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
Robert Ellis
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.
Fingers Crossed
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.”
I have so enjoyed discovering this web page…I do not feel so alone anymore. I am on a beta blocker in the morning and flecotide ( tambacor ) morning and evening. I have been in High Care twice in the past month with A fib …I convert intravenously after an hour ….the whole process is so exhausting. My heart feels “irritable ” at least 10 times a day …flutters/flip flops /missed beats …extra beats . I really am so tired of this …I tell my family I am fine most of the time as quite frankly my health is becoming a boring topic !!! I live in Kwa Zulu Natal , on the East Coast of Southern Africa ….I believe we do have one electro cardiologist in this part of the world , however I am terrified of dying whist having an ablation.
How is Robert Ellis doing now after his second ablation. I am 3 month after my first..had 62 zapps. Still have some afibs..
I had a rough first year after my second ablation, lots of palpitations and the very occasional afib, but my heart is fine now. It takes time for your heart to heal. Wishing you well.
Hi Robert,
Hope you’re well. Would appreciate it if you would update us on your afib and the number of ablations you had and whether you recommend using the same doctor and center where you did the ablations?
Regards,
Saad
Saad, it’s good news. After my second ablation, I had a rough year or so, but have been fine since then. I’m not on any medication and I had a complete checkup with my cardiologist a couple of months ago and my heart is in great shape. If you’ve had an ablation, have faith. It may take a year or more for things to settle back down to normal, but it’s worth it. Be well, Robert
Hello. As a newcomer to the afib experience, I want to express my deepest sympathy to all who experience this heart issue. My experience began about a month ago when a powerful cramp occupied below my left rib cage and it would not let go. The same thing happened the previous week but only lasted about a minute under my right rib cage. That previous episode made me go to the doctor that same day only to be told that it was due to stress.
I thought this new episode was due to stress and would go away but it would not. I became anxious, my heart beat faster and began to beat irregularly. It felt bad enough for me to tell my wife to take me to the ER. I was injected with numerous items and placed on an IV. Over two hours later my heart went back to normal rhythm.
The cardiologist said he was going to keep me in the hospital until he figured out what caused my heart to go into afib. After two days in the hospital and going through many tests on my heart including the stress test, everything about my heart was deemed as normal, no problem of any kind. But one test result came back showing what the heart issue. My thyroid test revealed that I have a very overactive thyroid.
The cardiologist said that this is what is driving my heart to go into a-fib. I am writing this to possibly help someone who may have an undiagnosed thyroid condition causing their atrial fibrillation. I thought my thyroid had been checked during my yearly physical exam and blood test but it was not. Right now I’m on metoprolol to suppress my heart, digoxin to help it beat normally and a blood thinner. And of course I’m on thyroid medication to slowly bring it down to normal.
When it gets to normal, then tests will be done to determine why it went hyper. So for now I take my meds and deal with occasional afib until my thyroid is normalized. I hope the best for all of you. I am working on my stress which makes everything worse. I’m 55 years old and until now felt pretty healthy.
Bill, Here is some advice: I have had a-fib for about ten years. Make sure that you see an electro-cardiologist (EP) rather just a regular cardiologist. The regular cardiologist deals primarily with the cardio-vascular system. Whereas the electro-cardiologist deals with the electrical side of the heart.
A quick update:
After having an episode of SVT last fall, I had a second ablation on December 16th, so as I write this I’m just at the tail end of the blanking period. A few days after the ablation, I had an episode of afib and they put me on sotalol, which I’ve been taking until today. I’ve been cutting down the dose for a week and skipped my dose last night. Woke up this morning feeling pretty sure I was in afib. I’m feeling a little better now.
I’ve had low energy and palpitations for most of the past three months. The drugs make me tired and nauseous and the sotalol seemed to have made my vision blurry after a couple of months. A few days after I cut the dose in half, my vision improved a bit.
The biggest problem is the fluttering sensation I’ve had since I had the episode of atrial flutter after the first ablation. My pulse will be normal—it’s not PACs or PVCs—but I feel an irregular beat in my chest, like 2 regular beats followed by 4 rapid ones, or some similar combination. It’s a very odd sensation and nothing seems able to record it. My EKGs are normal, I wore a Zio for a week which couldn’t record it, and it doesn’t show on my LifeWatch recordings. I had hoped the second ablation would correct it, but it’s been more or less constant, though often so faint that it doesn’t bother me.
It’s incredibly frustrating to think I’ll need another ablation. I’m waiting to see how I do without the sotalol and looking forward to seeing Dr. Natale (they won’t give me an appointment until after my four-month follow up with the Nurse Practitioner). I know some people need more than two procedures, but this is a long road.
Best wishes for anyone else struggling with this disease.
Robert
Hi Robert,
Hope you are well, would appreciate if you share and update us on your current experience after the 2nd ablation.
Best wishes,
Saad
Hi Saad,
As far as I know, I’ve had no episodes of afib since my last post. I continue to take the Sotalol. I tried to come off of it a couple of months ago, but had so many palpitations that I went back on it.
I went through a stressful period a month or so ago, experiencing stage fright (I’ve been doing presentations in my work for almost 30 years without any problems) and tried propranolol for awhile. The propranolol worked for the anxiety, but made me nauseous, so I switched back to the Sotalol. I still have the fluttering sensation, which they tell me are PACs and PVCs (which doesn’t feel right to me). The Sotalol keeps it mostly under control, but it makes me tired.
As it turns out, I was at Dr. Natale’s office today and had a TEE to make sure I don’t have any clotting. I’ve been off the Eliquis since May. I’m going to try going back on Metoprolol instead of Sotalol to see if I’m less tired.
Bottom line, my ablations have been a mixed bag. I haven’t been in afib, but I still experience palpitations and I’m reminded daily that my heart is not quite right. There’s nothing more they can do for me, so either my heart gets better on its own, or I’m on beta blockers for the rest of my life. Since I was never on the drugs for any length of time, I do sometimes wonder if I would have been better off if I’d given them more time before having my ablations.
I think it can take a long time for the heart to heal after two ablations in the same year, so I still have hopes that things will settle down. I had a few conversations with Shannon and I think he said he was on a beta blocker for a year before his heart settled down (thanks again for the help, Shannon and Travis!). Either way, I’d rather deal with this than have an afib episode every week or so.
Hope you’re well and, if you’re considering an ablation, I wish you the best.
Robert
Hey Bob, sorry to hear things haven’t quite worked out for you. You probably won’t remember but about 1 year ago I read your story and had asked for your feedback on ablation. I had a cardioversion the year previous to that but the afib was back within 6 months. They put me on beta blockers for a year but I finally decided to get the ablation in May 2017.
I have to say that for me it was a game-changer. It’s like someone turned a switch on and I feel energized like a 20 year-old now. I felt the improvements within two days of the procedure and the old ticker hasn’t missed a beat since then. I stayed on medication for 6 weeks after but I’m off all that ever since.
I know it doesn’t work for everyone but all I can say in my case it is a success. I went from being technically in heart failure with an ejection fraction of 19% to now near 60%, just amazing. I don’t know what they do in the U.S. in terms of procedure, but here in NZ they try to isolate all the pulmonary veins in one hit not just the ones they see as problematic on the monitor. The doc said they isolated over a dozen of spots on my heart to eliminate all possible electrical “shorts.”
Anyway, thanks for your testimonial and to Travis for what proved to be very good advice in my case. All the best, Dave
Hi Robert,
Thank you for the update. I would like to mention that Travis has experienced a similar issue with palpitations post ablation, however he mentioned in his recent posts that his palpitations have significantly improved if not completely resolved, perhaps you will experience the same improvement as he did with the passage of time, I think patience is a must in this case. Also, it’s good news that your persistent dry cough has finally resolved, hopefully, your palpitations will also ultimately get resolved.
I would like to add, maybe you should consider taking a small dose of flecainide instead of the beta blocker to address the palpitations and avoid the fatigue, in my case I have a slow heart beat (40’s). Do you? I took flecainide instead of the beta blockers and that helped me. May be worthwhile to check with your doctor.
Please keep us posted about your progress, my best wishes of good heath and good luck to you.
Saad
Saad:
All great points!
Robert – I’m now 2 1/2 years out from my ablation. While I haven’t had a single event of afib (knock on wood) I have battled palpitations on and off ever since. The good news is they have gotten better but I still get flare ups. I just came off such an episode. For about 2 weeks straight I had hardcore nonstop palpitations. I stopped all my magnesium supplementation and they were 90% better! At any rate, hang in there and fight the good fight! As Shannon says, I’ll take battles with palpitations over afib any day!
Travis
When you get your palpitations, do you feel them in your peripheral pulse? My pulse will be normal, but I feel beats in my chest. It’s like electrical activity that doesn’t quite cause the heart to beat irregularly. My Kardia recordings will look (mostly) normal. That’s why I don’t think what I’m experiencing are PACs and PVCs. When I last saw Dr. Natale, he said a very small percentage of people experience something like what I’m experiencing, but I didn’t understand his explanation. I see him next month and will try to find out more.
How long did it take for your heart rate to come back to normal? Without the beta blockers, my heart rate is still about 100.
Interesting that your palpitations got better when you stopped taking the magnesium. In any case, glad to hear you’re doing well!
Thanks, Saad. My heart rate is fast. On the sotalol, it’s usually in the mid- to high-70s. When I tried the metoprolol, my heart rate would be in the mid- to high-90s as the dosage wore off, and when I tried to stop last time it was over 100, so I seem to need the beta blockers to keep things in check.
Hi Robert,
Give it more time. Palpitations … in this case, garden variety ectopy .. while a bit of a nuisance no doubt, it is largely benign and in the vast majority of cases will gradually subside usually within two years with it tending to get better over time during those two years. And it’s no-brainer a better trade off compared to living with progressive AFIB, in any event!
One association I have seen a lot in following so many Afibbers after ablation … and others have reported this too … is that it is not uncommon for those who experience frequent extended ectopic runs in the absence of active arrhythmia post ablation, to report a history of anxiety as well. Keep looking into a possible adrenal dysfunction connection as well, as we discussed 6 months or so ago. And as Saad noted too, patience goes a long way as well and odds are high you will gradually find this issue is less and less prevelient and noticable over time.
Best wishes,
Shannon
Thanks, Shannon. I’m trying to be patient. Would be really great if my heart rate would come down enough to get off the beta blockers.
I’ve been taking Ashwagandha since we last spoke and it definitely helps with the anxiety.
Thanks for that tip and for all of your help! Hope you’re doing well.
Robert, I have had a-fib for almost eight years now. I was diagnosed with a-fib in 2008 prior to a pre-op for a hip replacement. The cardiologist that initially saw me wanted to do invasive procedures. I went to an electro-cardiologist and his approach was totally different.
For example the initial cardiologist did an echo: I took the results of that echo to the second cardiologist and he exclaimed that the echo was so poor that he could determine nothing from it. He did an echo in his office and when he received the results he exclaimed: “I know exactly what is going on now and here is the plan” The next day he did a cardio-version and I was in sinus rhythm. I was put on cardiovol and flecinide
Since that time in July of 2008, I have had 6 cardio-versions: In all of these episodes my heart rate would jump to 100 – 120 beats per minute and the cardio-versions would convert my rate back to normal: My resting rate is in the 50s and 60s.
In 2014 I moved to another state and obtained a different electro-cardiologist and in August 17, 2017 I had an ablation. On Sept 19, I went into a-fib I had a cardio-version on September 21.
When I was diagnosed with a-fib in 2008, I was 70 and I am 80 now.
I am sharing this with you and anyone else who reads about this experience to tell you about some concepts in life style that help alleviate many of the symptoms and problems with a-fib. In 2008 my diet was plant based; however, I ate dairy, cheese, eggs, and fish. After eating a very large bowl of ice cream one evening I went into a-fib the next morning. That did it, no more dairy or cheese. Then in 2013, I was convinced to go total plant based. I had opportunity to watch a documentary called “Forks over Knives” the research done by the doctors in this documentary was thorough.
I highly recommend that you watch this documentary. It is available on the internet and netflix.
As you adopt a plant based diet you will experience some remarkable changes in your heart health. At this time my rate is 67 and my pressure is 117/82 and I not taken my blood pressure medications.
One of the effects of my plant based diet is that I cannot take any blood thinners as they cause my fingers and hands to blister, hurt and swell. i.e. Pradaxa and Xeralto, Violent nose bleeds and memory loss on Eliquis: When I was on coumadin, I had four infections, each infection becoming more ant-biotic resistant: I was hospitalized with one of the infections.
I have shared this journey hoping that it be of benefit to whoever reads this. Gary Fisher
Gary, thanks for sharing your story. I’ve experimented with different diets with mixed results. I do limit dairy and it does seem to make a difference. It’s important to get enough magnesium to balance the calcium.
An update: I saw Dr. Natale yesterday. The results of my TEE were excellent, better than normal apparently. My ECG showed some very brief ectopic runs, but no afib. According to Natale, the fluttering sensation I feel is electrical activity in the heart muscle that’s insufficient to contract the heart, which is why my pulse is normal. He said it’s rare and most people get used to it over time, or there’s a chance it will go away. In the meantime, my resting heart rate is still elevated. He said it can take a year to a year and a half for it to return to normal, so I’ll be on the metoprolol for awhile. He also said I should get more exercise.
As they say, the reward of patience is patience.
Robert:
Thanks for all the updates. I’m glad to hear you’re doing well. I will tell you it took me a full two years for my heart rate to go back to my pre-ablation heart rate of 50 bpm. I actually hoped my heart rate would stay slightly elevated but it just kept coming down over the months. Hang in there. Your heart rate will eventually come down.
Take care,
Travis
Thanks, Travis. That’s reassuring. I’d really like to come off the metoprolol.
Thanks again to you and Shannon for your support and all the work you guys do to support all of us. Be well!
Robert,
It’s good to hear that you are doing better and that all your test results are normal, and I agree, patience is it’s own virtue, what was your hear rate before the ablation? And with and without the metoprolol? IN my case, I take a single dose of metoprolol only at the onset of an episode along with the daily flecainide, however that single dose really saps my strength when I’m back to nsr, since my nsr heart beat is in the 40’s, I agree with Travis, it would’ve been nice if we we’re in the 60’s instead.
Thanks, Saad. My heart rate before my first ablation was high 70s, low 80s, so it’s always been high. After my first ablation in was in the low 90s, but came down in the 80s again after 5 or 6 months. Since the second ablation last December, it’s been above 100 without the drugs. With metoprolol, it’s in the low 80s, but it will be in the 90s in the morning when I wake up before I take my morning dose. So it looks like I’ll be on it for awhile. I need to get more exercise, too. Natale says that can help.
Hi there,
Glad to have come across your site today…divine timing I say;). I remember having some irregular heart beats over the years but dismissed it (very very short lived). Now I am 53 and they have started a little more frequently and the past 2 nights it’s been full on. I am sitting here at 11:15 in my pj’s because I am so tired.
A couple of years ago I was diagnosed with adrenal fatigue so I’m a bit confused sometimes whether it is Afib related or adrenal. I have made my first doctors apt for Monday (today it’s Friday). I think it’s time to get it all checked out. I am nervous for sure. I am NOT a Dr. person, have never been on meds and I do not want to start that path that’s for sure!
I have been drinking hot chocolate this past week, and coincidentally or not, I have been having many Afib attacks. So today, back off that. I take hawthorn and magnesium. I also read that gluten can be a great contributor.
I know going forward with whatever is going on here that I will stop hot chocolate (I haven’t had caffeine products since I was 19 – just thought it would be nice to have some HC).
This seems to happen as soon as I lay down at night in bed. I’m so frustrated and tired. Thank you for listening to my rant.
Sandi
Sandi:
Thanks for sharing your story. I have some questions and comments. When you say you are having “many afib attacks,” how do you know you’re having afib attacks? Have they been confirmed with a monitor or by your doctor? I was just confused when I read your story because I wasn’t sure if you knew you were having afib or you thought you were having afib attacks.
Also, have you been diagnosed with sleep apnea – or is it possible you might have sleep apnea? There is a strong connection between sleep apnea and afib – especially if afib primarily strikes in the middle of the night when you’re sleeping. Depending on what your doctor tells you on Monday, you might want to think about having a sleep test completed. Even if you don’t have afib, sleep apnea could be causing you to not sleep that well, which might explain why you’re so tired. It’s just a good idea to rule it out regardless.
Travis
Hi guys, I live in Adelaide Australia. I read your blog about a year ago. I agree that having an ablation is the best for Afib. In Australia they prefer to keep people on medication until this does not control the Afib. In the UK apparently they do the ablation almost immediately.
I was diagnosed with atrial fibrillation about 5 years ago and put on Flecainide and Diltiazem. Then atrial flutter developed and after 3 episodes of atrial flutter my cardiologist did an ablation for the flutter only. I was still on medication for AFib but after 2 years of being really stable on it I asked to have the ablation for AFib.
I had the ablation in July and they checked the aflutter ablation as well and all went really well. My main reason for having the second ablation was to get off the medication which I feel was affecting my life. I am really happy I did it and I have one more test in January which will be a 24 hour holter monitor to see if my heart is behaving overnight. I am exercising normally and trying to get fitter to make my heart as strong as I can now.
Gabrielle:
Thanks for sharing your story! I’m so glad to hear your ablations were a success. It’s awesome, isn’t it? I wish you many years of NSR!
Travis
Hi Robert,
This is Shannon Dickson here and a friend of Travis. Your symptoms are entirely within the normal range of a those that can happen in ablation recovery during the blanking period. Some people have very little to no post ablation AFIB, Flutter or Tachycardia, but that is more rare than common.
Most people will have some degree of activity during the blanking period, and often it can be quite a lot including needing a cardioversion or two, even when such index ablations wind up delivering a quiet heart for well over 10 years to indefinitely after the blanking period ends.
Such post ablation activity is not an uncommon manifestation of the healing process with variable rates of inflammation healing that can set up mostly temporary flutter/tachy or new transient AFIB circuits that can rattle on for a bit before the underlying scars form as the variable thickness of the lesion lines heal and form solid blocking scars that should be transmural (all the way through the thickness of the atrial wall).
The majority of the time such blanking period activity will start to subside past the 8th week and should be much quieter after week 10 and be fully quiet by end of week 12.
In other cases, and especially is actual arrhythmia such as AFIB or flutter is documented and that is increasing during the third month, that is a good indication of very likely needing a touch up ablation sooner rather than later.
Every ablation candidate should always be prepared for a two procedure process and then be happy as a clam if they turn out to be done in one. The silver lining too, if a person turns out to be an early recurrence afibber after going to a true maestro like Dr. Natale, is that they will surely get this thing put to bed with the least amount of total work their hearts might require for true freedom from arrhythmia and the vast majority of the time that will be with achieved with the upcoming touch up. And if Natale did the first one, as in your case, should you need a follow up ablation it will be just a touch up with very minimal added ablation burden on your heart.
Unlike with less experienced operators who typically will just repeat a full PV Isolation ablation for any follow up and not do a targeted touch up to only tube offending area found during the touch up procedure.
Requiring two procedures to finally put this behind you for the long term is quite common, and you made the best decision for yourself in selecting the most experienced operator anywhere in the world to be in charge of your heart’s care from beginning to end of your own expert ablation process. … and it is a PROCESS.
Hopefully, you will be ‘one and done’ when the blanking period is all done and for the rest of your life, but do not get discouraged if you need a follow up sooner … it will just be that much quicker that you will solidify your NSR for the long term. There is a wide range of how different people heal, and depending on the degree of progression one brings to the table and such things as variable thickness different people have to their atrial tissue can make for a greater likelihood of needing a touch up sooner rather than later.
Ive followed so many ablations at Afibbers.org directly over a good many years now and the vast majority of folks who have gone to Dr Natale, close to 400 hundred over the years we have been hosting our forum, for those who do require more than ‘one and done’ it is almost invariably done with that 2nd true touch up. Occasionally a third one is needed down the road, but that is far more rare in our extensive experience with this elite level operator.
As such, while I fully understand how we all obviously wish to be done with the first one. Nevertheless, the smart and real world perspective to take is that you have already crossed, by far, the largest span of your bridge back to permanent NSR.
Thus, if you need to take another short walk still yet to button down a few remaining spots that may have been suppressed during anesthesia or where not fully mature enough triggers during the index ablation to address with ablation then, then so be it and bring it on .. the sooner the better and get this thing over with for the long haul.
In any event, success with this lousy condition is all about taking the long term big picture view and not get side tracked for discouraged by putting all one’s eggs into an “I must be one and done or this was a failure” type of mentality which is very short-sighted and counter-productive for those who don’t see the big picture here. Especially, if they let a deflated attitude prevent them from even getting to round two with the same elite level ablation expert.
Also, with the short runs you describe recently, be sure they are not just runs of ectopy with a mix of PVCs and/or PACs which can happen too during the blanking period and afterward, but the vast majority of the time are benign and do not signal any need for a follow up visit to San Fran and CPMC. When such ectopy come in spurts it can very much feel like AF or flutter too.
If you don’t have an Alivecor iPhone monitor that is a good investment to make to help clarify what is going on.
Best wishes to you Robert and take heart that you are far closer to the end of all this business than you were before July 25th and the end is quite near one way or the other. Either already or perhaps with one more step in all likelihood, assuming any further step at all will be needed. Keep focused on the goal and don’t get diverted from establishing durable NSR period. You’ve made good decisions so far and keep it up!
Be well,
Shannon
Shannon:
You’re the best! Thanks so much for taking time to read Robert’s story and replying to him. I’m confident your comments will not only help put Robert’s mind at ease but other afibbers as well who are either struggling during their blanking period or who are considering having an ablation in the first place!
Be well, my friend, and I’ll talk to you later!
Travis
Shannon,
Thank you so much for taking the time to write such a thorough and reassuring comment. It’s very encouraging to hear about your experience. I know I”m still in the blanking period and hopeful I’ll be “one and done,” but if I have to go through it again, it will be a small price to pay for permanent NSR. Thanks again, and be well.
Robert
Robert:
I know I sent this to you directly via email but I want to include it here too for the benefit of others.
Shannon encourages you to visit his forum and browse around (and post any questions you have). Here is a link to his forum again: http://www.afibbers.org/toboards.htm
He also recommends you read the following article and apply the strategy asap to help calm down your heart:
http://afibbers.org/resources/strategy.pdf
Be well!
Travis
Dave and Travis:
What a coincidence! I was just checking the site today because I’ve been having some symptoms and wanted to read up on how you’re doing, Travis. So, time for an update:
I was feeling good after my ablation. Everything healed up nicely and the migraines disappeared after a couple of weeks and haven’t bothered me since.
A week or so after my ablation, my throat irritation developed into a chronic, dry cough. I still have it. Dr. Natale told me not to worry, that it should clear up after a few months, but it’s really annoying and I sometimes worry it’s more serious. We’ll see.
Almost a month to the day, I had an episode of rapid heartbeat. I thought I might faint. I was finishing dinner with a friend and drove to the nearest emergency room. My heart was beating so fast (about 200 bpm) they couldn’t tell what kind of rhythm it was in. They had to give me adenosine to stop my heart (a very strange sensation) so they could read the EKG as it started up again. They diagnosed atrial flutter. They gave me some Diltiazem to get my heart rate down and sent me home.
I had a follow up with Dr. Natale the next day. I was still in atrial flutter. He said they should have done a cardioversion and he scheduled it for the following day. After the cardioversion, they put me on Multaq and also gave me some Diltiazem to take if I had another episode.
It’s been a mixed bag since then. I don’t know if it’s the Eliquis and the Multaq, or my heart, but I’ve been fairly low energy. I have brief episodes, mostly in the middle of the night, of atrial flutter or atrial tachycardia—just several rapid beats strung together—which feels weird since my pulse is normal. It’s an odd fluttering sensation in my chest. Today has been the worst day. I’m feeling a little better now and hoping that it will pass. If things aren’t better in a day or two, I’ll have to call Dr. Natale again.
Hope things are getting better for you, Travis. Dave, I wish you well, and everyone else who’s suffering with this frustrating condition.
Robert
Thanks for that update Robert. Sorry to hear about that relapse and hope things get back to normal soon. But as others have pointed out, I realize that it won’t always be a 100% fix on the first go and it might take a few adjustments down the track.
Ten years ago this year I was diagnosed with base tongue cancer out of nowhere. I got some pretty rough treatment and the damn thing came back within 9 months! My 5 year survival stats weren’t looking good then, in the single digits % but hey I’m still above ground and the second go wiped it clean so there you go. Thanks, Travis, for a wonderful resource here. I’ll keep an eye on it regularly and also let you know how things evolve form my side. Cheers, Dave
Dave:
Thanks for sharing your successful battle against cancer. That’s so awesome to hear. I love reading successful and inspiring stories like this! They encourage us all.
I wish you well!
Travis
Robert, I hope you are doing well, can you kindly update your condition and your feelings after the ablation as of today 10/17, really appreciate the feed back.
Saad
Saad:
I’m feeling a little better, but I still have an odd fluttering sensation in my heart, even though my pulse is normal. I had an EKG and it was normal, so not sure what to make of it. My cough is just a little bit better, so hoping that will resolve soon. It will be three months next week. I’m going to see if I can get off the Multaq and hope that I’ll be okay. The jury is still out. I’ll post an update at some point if things change.
Robert
Thanks for the update, Robert. It sounds like you’re doing pretty well all things considered. I hope you’re able to come of the Multaq soon!
Travis
Hi Robert, I am curious if they told you to take Prilosec for the first month after the ablation. After my ablation, I was instructed to take Prilosec to avoid any acid reflux damaging the lining of my esophagus. That may be causing your dry cough.
Thanks for the suggestion, Mario. No, they didn’t tell me to take Prilosec. I don’t think the cough was caused by acid reflux. It felt more like a nerve issue. It did clear up after about 5 or 6 months and I didn’t experience it at all after my second ablation.
Thinking about having my second ablation. How you doing now ? Had 62 zapps but still have af accasionally. JFK hospital.
Thanks Robert for that. I just found out about Travis’ web site today while doing a bit of fact finding about ablations. It was 1 year ago when they “shocked” me out of it with a cardioversion and since I’ve been on baby aspirin and carvedilol beta blockers. Was ok for first 6 months but now my afib episodes are coming back at least a few times a week and the beta blockers really are sucking the life out of me. I feel like a zombie so my doc suggested I consider an ablation to try to fix it and get off the meds. I’m definitely thinking of doing it just to get my life back. Thanks Dave
Dave:
Having an ablation is the best thing you can do – IF you have an expert EP do it! Short of having an ablation, you’ll be on drugs the rest of your life and your afib will likely only get worse. I wish you the best in whatever you decide to do!
Travis
Thanks Travis, I read your story with great interest. I’m certainly leaning towards getting that done. I’m scheduled to meet with the cardio team here in a few weeks. I’m based in Christchurch, New Zealand and there is a Dr. Crozier here who is an expert with this technique so heard really good things about him and he has been published in several medical journals. But as Robert pointed out in his update, it probably isn’t always a “slam-dunk” on the first go.
Dave:
That’s spot on…it’s not always a “slam dunk.” Like Shannon pointed out in his comments, we always tell afibbers to go in expecting two procedures (and maybe even 3) and if you’re a “one and done” case that’s just icing on the cake!
I know people get really bummed when they hear they may need 2 or even 3 procedures but that’s just the way it is now. For me personally, it’s a relatively small price to pay to have NSR and a normal life! I’m hoping I don’t need a 2nd procedure but if I do, I’ll be focusing on the fact that there is a very good chance I’ll finally be done dealing with this for good after the 2nd procedure!
Travis
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