Editor’s Note: Robert was the original owner of this blog. He sold this site to me in 2013. He recently had an ablation to treat his atrial fibrillation and was kind enough to write a blog post about his experience. This is his story. I wish him well and I wish him many years of NSR!
A Little Background
I was diagnosed with afib in 2008. I was given a prescription (Cardizem CD), advised to take a baby aspirin, and referred to an EP (who wanted to do an ablation; I told him I’d think about it). I started doing my own research (which later became this blog) and stopped the medication and the aspirin.
Since then, I’d managed my afib on my own. I avoided my triggers, took an assortment of herbs and supplements, and tried to keep my stress to a minimum.
It seemed to be working. I’d have maybe half a dozen episodes a year, each lasting a few hours or occasionally longer, always converting to normal sinus rhythm without medication or intervention. Even in the past couple of years, when a confluence of events dramatically increased my stress (heartbreak, financial pressure, a move), my episodes were minimal and mostly short-lived – until last fall.
Deciding to Have an Ablation
My episodes became more frequent. They lasted longer. They seemed more random, coming without any known trigger. In the first five months of this year, I had 21 episodes, many of them lasting over 24 hours.
I’d been checking on Travis since I sold this site to him in 2013 and read with keen interest about his afib journey. I always knew, since I first saw the EP in 2008, that I might eventually need to have an ablation, but I wanted to wait as long as possible and have the best EP when the time came. I knew the time had come and, reading about Travis and his experience with Dr. Natale, I knew I wanted Dr. Natale to do the deed.
Would I have to go to Austin, Texas to do it?
Turns out, Dr. Natale also practices in San Francisco. I scheduled an appointment in May and started Eliquis. I was concerned about side effects, but the Eliquis turned out to be a non-issue.
My Ablation Experience
On July 25th, I arrived at California Pacific Medical Center a little before 6 a.m. for my 8 a.m. procedure.
There’s always something to look forward to when you have an ablation. Sitting in the waiting room, I couldn’t wait to be taken to pre-op. Waiting in pre-op, I looked forward to being taken to the operating room. My niece, Erica (who is an angel and may be a saint), and her adorable two-year-old daughter, Hannah (who is most definitely an angel), kept me entertained.
In the operating room, the anesthesiologist explained everything he was doing as he fed the sedative into my IV and then said, “Bye, bye.” I thought, I don’t feel anything—and for an instant I looked forward to really not feeling anything.
Waking up in the holding area, my first concern was my heart rate. I’d read that Travis had a resting heart rate of 52 beats per minute before his ablation and that it fluctuated between 80 and 90 beats per minute after the procedure. My resting heart rate was in the high-70’s or low-80’s prior to my ablation. If I experienced the same kind of increase I’d be in tachycardia all the time and would have to be on rate control medication. Fortunately, the monitor showed my heart rate was in the low 90’s.
Reassured, I looked forward to being able to move (I had to lie still for six hours so as not to disturb the incisions in my groin). My heart felt fine—odd sensations, fleeting pressure or heaviness, but no pain. My chest and throat felt tight when I took a deep breath, but this was from the breathing tube.
Unlike Travis, I had no elephant on my chest, no nausea, no drop in blood pressure. Mostly, my back hurt from having to lie still. I couldn’t get comfortable. I tried to relax, closed my eyes, but couldn’t sleep. And I had a long time to look forward to being moved to my hospital room. I was only supposed to be in the holding area for a couple of hours, but they didn’t move me until almost 7 p.m.
While I was waiting, Dr. Natale came by. He’s a man of few words, with a calming presence and a comforting touch. He assured me that everything went well, that the odds of the ablation not being successful were very small. I asked him if he had to ablate my left atrial appendage and he said, No (if they ablate your LAA, you’re on blood thinners the rest of your life). He told me where they ablated, but I don’t remember much of what he said.
Finally, in my room, I couldn’t wait to have my catheter removed (they inserted it while I was under). While I waited for the nurse, I did a Google search on my phone. Everything I read said it wouldn’t be painful. It was. A lot. Thankfully, the nurse didn’t hesitate so it was over almost before my muffled scream was out of my mouth. I immediately had to pee and managed to squeeze a thimble full of blood into the plastic urinal.
The next morning, my urine straw yellow, I felt fit enough to take a walk before breakfast. I was still wearing my compression bandage, so I waddled like a penguin. Still, it felt good to be up and moving. Later, with the compression bandaged removed, I was able to inspect my incisions. My groin was so bruised that I was surprised how tiny they were, perhaps a quarter of an inch.
As I lay in bed, looking forward to being discharged, I reflected on how relatively good I felt considering what I’d been through. I had no real pain, just a backache and some discomfort in my throat. Dr. Natale came by for a quick visit and again assured me that everything went well.
Shortly after Dr. Natale left, I started having odd visual effects. I saw jagged, shimmering zig zags. Ironically, the only time I’d ever experienced this before was in 2008 when I was first diagnosed with afib. I knew that it was a migraine aura, or silent migraine (aura without headache), but I asked the nurse just to make sure I wasn’t having a stroke. I wasn’t, and the zig zags became less ziggy and zaggy and finally faded away.
After My Ablation
As I write this, it’s been four days since my ablation. I have no chest pain, but I still have some discomfort from the breathing tube. My throat feels achy and tight and I’ve had some difficulty swallowing (I have a mild case of esophageal dysmotility, which could be exacerbating the problem).
My heart is steady. Maybe too steady. Having an ablation lowers your heart rate variability, an indicator of vagal tone, which is a measure of your parasympathetic nervous system. In other words, an ablation impacts your nervous system’s ability to deal with stress. I’m also just very aware of my heart. My heart is in NSR, but I frequently experience palpitations, especially when I’m lying down.
I’ve been peeing a lot, especially at night. I have nocturia and usually get up two or three times a night to pee, but last night I probably got up eight or ten times. My body is probably still getting rid of the excess fluids I took on during the procedure.
I’ve had three more silent migraines. I found a few references to this after searching Google and it seems to be a known side effect of ablation. I’m hoping it will disappear in a week or so.
In most ways, the procedure was not as bad as I expected, and in other ways it was worse. Everything to do with my heart turned out better than expected. The bed rest, catheter removal, and discomfort from the breathing tube were worse than expected. The migraine aura was completely unexpected.
At this point, I have no regrets. I’ve got my fingers crossed. I’m hopeful that I’ll be “one and done.”