Editor’s Note: I reached out to Doug recently for an update on how he’s doing these days. This is the exact reply I got from him via email on 4/29/22. “Travis, thanks for reaching out. I am doing great, absolutely zero recurrence of AFib or any kind of arrhythmia (PAC’s). I’m still working out quite a bit, riding around 70 miles/week and playing golf. I consider my ablation a medical miracle!”
I am writing this on the one-year anniversary of my successful afib ablation. When I was suffering with atrial fibrillation I read every “testimony” I could find looking for hope. My story is one of hope and recovery, and it is my intent to inspire others who are dealing with this debilitating condition to seek treatment, and to not accept that AFib is something you must live with. In addition, I apologize in advance for the length of this testimony, but I have included details and reflections that I feel are important to others seeking answers.
Jump Ahead To:
My Background
I recently turned 65, work full-time as a project manager at a science/engineering consulting firm, and live in the Tampa, Florida area. I have been somewhat of an endurance athlete for most of my life, logging over 6,000 hours of training time as a runner and cyclist. I am by no means a Master’s champion, or anything like that, rather, I am just a guy who has enjoyed staying fit and “competing” in local events.
Other than sport injuries, I have generally been very healthy my entire life. Of significance, my father was diagnosed with AFib in his early 50’s and lived until age 73 in persistent AFib. He was prescribed digoxin, which he was on for decades. He died in his sleep in 1989 of unknown causes, but his death certificate said that it was a possible myocardial infarction (heart attack). To my knowledge, he was never diagnosed with heart failure.
AFib Onset and Progression
When I was in my early 30’s I experienced an episode of pronounced ectopic beats that pretty much came out of nowhere. I was having one or more pre-atrial contractions (PAC) every few minutes, with the skipped beat sensation and the hard “thunk” of the recovery beat. This episode lasted maybe 10 days and was disturbing enough that I made a doctor appointment.
By the time I got into to see the doctor, the episode has pretty much run its course. He put me on a Holter monitor for a week or so and did see a few PAC’s, but he said that they were normal and there was nothing to worry about. I then went the next 30 years of my life without experiencing any type of arrhythmia.
My first recollection of an AFib event happened in May 2016, when I was 61 years old. I recall waking with a noticeably irregular and rapid heartbeat, and had trouble catching my breath. My normal resting heart rate (HR) was about 54 bpm, but this morning my HR was about 80 bpm. Since I had been out the night before with friends drinking beer, I chalked it up to too much alcohol and not enough sleep.
I went for a 20-mile bike ride and about halfway into the ride, my HR just dropped back into sinus rhythm. I know because I always train with a heart monitor, and I plotted the chart of that ride. I went another 6 months without any episodes, but then I had two similar events in October 2016. I tried to “ride off” the arrhythmia as before, but it didn’t work, and I found it very difficult to exercise while in arrhythmia. Both of those episodes lasted about 4-6 hours and self-terminated.
On New Year’s Day of 2017, I again awoke in arrhythmia – again after a night of partying. That event also lasted 4-6 hours and self-terminated. In May 2017 I had my annual physical exam with my general practitioner (GP), and I mentioned these episodes to him. I had been doing some research on my own and had pretty much concluded that I was experiencing paroxysmal atrial fibrillation. He did an ECG in the office and said that it looked perfect; but he also said to call him the next time it happened so that he could maybe catch it on an ECG.
Three months later, in August 2017, it happened again on a Friday. I called my GP, and he said to come in Monday morning if I was still in arrhythmia. This episode persisted through the weekend, and into Monday when my GP did another ECG. This time he said that I was definitely in “some sort of an arrhythmia.” I asked him if it looked like AFib and he said he didn’t know for sure, and that I needed to see a cardiologist for a diagnosis.
He prescribed Diltiazem and aspirin and said that the Diltiazem would probably bring me out of it in a few days. That episode lasted almost an entire week. Thus, began my long AFib nightmare.
The Cardiologist
I made an appointment with the cardiologist recommended by my GP and got in to see him in early September 2017. He did a full cardiac workup, including an ECG, an echocardiogram, and a stress test with barium dye to check for any restricted blood flow around my heart. He said the ECG looked fine, but he was going to prescribe 3-weeks of 24-7 HR monitoring. I wore the monitor for three weeks, including during workouts, and never had any arrhythmia during that time. I went back to see him again in late September, and he pronounced me to be heart healthy.
He said that the stress test showed no blockages, my valves were normal, and the monitor picked up no AFib. However, he said that my echocardiogram showed bi-atrial enlargement, and an aneurysm of my aorta root. While I was happy about some of this news, the issues with the echocardiogram were very disturbing. He said that I didn’t need to take the Diltiazem, but he recommended that I continue with one 325 mg adult aspirin per day as an anticoagulant just in case I had any more AFib occurrences.
Four months went by with no more AFib episodes, and I began to just forget about it. Then in mid-January 2018, while traveling on business, I had a really bad AFib attack. I had gone out for dinner with my project team and had several drinks and a big meal, and then went back to my hotel room to prepare for a major meeting the next day. About 9 pm, while lying in bed, my heart suddenly shifted into another gear, with a very rapid and irregular HR. For the first time I had the sensation of the fish flopping in my chest. I called my wife and she said to take a hot bath and try to relax, which I did – but it didn’t help. I was filled with anxiety and hardly slept that night.
Somehow, I got through the meeting the next day, with my AFib raging, and then drove 5 hours home. While driving I called my cardiologist and asked if I could come in the next day. He slotted me in for an afternoon appointment, and I was still in AFib when I arrived. He did an ECG and confirmed the diagnosis, and that my “resting” HR in AFib at that time was about 120 bpm. He prescribed Flecainide (50 mg 2x/day) and Xarelto and said that I needed to see an electrophysiologist (EP).
He explained that treatments for arrhythmia had come a long way since my father passed, and that ablations offered a cure for some patients. He said that there were several good EP’s in the Tampa area, and recommended one that he thought I would like that worked out of a hospital near my home.
The Local EP
I called the referred EP to set up an appointment, but his office said it would be 6 weeks before I could get in to see him. I took the first available appointment. Meanwhile, my AFib event lasted for about 4 days, and either self-terminated or was stopped by the Flecainide, which I had just started. Two weeks went by, and then the Saturday before the 2018 Super Bowl I went for a 20-mile bike ride.
I felt fine while riding, with no arrhythmia. After finishing I sat down with a cold bottle of water and took a big swig, and my heart immediately jumped into a horrendous AFib attack, worse than ever. I rode a few short blocks home and told my wife I was in big trouble. She put her ear to my chest and said that she was taking me to the emergency room.
They admitted me and immediately hooked me up to a Diltiazem IV drip. It took about an hour to get my resting HR down to about 130 bpm, but they couldn’t extinguish the AFib. A partner in the EP practice that I had been referred to was on call that weekend, and he told the emergency room staff to admit me into hospital bed for the night and to continue the Diltiazem drip. He would not authorize a cardioversion without seeing me first.
I spent a sleepless night in the hospital, and stayed in AFib all the next day, albeit at a lower HR. The on-call EP finally showed up about 4pm and administered 300 mg oral dose of Flecainide. Within 30 minutes my AFib was gone. He said to continue with the lower daily dose of Flecainide, but if I had another attack it was OK to take the 300 mg “pill in the pocket” dose. I watched the Super Bowl in the hospital and was discharged the next day.
A week went by and I had another attack on a Friday night. I took 300 mg of Flecainide, but it didn’t work this time. On Saturday afternoon I called the local EP’s emergency number, and he called me back about 9 pm. He said to take one more 300 mg dose, which I did, and on Sunday morning my AFib was gone. I had two more attacks like this over the next four weeks before I finally got in to see the EP in early March 2018. He looked at my test results from the cardiologist and said that my AFib progression was still in its early stages, and that I could benefit from an ablation.
I asked about his experience with the procedure, and he said that he had performed about 300 cryoablations, and that his “success rate” was about 50%. That didn’t sound very good to me, so I asked him what constitutes a successful ablation. He said that about 50% of his patients require a second ablation within one year; and of those patients, about 70% remain AFib free for several years. He said he could get me in for an ablation within about two weeks, but I said I wanted to do some more research on my own before committing to anything.
Depression Sets In
Leading up to, and after, my appointment with the local EP, I was doing a lot of internet research on atrial fibrillation and ablations. In fact, I had become obsessed with the subject, and worried incessantly about the bad things I was reading. Most troubling were: 1) all AFib drugs eventually stop working; 2) AFib is a progressive disease, and once you get it you are destined to end up with persistent or permanent AFib; and 3) ablation technology is relatively new, the success rates are not very good, and the risks are significant. Taken together, these points painted a very pessimistic future for me.
During this time, I began to sink into a pretty serious depression. The stress of dealing with more frequent and more intense AFib attacks while carrying on in a high-pressure job was bad enough. However, I also believe that the negative pharmacological mood effects of Flecainide also contributed to my deepening depression. I was anxious most of the time and was sleeping very poorly. Worst of all, I actually began to have fleeting suicidal thoughts, which was very scary.
I went back to my GP and he prescribed Ambien for sleep, Xanax for anxiety, and Lexapro for depression. In a few short months I had gone from a healthy, happy, athletic guy on zero medications, to a nervous wreck now on five medications. The Lexapro took about a month to start working, and I slowly started to recover my emotional resilience.
During this time, I also discovered the Living with Atrial Fibrillation website, which presented a more optimistic tone. I reached out to Travis, the owner of this afib blog, via email and he was very kind and supportive. He offered to connect me with his friend Shannon, who had a long history with AFib, both as a sufferer and a patient advocate. Shannon is the owner of the Afibbers.com website.
He has acquired a depth of knowledge about AFib and ablations that equals or exceeds that of most EP’s. I was able to talk with Shannon on the phone and he was very encouraging about my future and recommended that I seek out a more experienced EP if I had good insurance and was willing to travel for the procedure. He explained that the success rate of ablations really depends on the experience of the EP, and that it is as much of an art as it is a science. When pressed on who I should see, Shannon recommended Dr. Andrea Natale at the Texas Cardiac Arrhythmia (TCA) clinic in Austin, TX.
Ablation No. 1
Fortunately, Dr. Natale was in my insurance network; however, his next available ablation date was not until July 19, 2018, still a long four months off. I took the appointment and began to feel hopeful for the first time in months. During the months leading up to my ablation, I recovered from my depression, was sleeping a little better, had less anxiety, and was cycling somewhat regularly again, albeit much more lightly than before.
The Flecainide seemed to be holding my AFib in check most of the time, but I hated the sluggish way it made me feel. It seemed to lower my resting HR, but when I exercised my heart felt jumpy, like it was on the verge of AFib.
My wife and I flew to Austin on a Sunday, met with the TCA staff and Dr. Natale on Monday, had the ablation procedure on Tuesday, and was discharged from the hospital on Wednesday. I will not go into detail about the procedure other than to say that it was scary as hell, but there was little very pain or discomfort. When I awakened from the anesthesia, I was in sinus rhythm and my chest was a little sore. Otherwise, I felt pretty good, and I had no problems at all with the catheter insertion points.
Compared to my rotator cuff repair, the ablation was a walk in the park. After the procedure Dr. Natale came in to visit. He is a gracious but subdued man. He said that my procedure went well, and that he didn’t see any fibrosis in my atria. He did a basic pulmonary vein isolation (PVI) using radiofrequency ablation and did not have to ablate any other focal sites. I was under anesthesia for only about two hours. I was directed to stay on Flecainide and switch from Xarelto to Eliquis.
By the weekend I was feeling pretty good, although I was still having fairly frequent and intense PAC’s. The following week I traveled on business to attend a professional conference and present a paper. I felt good enough to mingle with colleagues and party a little; however, I caught some sort of a respiratory virus, and a few days later I had a sore throat, a raspy cough, and a fever of 103.
Exactly two weeks after my ablation I went into a pretty bad AFib episode that lasted about 12 hours. Being in AFib with the flu was truly a miserable experience. The next day I called Dr. Natale’s nurse and she said that catching the flu that soon after an ablation can inflame the heart and trigger an AFib attack, and that it should calm down as I recover. Unfortunately, it didn’t turn out that way.
After I recovered from the flu, I continued to have what felt like AFib events about every two weeks, with each event lasting days at a time. I was still early in my blanking period and was sending in weekly ECG recordings through the telephone to Dr. Natale’s nurse. She said that the recordings indicated atrial flutter, not atrial fibrillation, and that this type of arrhythmia was common following an ablation.
To me, it felt indistinguishable from AFib. This pattern persisted for the next two months. Dr. Natale’s nurse also kept telling me that this was normal during the blanking period, but I stopped believing her. In late August I had a particularly bad episode, so I called my local EP and he saw me the next day. He did an ECG and said it was not clear if it was atrial fibrillation or atrial flutter, and that my “resting” HR was bouncing around 120 bpm. He scheduled me for a cardioversion the next day.
I showed up at the hospital the next morning with my wife, and as they were prepping me for the cardioversion, I suddenly went into sinus rhythm. The EP came in and told me to stay there for another hour or so to see if I stayed in sinus rhythm, which I did. When the EP came back and said I could go home. While driving out of the hospital parking lot, I again went into the same arrhythmia. I called the EP and scheduled an appointment with him the following morning.
At my appointment he said that Flecainide can sometimes exacerbate atrial flutter after an ablation and recommended that I discontinue taking it. He also said it was kind of futile to do a cardioversion while I was still in this on again off again pattern. When I left his office, I called Dr. Natale’s nurse and told her what my local EP recommended. She conferred with Dr. Natale and called me back and said that Dr. Natale agreed that I should stop taking the Flecainide. I scheduled an appointment with Dr. Natale in Austin in November, four months after my initial ablation.
Ablation No. 2
After discontinuing the Flecainide my atrial flutter episodes became less frequent and shorter in duration; but I was still having them every 2 weeks or so, and they were lasting 1-3 days. My life was still a mess. At my appointment Dr. Natale said that he didn’t know why I was still having arrhythmia, and that a second ablation was necessary to find out what was going on.
He speculated that he may have to ablate my left atrial appendage (LAA), as this small pouch on the side of the atrium is sometimes a source of erratic electrical activity that causes AFib. He said that ablating the LAA usually results in the loss of its ability to contract with each heartbeat, thus increasing stroke risk. Mitigating the increased stroke risk would require that I take anticoagulants the rest of my life, or a follow-up procedure to install a “Watchman” device that occludes the LAA and prevents blood from entering and pooling there.
We scheduled my second ablation for February 4, 2019, but both my wife and I left Austin feeling scared and demoralized about my future.
I continued to have AFib/atrial flutter episodes on and off through the holidays, and my last one ended on January 4, 2019, exactly one month before my ablation. We flew to Austin on Sunday, February 3, and I had my second ablation the following Monday. As with my first ablation, the procedure was not painful, and I had no complications with the catheter insertion points. When Dr. Natale came to visit with me later that day he said that he found electrical activity entering my atrium from one of my pulmonary veins, and that his first PVI had not been successful.
He “touched up” that area and ablated a few focal spots on my coronary sinus and atrial wall. He also tested my LAA for electrical activity and found none; so thankfully, he did not ablate that area. I was under anesthesia for about 1.5 hours. Although my chest was a bit more tender this time, my HR felt more “solid” and I was not having any PAC’s. I was directed to stay on Eliquis and was prescribed Multaq as an antiarrhythmic. I was discharged the next day, and we flew home on Wednesday.
Ablation Recovery
After my second ablation, I took the entire next week off from work and just rested and did some easy dog walking. I avoided crowds, as was very diligent about washing my hands to avoid catching the flu or a cold. My recovery went very well, and within a month I was on the bike again doing some light cycling. Although I did have occasional PAC’s and very short “atrial runs” (2-3 seconds of rapid beats), I had no AFib or atrial flutter.
Dr. Natale’s nurse continued to review my ECG transmissions during my 3-month blanking period, and she said everything looked great. After my blanking period, I was told to discontinue the Multaq. Then I wore a continuous HR monitor for about two weeks, and again those results were perfect. In June 2019, four months after my second ablation, Dr. Natale’s nurse said I could discontinue the Eliquis. At last, I was AFib drug free!
In August 2019 I went back to Austin to do a follow up visit with Dr. Natale and to have an echocardiogram at TCA. I was elated when the technician told me that he didn’t see any atrial enlargement, and that my aorta root diameter was well within the normal range. He concluded that the echocardiogram performed by my first cardiologist was simply in error, as the reported numbers were way out of line with the normal range of measurements that he found.
Since then I have continued to just get stronger and healthier. I have lost 20 pounds, cut way back on alcohol, and am back to cycling 75-100 miles per week. I have had no AFib or atrial flutter whatsoever, and I feel like my cardiac performance is pretty much back to where it was before my AFib nightmare began. Every day without AFib is truly a blessing, I am so thankful to all those who helped me get through this very challenging period in my life.
Lessons Learned
The most important lesson learned for me is that even though my ablations were performed by one of the best and most experienced AFib EP’s in the world, my first procedure was a failure. The first PVI burns were either incomplete or not durable. Shannon Dickson told me that it is rare for Dr. Natale to have a “failed” PVI, and he speculated that a normal level of ablation energy sometimes not be enough to create a durable lesion in athletic hearts that have “tougher” myocardial tissue.
I also learned that there is apparently a lot of variability in the skill of echocardiogram technicians. It is frustrating to learn that I worried needlessly for over a year about the potential for an aortic dissection, when in fact my aorta was perfectly normal.
I have thought a lot about why I developed AFib and surmise that there were multiple causes. First and foremost is my family history. My father was diagnosed with AFib in his early 50’s, and lived with it asymptomatically until he died, likely due to related heart issues. AFib is known to be strongly inheritable. I also think that stress, weight gain, blood pressure, and alcohol were important factors in my case.
At the time I first started have AFib episodes my mother was becoming ill, and she passed in April 2017. I was the personal representative for her estate, and this required a lot of my time. Simultaneously, I was managing a very stressful work project that required a lot of business travel, with drinks and big restaurant dinners most nights.
During this time my weight ballooned to 218 pounds (I am 6’1″), and my blood pressure started showing higher than normal readings. I tried to de-stress and keep my weight down by riding harder and longer on the weekends. Add these ingredients together and you have a perfect recipe for AFib.
I have also questioned whether all my cardiovascular exercise was a factor, and I have concluded that the jury is still out on that one. In his book entitled The Haywire Heart, Dr. John Mandrola, an AFib EP, examines this question thoroughly; and if you are an endurance athlete struggling with arrhythmia, I strongly recommend this book. I also discussed the role of cardiovascular exercise in my case with Dr. Natale. It was his opinion that it can be a factor in some extreme endurance athletes, but that my level of training was not harmful.
He said that excessive exercise will cause fibrosis in the atria, which can be detected during an ablation; but he noted that he saw no fibrosis in my atria. He recommended that I continue to exercise at the level I am comfortable with. Nonetheless, I am getting older and I am much more conscientious about getting adequate rest after hard training rides and competitive events, and not overdoing it.
Finally, I think it is worth noting that there are two types of AFib generally recognized in the popular literature: vagal and adrenergic. Vagal AFib events tend to occur when the body is winding down, resting and digesting; whereas, adrenergic AFib events tend to occur when the body is ramping up during exercise and/or stressful events that elevate adrenaline. My AFib events almost always started in the evenings after a big meal and/or alcohol; and on several occasions I was able to extinguish an AFib event by exercising vigorously.
Conversely, I have a friend – now AFib free for 9 years after a successful ablation – who’s AFib events almost always started during exercise or stressful events like public speaking, but never when he was winding down. He claimed that caffeine was a big trigger for him, but not alcohol. It was just the opposite for me. I don’t know if these two forms respond differently to various AFib drugs, but it seems likely that they would. Yet EP’s don’t seem to distinguish these different forms of atrial fibrillation.
Is an AFib Ablation a Cure?
I say why not! We still hear that there is no cure for cancer, yet millions of people have been effectively cured, or put into long-term remission, through new and evolving cancer treatments. I read somewhere that if after an ablation you are AFib free for five years then your risk of developing atrial fibrillation again is the same as the general population.
I’m not if sure that’s true, but I have since come to know several people – and have read testimonies from dozens more – who have had successful ablations and are AFib free for five years and well beyond. Why should we not consider them to be cured? Of course, I don’t know yet if I’m cured, but I feel like I am, and I very much want to believe it. I will be retiring next year, and I am committed to doing everything I can to ensure that I stay AFib free.
Hi, is there any recommendation for how to return safely to cycling or other exercise after ablation? How soon to start and how to do it in terms of frequency and intensity?
Thank you,
Andre
I was discovered i was in afib about 10 years ago during my first coloscopy. Otherwise, I wouldn’t have known. Afib has always been rather subtle for me even though I’ve been in persistent afib. Anyone else had this experience. The only reason I just had my second ablation is due to trying to be proactive and keep my heart from getting weaker.
I had my first ablation about 21/2 years ago and it kept me out of afib for about 1 and1/2. I was hoping for 5. I recently had my 2nd ablation. My cardiologist is one of the most experienced in the Boston area with this procedure and thinks I have a good chance of getting more mileage out of the 2nd one. I hope so.
Now that I’m fully vaccinated I want to get back into the gym and my Dr. and the P.A.’s I usually speak with ( is this common for everyone?) say I have no restrictions and can resume my exercise routine. I like to do a combination of weight training and cardio which they say is fine. However, I’ve read others that don’t recommend weight training which is the best way to retain muscle mass. It seems like no one really knows one way or the other. Anyone have any information on this?
I was diagnosed with Afib 10 years ago. I was put on Warfarin and scheduled for a cardio aversion after my hip replacement(s). However, the shock of surgery must’ve kicked me back into sinus rhythm. My Afib was gone! I didn’t experience another episode until about 5 years ago. I thought I was having a bad flu, or, worse – a heart attack! When I started googling symptoms of a heart attack I thought I better go to Urgent Care. They rushed me in, then called an ambulance to take me to the ER. I was in Afib for about 18 hours, then converted back to regular rhythm.
After that episode, I was put on Xarelto. And flecainide. I objected to the price of Xarelto and was recommended for a cardia ablation. In October 2019 I had the procedure and was able to go off of meds after 2 months without an Afib episode. But during the pandemic (stress, perhaps?) I noticed my blood pressure was crazy and I was probably in Afib but had no way to monitor it.
I finally got an appt with my cardiologist – said to get an Apple watch for monitoring, and put me on dilitiazem. And back to Xarelto. I still had episodes of Afib – sometimes when I was lying down watching tv, sometimes after having a cocktail, sometimes for NO REASON. My primary doctor prescribed coreg to get my rate down. But I still would have episodes.
Since I have arthritis, I am on Celebrex. Celebrex and blood thinners don’t work well together, I am slightly anemic. I decided to get off blood thinners with the insertion of the Watchman. But first I was scheduled for another ablation.
The EP didn’t find anything to ‘fix’ during the ablation, I was woken up and told to go home. I came back the next week for the Watchman – the procedure went fine, but back in my hospital room my heart rate dropped to 30 bpm. I was given atrophine to get my bp/heart rate back to normal.
I am now experiencing Afib about every 2-3 days. No reason this time. My cardiologist changed my meds to metropolol (sp?) and took me off coreg. It is a ‘wait and see’ time. He said for ‘problem’ afib patients like me I could go see an EP specialist at Penn State. Or, there is always a pacemaker as an option.
To say that I am frustrated would be an understatement. I have exercised all of my adult life and have eaten healthy. To now be under this condition and not want to do anything physical is very depressing. I guess I will just have to be patient. I don’t know if a third ablation would be beneficial. And I am just not ready for the pacemaker option.
I am new to this site but really appreciate the articles. I was diagnosed with Atrial Flutter and Afib in 2016 and had an ablation in 2017. While I still deal with short runs of tachycardia, there is nothing sustained over the last three years since the ablation. I am thankful for that. I had been almost daily runner for over 35 years and now have had to slow it down to waking as my tachycardia seems to kick in when I load my heart through exercise stress. It is bit discouraging but not as discouraging as an ER visit for AFib or Aflutter. During the ablation and a follow up heart Cath, it was determined that I had a lifelong ASD and so now I am on eliquis for the rest of my life and as long as nothing changes, my cardiologist says just leave the defect alone but of course if pulmonary pressures or other things occur we have to re-visit the idea of closure even though the location would demand a chest opening rather than laparoscopic closure. Hoping to avoid that. I am generally encouraged with the prognosis and appreciate this community. It helps to have others who are struggling with the same things and who understand what we feel about all this.
Thanks for a highly resonating account of your experience.
Just to clarify, Dr. Natale said 50% of his first ablations are successful, while 70% of second ablation are successful. So does that mean that 85% of his ablations are successful after one or two ablations? Or is there another category where the first wasn’t successful but there was no second?
I’ve had afib for 7 years, but didn’t get it diagnosed until 5 years ago. Flecainide worked well up until early this year, when the border-closings made it impossible for me to get it. Switching to amiodarone was a disaster, so then switched to propafenone, which worked wonderfully. Made the mistake of switching back to flecainide after finding a 3 month stash in the back of a cabinet, but it didn’t work as well as before, so switched yet again to propafenone. Now it also doesn’t work as well.
So no NSR stability for the past 6 months. I’m realizing that an ablation, which has been suggested by both the cardiologists I see, might be my next major step. I really don’t like the relatively low success rate, but if I can achieve a long period of NSR and cut out most or all of the medications, then it seems like it’s worth the gamble.
Your article was quite objective and gave me a good sense of the lay of the land. Thanks very much.
Just realized that it wasn’t Dr. Natale who gave your those success rate figures.
Thanks Doug for sharing your story. I was diagnosed with Afib in June. It was actually revealed by my Apple Watch. My cardiologist confirmed my condition and put me on propafenone. After a month with no relief, he changed my medication to flecainide. Still no relief. Long story short, I’m scheduled for an ablation next week at TCA Institute. You story has given be hope to say the least. Thanks!
I read here about everyone’s Afib and how their doctors put them on this drug or that drug or recommend doing a certain procedure to treat their Afib. What I never see mentioned is the doctor checking your RBC magnesium level. Low levels of magnesium have been shown to cause Afib. I never see the doctors doing a complete blood test to check out your thyroid to to see if you are hyperthyroid which is known to cause Afib. Vitamins C and E will also help with one’s Afib. Pity that these doctors are not schooled in nutrition. They would have a better chance of eliminating one’s Afib if they only knew and passed this on to their patients. Instead all they do is prescribe a drug that never cures but just treats the symptom.
Thank you, Joe. Good points about the magnesium. I do take mag taurate but did have one physician in ER tell me to not even worry about mag if I was not getting enough potassium. He said our condition requires adequate (not excessive) levels of potassium and the magnesium is needed because the magnesium pushes the potassium to our cells. One perspective only but I’ve followed the advice ever since. Thank you.
I eat fish, take vitamin C and D, exercise regularly and generally try to do healthy things and I still got AFIB. My Mother has AFIB, my Aunt on my Mother’s side has AFIB, so to me it seems to be hereditary. I will continue to do what the Doctor says and if AFIB episodes continue to rise, I will definitely look into ablation, thank goodness we live in a time that at least we have some options.
Get and read the book “The Sinatra Solution: Metabolic Cardiology” by cardiologist Stephen T. Sinatra M.D. Learn about how you probably have a magnesium deficiency. This can be a major cause of Afib. How is your Thyroid? Have your doctor run some blood test to check your thyroid. If you are hypothyroid, it can also be a cause of Afib. And don’t have the doc just order a TSH. You need about 5 other test on the thyroid that most doctor don’t check. You will learn things from the book your regular doctor does not know about healing the heart. You will learn about using the amino acids D-Ribose, Taurine, Arginine, L-Carinitine, and COQ10. Have your doctor order a blood test for checking your RBC magnesium blood level. Also if you can, get the doctor to include the RBC potassium blood test along with C-reactive protein and Homocysteine. You mentioned you take vitamin D. Have you had it checked? If not, have in included in the test. I hope this help you.
I’m curious how your ablation went? I had mine at the Cleveland Clinic Oct 26 and had complications of a hole in my heart during the procedure resulting in a bleed and night in ICU. I have since had AFIB events but nothing in the last month, however I’m having increase in PVC’s ? Has anyone else had the increase in PVC’s ? We have a belief that complications will never happen to you and especially when you go to the best hospital but beware it can happen to you… The Doc said in 300 procedures he never had that happen.
Two weeks ago I had my first atrial fibrillation episode. I have been very active all my life doing long-distance backpacking since my 20s. I injured my hand back on June 20 of this year and subsequently it turned into a very bad bone infection requiring surgery. After the surgery I had a picc line install and I am receiving the big gun anabiotic’s associated with bone infections. I have read that pick lines and surgery can bring on atrial fibrillation issues. Does everyone have personal experience with these kinds of issues? Thank you
I’m also curious about these connections. It appears that the first AFib episode often occurs after serious injury or serious illness. Mine occurred shortly after I had shingles. Perhaps the common denominator is inflammation – I am beginning to read more about inflammation and AFib. And how inflammation is caused by the serious illness ur serious injury.
congratulations on your ablation. I’m in my high 40s and I have been afib/flutter, drug free 17 months after my PVC ablation in 1/2019, sometime I almost forget I once had afib, however sometimes I do worry it will come back again…..my EP told me, 99% of recurrence is due to re-connection, I guess it won’t be a big deal if it comes back: I just have another ablation!
Your response gives me hope. I have had one ablation. It’s been a year and it is coming back. I am on Propafenone and feel terrible. Debating on a second ablation.
Well there is an answer to everyone’s afib cause, that is a fact. Finding it, just as with any other health condition, is the challenge, to say the least. In the meantime, those symptoms are a real pain. Ablation, if done correctly by a chosen few such as Natale, seems to be the ultimate symptom reliever. I do believe also that enough time has passed for us to determine the long term negative effects of ablation, and they seem to be few or benign, such as PVCs and increased HR. With that said, as I turn 66 and 10 years into this condition, ablation is not in my conversation as daily meds are not either. I dont use the cured word, but I can tell you that the search has been eventful to find a natural symptom reliever. It seems I find a new one with each passing year. NSR for close to 15 straight months and two episodes in the last 2 years keeps me encouraged. With that said, after Travis’s and other stories of battling this condition unsuccessfully with meds or supplements, I wouldnt hesitate to seek the ablation route at that point, with the best EP.
Very interesting info. What kind of approaches have you used that show some promise.. ? I have had episodes since last November ( probably for years)and since have had a couple incidents. I did see a Doc at the Cleveland Clinic and another hospital. I’m currently not on meds for this and have considered but not decided on Ablation. I have to credit knowing about the Afib because I got a Kardia Mobile, otherwise I would not have actually seen what was going on. Thanks
Hi Ed, The list over 10 years is quite lengthy, so Ill be brief. The first shocker might be to the supplement folks, Magnesium is not the miracle mineral for our condition most purport it to be. It is one I believe most over use, myself included, and will eventually fail and disappoint many. The issue I have with most minerals and vitamins is the RDI levels are ridiculously low, too low to be effective. Secondly is testing for levels is of the utmost importance. In the order of supps most effective and my dosages, without taking too time of much of my good virtual friend Travis’s site: 1. Vit ADK. 5,000 iu.(150,000 over a few weeks to build up) 2. Vit C. 4000mg 3. COQ10 200mg 4. Ashwaganda/Holy Basil 300mg/200mg 5. Magnesium Glycinate. 240mg. 6. Iodine, if you lack can cure afib in many. Good day.
Hello James, I would like to hear what natural remedies worked for you. I get afib on occasion after vigorous exercise and occasionally after Alcohol consumption of more than a few. I can get afib that same evening or most likely the next day or two in the morning. I will take 25mg of metoprolol to get back to sinus rhythm. I am a relatively healthy 61yr old. I enjoy bike riding and life cycle of 30min a day .. but want to play tennis and work out more vigorously. I will be wearing a new monitor on the market to determine my type of afib. I believe it is caused by the combination of the effects of undo excessive stress and physical activity.
All the best to you and yours,
Michael :) . .
Great article, glad you got it sorted, I am just starting my AFib journey at 54, the main consensus is that it was brought on by Audax (Randonneuring) cycling. On Beta Blockers and booked in for a Cardioversion so fingers crossed.
I am being told that Cardioversions are not very successful or do not last very long and that I am looking at Ablation down the road…… my first reaction was no, but after reading your article I may reconsider.
Cardioversions have their place for our condition. As they say its a procedure to get you back to NSR, not to keep you in NSR, vs ablation which is done for the latter reason. At the very least it could be a sign of the degree of your condition and how to proceed. I had 5 CV’s over the first 4 years, none for over 6 years now and chose chemical conversion. Each time, I stayed in NSR at least 9 months. If one does not stay in NSR within weeks, I would be seeking more aggressive treatment
Thanks for the story. I had my ablation in March 2019 and have been almost afib free since then whereas it was a daily occurrence as soon as I chilled out in the evening. Also if I touched alcohol.
Thankfully apart from a couple of minor episodes it has been clear for a year. My surgeon said often people need a second one so I was prepared for that. I still am.
I am happy for you. After years battling afib, I had several cardoversion some would last 4 years. But after the fifth one and seven years later with was coming back more often as If it older. I first noticed with at 62yrs old when rushed to emergency room.
After much research and many EP opinions on ABLATION, I was advised the best for me was a new wireless tiny PACEMAKER. It only took 45minutes I was put under, recovery 6hrs laying down overnight hospital stay. No pain whatsoever, best decision I made it will be one yr this June and feel fine no afib episode, because the PaceMaker kicks in when it detects irregular heart beats and puts the heart back to normal rhythm. The battery will last at least 10 to 12 years. You can have up to 3 put in without removing the old one since they are so small, small as a tip of a pen. Off on all heart meds only take Eliquis 5mg twice a day. My opinion is better than going threw an Ablation, without the fears and this will last longer, because there is no guarantee on any procedure for afjb.
Hope this helps anyone with decision what to do, look it up on the web great reviews and safe and no risks of deaths.
I have been told that I’m too young, 60, for a pacemaker and to go with the ablation. But comments have given me another option. I have no health issues except for he afib which hit me hard but haven’t been an issue while on the meds. I’m going to look up your pacemaker and do some research. Thanks Holly
Have you had your RBC Magnesium checked? Low Magnesium can cause AFIB.
Are you Hyperthyroid? That can also cause AFIB.
Hello Antoinette,
Question, where did you have the pacemaker installed and do you have any information on it ? I don’t have Afid frequently but when I do it takes time to return to normal.I also have other abnormal beat during normal rhythms.
Thank
Ed, did you find out anything more about this wireless Pacemaker, I may be interested in it in the future after just having 2-nd ablation few days ago, just in case this one is also not successful like the first one.
I never got a response, that is characteristic of this site!Few responses to questions?
Thank you for the info Antoinette.
Did your doctor explain why he recommended pacemaker instead of ablation for you? Was there specific reasons?
Thanks.
Where did you have this done and why did they go this route vs ablation ? What are the risks ?
Thank you for sharing your experience with afib and the pacemaker which is wonderful! Can you tell me the name of the pacemaker, in what part of the country you live, and where you had the pacemaker inserted along with the doctor’s name. Thank you.
Unfortunately you rarely get a response, and I don’t know why? I have asked a number of questions for info not )??
Great description – full of detail. Thank you for sharing your story. I learned from it – and now feel much better informed about the different types of AFib. RE: Your commitment to regular exercise – I bet that helped you lift out of the AFib-related depression. Very best wishes and continued success post-ablation!
Did Your cardiologist ever check your RBC Magnesium? I bet he did not. It is a simple blood test that he can order. Read the book “Is Your Cardiologist Killing You?, By Sherry A. Rogers, M.D. and also Subscribe to her newsletter. Also subscribe to the monthly newsletter, Health Alert, by Dr. Bruce West. With a one years subscription he will send you a copy of “Encyclopedia of Holistic and Pragmatic Medicine”. It is about 180 pages of information on different heart conditions and what supplements you need to repair your heart. To also expand your heart knowledge you should by the book ” The Sinatra Solution: Metabolic Cardiology by Stephen T. Sinatra M.D.” who is a cardiologist. With these 3 doctors recommendations you will learn what most cardiologist will never tell you about healing your heart.
I was going to ask him the same about magnesium. Most doctors won’t agree to it and/or insurance companies won’t pay for it. You have to find a lab who will do it for you. Also, do you have A-Fib, Joe, and if so, did you get your magnesium tested? Just wondering what were the results were and if all A-Fib patients have low magnesium levels. My doctor never mentioned to me about magnesium. On my blood tests it’s normal. From what I read the regular blood test does not give an accurate reading of magnesium in your body. Thanks for the info on the books. Will read them.
Ever. I was diagnosed with AFIB in 2016. I was 67 years old. The EKG turned out to be abnormal and I had a heart rate of 122 bpm. The doctor told me the that drugs should be tried first, and then Cardioversion and if those two didn’t work he was recommending ablation. I knew the third one was definitely not an option. I had a sister who had the ablation and died in the hospital two days later. A nurse went in one morning to check on her and found that she was dead. I decided to try natural treatments. The books and newsletters that I mentioned before I already had on hand and started to do a lot of reading. The main thing I did was use the recommended supplements by Standard Process from the Health Alert newsletter. Then I added four amino acids that were recommended by Dr. Rogers and Dr. Sinatra in their books. I also went to a local place in Florida that did IV therapies. They consisted of high doses of vitamin C, B vitamins and magnesium. I also took Calm, which is a magnesium citrate supplement. I was also going to a place that had a far infrared sauna. Within two weeks I had converted and my blood pressure was about 124/80 and my pulse was at 68 bpm. I was scheduled to see it cardiologists at the end of the month. They were supposed to do an ultrasound scan of my heart. They hooked me up for an EKG which turned out to be normal and they did not do the scan. I was sent home.
Yes I did have the RBC magnesium blood test. The doctor I was going to in Colorado recommended that. She also added CRP which stands for C-reactive protein and homocysteine. These two tests will give you a better idea of your hearts condition and your risk of heart attack than having your cholesterol checked. Read the books by Dr. Rogers called the “Cholesterol Hoax ” along with the “Blood Pressure Hoax” to learn more. Most doctors don’t or won’t order these blood tests. All they do is the serum magnesium, which after reading a couple of the books I recommended would tell you that the serum test is almost useless. As I understand they practice what is called standard of care, and these other blood tests are NOT part of that protocol. The doctor I am now going to in Nebraska also added those three tests. Medicare paid for all of them. I hope this helps.
Dr. Sanjay Gupta
Consultant Cardiologist & Heart Specialist.
https://drsanjayguptacardiologist.com/about/
He’s a cardiologist and heart specialist in York, England, UK
He has hundreds of videos on Youtube. He’s fantastic.
Thanks for the information, Joe. Here’s wishing you many years of being A-Feb free.
One question, why did they use Flecainide so frequently given the dangerous warnings about cardiac arrest. Were precautions taken in case that happened ? Thanks
Great story/article… All of us are on our own A Fib Journeys, and each journey is different from another person.. The key as you have said is to get educated…. I do have one question for you. I am on Xarelto —and can change to Eliquis with no problem. BUT–why? I’ve never heard a good explanation as to which one is better.. Why did your EP change you to Eliquis?
Right now I am in NSR and have been since my Ablation last June. Xarelto is the ONLY heart med I am now on… Feeling pretty good for an almost 78 year old.
Thanks,
Betsy Adams
Doug, Thank You for the very detailed and helpful account of your journey. I had been experiencing an afib episode every 4-5 weeks – lasting 24 hrs, until October of 2019 when I set up a gym in my home and started working out with weights and riding a stationary bike every day. I have not had an episode since. I am on Pradaxa (blood thinner) and sotalol (anti-arrhythmia). These are the only meds I take and am 5’9” and 205 lbs – about 20lbs heavier than I wish to be.
I am scheduled to speak to my cardiologist on March 31st to discuss ablation, so the description of your journey holds particular interest for me.
Wishing you continued health.
Thanks for sharing Doug, I have had one Ablation done by a very good EP in Calgary and felt pretty good for about 4 months and have recently had a few more episodes but minor compared to what you have been through. I will have to decide whether to have a second one performed and after reading your story i think i will go ahead with it. Like you I was pretty active, and was a big hiker and skier but not able to enjoy it so much anymore as i’m always worried about overdoing it and triggering an episode.
Really enjoyed your story as well as Travis’s web site and so glad you have both made solid gains in your A-fib journey!
Cheers,
Mike
Thanks for this informative discussion of your afib journey. I’m currently in the stage that I’m researching afib and did see an EP at the Cleveland Clinic after a bout and emergency room experience. I found out I was in Afib via a Kardio mobile device , later confirmed in the emergency room. They had suggested ablation but I advised I wanted to wait and see how my Afib was experienced over a four month period. I routinely use the kardio mobile to check the arrhythmia feelings and find very few Afibs but a number of undetermined readings and get a monthly summary to share with my Doc’s. In any event thanks for sharing and answering many questions.. Best of luck and God Bless..
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