). I told him I was told by many doctors (ER doctors) that pushing the heart at this stage could further increase my overall risk to the heart. He looked at me and asked me to give him an example. I said one ER Doctor and I had a discussion about boxing. Turns out he helps the local professional boxing associations with the physical clearances and licenses. He said he would not clear me because of my condition for the possible risk of “electrical bypass from my condition to the ventricles which could cause immediate death in the ring” (Not an exact quote but essentially what he tried to explain to me and how I understood it)… Dr. Hruczkowski gave me a look, smiled and then looked down at his documents. He looked back up at me and said “Yes that can happen, but those “pathways” are there from a birth defect only”. As relieved as I was to hear that I had another pile of questions in my mind to ask him. He took my time to answer a few more questions for me but as we were discussing it came apparently clear that although I had done some research, I was only scratching the surface compared to Dr. Hruczkowski’s expertise. He did help me dismiss a lot of conjecture out there associated with Afib. He also took me off of blood thinners, and seemed irritated that I was on them to begin with. He said that ablation will help with my PVCs/PAC’s since they occur in the pulmonary vein (I think he said something like that) In the end I cornered him into giving me a straight answer (He talks about facts only, the ice man I swear no emotion) when I asked him what he would do in my place, live a life on meds to manage this condition or to get ablation. He said he would choose Ablation in my case. Since I saw a newly formed weakness in his armored personality I followed up with “why should I get my ablation done here with him instead of seeking a high volume center”. Dr. Hruczkowski has been performing ablations since 2005 at a rate of 25-40 a year. He is the Clinical Director of the Electrocardiography laboratory and completed a fellowship in Clinical Cardiac Electrophysiology and Advanced Cardiac Electrophysiology at the Bringham and Woman’s Hospital and Harvard Medical School. Before Medical school he was an electrical engineer on the faculty in UNB’s department of Electrical Engineering and worked as a research associate in the Institute of Biomedical Engineering. His research interests included application of digital and microcomputer technology to the study of electrophysiological properties of skeletal muscles and the control of artificial limbs. I know it sounds like I’m trying to sell this guy and justify my decision (you probably don’t think he has enough procedures under his belt) but I know he’s one of the best up here. Its also not easy to shop around in Canada. There are doctors that “advertise” their services in the US (I challenge the validity of their claims), doctors up here don’t do that in the socialized health care system. I’m essentially not paying for it and I am more or less referred to doctors. Dr. Hruczkowski said that the Canadian high volume centers are in Ontario, and there are high volume clinics in Europe and the USA. Since I am Canadian this procedure is free for me pending I choose to receive the Ablation in Canada. He said that he can recommend me for an Ontario center but his professional opinion was that It would not necessarily give me any better outcome than doing it at the Mazankowski institute which is a leading center in Western Canada. He seemed very confident and has great references. I asked him if he has patients like me who are now Afib free and no longer on medication. He said Yes. I had a month to think about it and finally gave in to having the procedure. My Ablation will be on Friday August 28 (This Friday Yikes). Looking forward to hearing a reply from you Travis, I have 4 days to change my mind LOL ;)
Anyways I feel like I should share, I have been snooping on your site for quite a while and feel like I should take a turn. Your right there is something therapeutic about it isn’t there. I am writing this because I am nervous about the procedure, I choose not to talk about it with family at this point so close to the procedure. I keep thinking about maybe my Afib was brought on by Sleep Apnea which I am controlling with my CPAP so maybe I shouldn’t have the ablation. But I feel beneath it all is a sleeping monster only being managed waiting to jump out and make this paroxysmal condition permanent. The earlier I can get adequate treatment the better for this condition in the long run as per my research (less remodeling etc.). This means I would have had Ablation 7 months after my first Afib diagnosis, which is within my first year of diagnosis. I hope I am doing the right thing by jumping the gun and just trusting my instinct and the overall advice from all of you out there.
I will keep you posted on my experience… I’ll give another update next week after its all done. Thanks again!!
Thanks for your kind words about this site. I’m glad you found it helpful. And thanks for sharing your story!
In my humble opinion you’re definitely making the right choice. I wouldn’t look back. Move forward with complete confidence in what you’re doing.
You are way ahead of the game on this than I ever was. I waited for 9 years until I had my ablation and in hindsight I wish I would have done it sooner. Even though on the surface my case seemed “simple,” I was actually a more challenging case as far as ablations go. Once they got inside they had to do more work than usual. By holding off for 9 years, things slowly progressed for the worse – silently.
That’s the thing with afib. Once you are officially diagnosed with it, you have it – period. It doesn’t get better. It doesn’t go away. And there is no cure. So even though you might go months or even years without another episode, it’s still there – progressively getting worse.
I have to warn you, however. Ablations aren’t a cure-all. You may still need meds after one and it’s very likely you’ll need a second – or even third procedure. It’s best to go into these assuming you’ll need at least 2 and if you get by with one, consider yourself fortunate and count your blessings! Unfortunately, that is usually not the case. Most of us afibbers need 2 or more before they stick and we’re able to enjoy as many years as we can with NSR.
It’s funny you bring this up now. I was talking to Shannon over at afibbers.org today on the phone and he told me that the goal here is to get as many years of NSR as we can – period. The reality is we have a condition we just have to learn to live with and make the most of. Our goal is to do whatever it takes to have as many years of NSR without drugs (or as little drugs as possible).
The other thing you have to know going into this is that your success rate will be 100% tied to the experience of the guy doing the ablation. If he’s good, you’ll have the best shot at beating this for a while with one procedure but even patients with the best EPs will still need 2 or more procedures. That’s just the way it is right now. Hopefully someday soon the ablation procedure will be more effective – and easier for even the average EPs to do.
Bottom line, you’ve done your homework and it sounds like you’ve done everything you can to beat this – even going as far as having a sleep study and wearing a CPAP. I haven’t even done that yet (have a sleep study that is) so you’re way ahead of the game here.
If I were in your shoes I wouldn’t think twice about having an ablation – BUT I would also go into it knowing what I’ve just shared with you.
I wish you total success this coming Friday. Be sure to report back as soon as you can. I’m sure there will be a lot of people reading this wondering how things went for you.
Sorry it took so long to reply and give an update. August 28 I got up early and went to the Mazankowski heart institute for my ablation appointment. Eventually I was admitted and settled into a waiting room where I would meet up with my Electrophysiologist (Dr. Tom Hruczkowski). Looking around the room I saw my chart, but Dr. Tom wasn’t on the paperwork for the day. I was prepared to call it quits and reschedule (already uncomfortable having the procedure, not going to have it done by a doctor I don’t know and didn’t research). But to my delight, Dr. Tom did show up and we had a little bit of a briefing together.
He was very direct and discussed all the statistics on the surgery (mostly negative) and had me scared to death once again. In our conversation I let him know some very important details that he was not aware of. I told him that since my last Afib episode I had received a sleep study and had been sleeping with a CPAP. Since I brought the CPAP home May 30, 2015 I did not have another Afib episode since. He looked at me and said that this was terrific news. I did not have a followup with Dr. Tom since my last episode which was May 26, 2015 therefore he was not aware of the sleep apnea.
Since I had already been 3 months without an episode he told me in the hospital waiting room that he would much rather treat an underlying condition than to try and fix the manifestation of that condition. He told me that the only reason we were here today was because of my insistence on having the surgery. He was not convinced that it was the best route for me yet, but was willing to do it for me. He recommended that we wait and see how this plays out and if we decide in the future to get the ablation done anyways that he would be willing to do it for me. I agreed with him but felt defeated on my way out of the hospital.
I kept fighting with myself over the decision… was I a coward? I mean… I was there, it would have been done… I stressed myself out for months and I take the easy way out? Although eventually I was able to wrap my head around it and control my emotions one thing was clear…I was glad to be out of there and I was relieved that I had AN option. As I write this it is 9:43am November 13, 2015. My last Afib episode was 170 days ago (almost 6 months). Before I brought the CPAP home I had an episode a month on average.
I just did a follow up with Dr. Tom 3 weeks ago. I got an opportunity to get everything off my chest at the meeting and build a stronger relationship with him. He was pleased about the CPAP therapy and explained to me the link between Sleep Apnea and Afib. Although mine was mild and almost normal it was still an underlying cause to my condition. He told me that I should be clear on the fact that there is no known cure for Afib and although it has not reared its ugly head in 5 months that it will most likely come back to visit now since I am predisposed.
He said he wanted to meet up with me every 6 months (or sooner if I choose). I told him that I wanted to reduce my beta blocker medication because I can’t get my heart rate over 120 when performing my cardio excersices (concept 2 rower). I told him that because of the reduced efficiency of the heart on the medication I wasn’t getting into the fitness ranges I need in order to keep fit. Right now I’m 210lbs at 6′, when I was boxing and rowing 2 years ago I was around 190lbs.
Extra weight will eventually bring on new underlying conditions that will aggravate my Afib as I get older therefore I’m really between a rock and a hard place. If I don’t exercise in a range that will promote an aerobic and slight anaerobic response than I will have a hard time controlling my weight. When we talked about exercise he told me that he has some patients that are extreme athletes that have their Afib in “check” but their episodes return when they perform rigorous activities.
I asked him about weight lifting, he cautioned me about the blood pressure spikes while training, they could be a trigger as well for some. He lowered my dosage for metoprolol to 12.5 mg twice a day and on my last 10k row I was able to get my heart rate up to 158 and felt great. I’ve done a bunch of 5k and 10k rows and no issues to report. Feels like I’m back to my old self again. I asked Dr. Tom what I should do if I get another Afib episode. He told me to wait 24 hours (unless my symptoms are intolerable, which they haven’t been when I had them) to see if I would self convert. If not between the 24-48 hours I should go to the ER for conversion.
If I wait past that then I’ll have to go on thinners for 3 weeks before conversion (this we all know). I asked him about heart failure with Afib. I had read that for some this can happen although rare. He said that for me my heart would have to be in Afib in the 160 bpm range for 2 weeks straight. We both chuckled knowing full well that I am too damn symptomatic and too damn obsessive to let that happen but it did give the closure I was looking for (to calm my anxiety when I am in Afib). I asked him if I had enough Afib episodes to “remodel” the heart and he said no, my episodes were too short and too few to have caused any remodeling.
My advice for all you Afibbers like me out there is to get all the info you can on Afib, this will make you more comfortable with the condition. When underlying causes are not clear doctors will only go so far in helping you. My family doctor referred me to a cardiologist (he’s the plumber), all he cared about was the physiology of the heart. Once the plumbing checked out I never saw him again and was referred to doctor Tom.
None of the 3 recommended a sleep study. And when I went to rule that out (amongst a long laundry list of other things) they told me that I had very mild apnea and treatment is up to me if I choose but can go without. I chose to bring the CPAP home and try it out and lone behold I sleep better, my mood has improved and no more Afib (for now).
I asked Dr. Tom what the plan was for me, he said we are going to try to hold out as long as possible. It may never come back although he’s pretty sure it will, and if the frequency of episodes are at a point where my quality of life is affected we will look at surgery. The game is to hold on as long as possible so that we have the benefit of medical advances in the field to reduce the risks. Right now I have this luxury. I know some of you out there would disagree (I read all the books too) and that you feel that waiting could be a risk, the condition may get harder to treat later on… but every case is different, no book can truly attest for individual conditions and it really comes down to how you feel and what your gut tells you.
If I was still having episodes going into surgery instead of being 3 months afib free since picking up a CPAP I would of gone through with the surgery. But the hope that I may have crippled its advances with tripping over a contributing cause to the condition (where no other underlying cause was clear, thyroid good, no alcohol, no hypertension, no diabetes etc.) gives me hope and I feel justified in not treating the manifestation yet by surgical means.
I wish all of you the best on your journey and big thanks to Travis for this terrific site, I know I am always looking forward to your updates!
Sorry it took me so long to respond to you. I didn’t see your comment come through until now. Thanks for the detailed update. That was awesome to read!
I admire your ability to make such a decision just moments before your ablation. Like you, I had been afib-free for 3 months leading up to my ablation so I was constantly second-guessing what I was doing as well. At one point I almost cancelled my ablation too.
I’m going to be scheduling a sleep study myself this spring. I have to tell you, if they tell me the same thing they told you – that I have very mild apnea and that I can treat it with a CPAP or not – I will likely turn it down. I already have a difficult enough time sleeping (have been suffering from insomnia for years) that wearing a mask would only make things worse for me.
I have to be honest with you. I’m very leery of these sleep studies in general, which is why I’ve been dragging my feet on having one. I have a feeling every person over the age of say 35 has some form of sleep apnea. I’ll bet anything that if 100 sleep studies are done on people over 35, 98 of them will be diagnosed with some form of apnea. I’m only going to have one done because I’m curious what level of apnea I’m sure I have:)
Can’t “very mild” to “mild” apnea be treated with a dental device or even sleep apnea exercises? I thought I read once that these mild cases of apnea don’t require a mask. Those are the options I’ll be looking at if they tell me (excuse me…WHEN they tell me) I have mild apnea.
I’m glad you’ve found a solution that works for you now. It sounds like you’re doing great! I wish you many years of NSR. Be sure to drop by from time-to-time and leave us an update.
I wish you well!
I’m sorry to hear about your father passing.
Now I’m passing the 6 month mark post ablation. One of the things that I learned in my case is that the stress or a bad night’s sleep is equal a PACs or PVCs in the following days. Once my stress level goes down, the extrasystoles disappear.
I believe that soon you will have your days of “no events” back.
Thanks for the perspective and insight. I hope my days of “no events” return as well! Since I wrote this post, I’ve already had a couple days of no PVCs! But then I have some really bad days…like yesterday where I had them nonstop from noon and until night:(
Just wanted to follow-up my earlier posting to clarify that I’ve found a source (StopAFib 2013 Conference Q&A session) that says it takes “months and months” of rapid heartbeats… before it starts to cause real problems (diminish heart pumping function). Ref: https://www.youtube.com/watch?v=ueK5iVOABak (about 9:58 into the video)
sorry to hear about your father .. he was quite young .. sorry about the PVC’s and PAC’s .. they are not dangerous but are scary and frightening – will keep you in my prayers
I’m sorry to read of your loss… My condolences to you and your family.
I’m very sorry to hear about your father passing.
Regarding your PVC’s, the Dr. John (Mandrola, an EP) blog seems to suggest:
1) thinking about PVC’s causes them to stick around longer.
2) most of the time PVC’s are harmless, but if one is having 20,000+ PVC’s per day (out of 100,000 heartbeats), then it could lead to a weakened heart (?!). He suggests wearing a 24-hr Holter monitor to quantify how bad the PVC situation is (or isn’t). He doesn’t specify how long it takes to weaken the heart, so perhaps it’s a long time (eg, months of 20,000+ daily PVC’s). So, don’t panic. Perhaps your local PCP (Primary Care Physician) could arrange for you to get access to a Holter monitor?
Best wishes for a quick return to NSR,
I’m sure my obsession over my PVCs aren’t helping the situation so Dr. John’s suggestion that thinking about them causes them to stick around longer is probably spot on. I try not to think about them but it’s hard not to.
I agree that PVCs are harmless to a point so I’m not freaking out just yet but if they get worse or I still have them 3-4 months from now then I might start freaking out…lol.
I have an event monitor right now so I take periodic recordings and send them in. They just tell me I’m having PVCs and it’s nothing to worry about.
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