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Catheter Ablation - what to expect ?

  • 1.  Catheter Ablation - what to expect ?

    Posted 03-16-2021 12:45

    Hello everyone, 

    I just joined this support group this morning and just came back from an echo gram.  The decision I dreaded seems finally arrived per my family doctor and cardiologist's recommendation - to undergo Ctheter Ablation.  I felt so unprepared even though the doctors discussed such option back in 2016.  A brief medical below before I go any further.

    2016 : 4+ years ago I first experienced periodic heart racing. I am 66 years old not a smoker nor smoker.  Only cause I can think was for several months I drank a lot of green tea.  Other cause may be hereditary as my mom and my sister both have some heart beat issue

    2016 - 2020 : with daily Metoprolol 50mg, life is bearable, not too many bad AFib episodes. Or may be I do not know other than some chest tightness & discomfort.  

    Dec 2020 : right during the ECG  in my physical annual, my family doctor was so alarmed by my fast heart beat 130 - 140BPM, he asked me to see my cardiologist immediately who performed another ECG that was normal (done within 60 min of the bad one).  He changed my medication from Metoprolol 50mg to Sotalol HCL 80mg.

    Jan - Feb 2021: I felt AFib seems more frequent and stronger.  ( I brought the AppleWatch 6 and it helps greatly to monitor and record any occurrence of AFib). 

    March 5 2021: right before dinner, the AFib (130 - 140 BPM) would not go away. I was so scared I checked into ER. They use IV injection of diltiazem to bring the BPM down to normal of 50-60 range.  

    Last couple weeks since ER visit : somehow my AFib turned more frequent and longer. I do not know why. The cardiologist changed my Sotalol HCL from 80mg to 120mg and for the first time both my family doctor and the cardiologist stated that I need to seriously consider Catheter Ablation.  They are very concerned the risk of in and out AFib greatly increase the chance of stoke (blood not pumping correctly, pool of stagnant blood in chamber etc.,).  FYI - Thanks to AppleWatch, I can watch real time how my heart beat goes fast (then back to normal after taking an extra Sotalol 80mg within an hour).

    At his point, I have decided to go for the catheter Ablation.  This come upon me so fast, I can only think of a few question to ask the group. I will have more later as time progress.

    Q1 - Catheter Ablation (CA) - I read CA is about 80% successful. What if CA does not help me, what is the next option ( I really fear pace maker implant !)
    Q2 - Any side effect of the CA procedures, long or short term?
    Q3 - do I need to continue the current medication like Sotalol ? or extra med like blood thinner?
    Q4 - how long will I have to stay in the hospital after the procedure?
    Q5 - my understanding is CA will "burned" off some heart tissue to break the bad circuit.  Will CA needs to be done multiple times to get rid of more bad circuits in the future.

    Q6 -What cause AFib : every time I slept bad, the chance of AFib goes up. I literally believe I can worry myself into an AFib episode. More I worry, more likely it occurs

    These are all I can think of now. I will continue to research and learn from the support group.  Many thanks

    Josh



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    Josh McDonald
    MD
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  • 2.  RE: Catheter Ablation - what to expect ?

    Posted 03-17-2021 06:40
    Josh ~ Welcome to the family nobody wants to be part of.

    So what comes after an ablation if not successful...well they can continue medication therapy and/or perform another ablation. In fact while I don't remember the percentage I did see an Electrophysiology study indcating that a second ablation is sometimes required before successful.

    Side effects can be, more arrythmias, blood clots, stroke, heart attack

    Typically they monitor for a short period but release you within hours of the procedure.

    Again, yes they do sometimes have to perform an ablation more than once to be successful. My Ablation never worked

    The list of causes for A-Fib is extensive and you'd only be guessing as to root cause. I did discover mine may well be caused by the pillow my wife hold over my face at night being a stressor but again just a guess.

    In the end, many Ablations sre successful and as a long term sufferer, I can attest living with A-Fib can be disruptive and unpleasant. You need to weigh any discomfort you are experiencing with the risks and decide for yourself the best path...

    By the way, I'm on my 3rd pacemaker (actually a CRT-D) and am paced 100% in both ventricles. More often than not I don't even think about having it, except for those pesky refrigerator magnets my wife keeps stacking on it. Mine is for a host of other arrhythmias including LBBB and V-Fib, but not A-Fib. I know they sometimes use a pacemaker for A-Fib but not sure I would buy into that approach. I know my device has never stopped my A-Fib.

    Good luck to you

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    Warren
    TucsonAZ
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  • 3.  RE: Catheter Ablation - what to expect ?

    Posted 03-17-2021 09:31
    I had a leaky Mitral Valve that we monitored for years,  Eight years ago AFib hit me.  The doctor did open heart surgery to repair the valve and while he was in there, did a MAZE procedure to fix the AFib.  It worked for a couple of years but the AFib came back.
    Cardioversions and medications would fix it for a while but it kept returning.
    Then I had an ablation and it worked for 8 months,  A second ablation was done and it has lasted for 1 1/2 years so far.
    I have had no known side effects.  I am 79 years old and active.  I also go to cardiac rehab 3 times a week.
    I am continuing to use a lower dosage of medication to hopefully reduce the chances of AFib returning.
    I stayed in the hospital overnight.
    I have heard of people having multiple ablations while others needed only one.  Also, AFib ablation procedures continue to improve.
    There are lots of possible causes.  There are millions of people with AFib with a lot of them not even knowing it.  The older you are the more likely you will get it.
    I would check websites for Mayo Clinic, Cleveland Clinic, stopafib.org

    Marv Norman
    Chapter 350
    Noblesville, Indiana

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    [Marvin Normann]
    [Noblesville, Indiana
    [Phone]
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  • 4.  RE: Catheter Ablation - what to expect ?

    Posted 03-17-2021 14:16
    My only suggestion, since I never had an ablation, is to find the best cardiac electrophysiologist even if you have to go to a different city. I'm sure others will reply to you and offer this advise and maybe those who have had the procedure can recommend one.





  • 5.  RE: Catheter Ablation - what to expect ?

    Posted 03-18-2021 03:49
    Thanks everyone, it is comforting to hear someone who share the same frustration with AFib.  My appointment with the cardiologist who perform the CA will be next Tuesday.  Now is the wee hours of the morning 0340, cannot sleep, checking on my applewatch ecg.  Down side of the watch is I constantly checking it for signs of AFib.  Happy to see the normal wave but extra stress and annoyance to see those chaotic irregular wave shape.  Right now I seems entirely dependent on Sotalol HCL as I noticed my AFib occurs like clockwise near the time I need to take the next pill.  Guess the previous pill worn out.  I am just tired of living with this dark cloud over my heart.  I feel tired and can not trust myself travelling. I carry extra pills just in case.  Going to bed now.  

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    Josh McDonald
    MD
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  • 6.  RE: Catheter Ablation - what to expect ?

    Posted 03-18-2021 10:29
    Oh, one more thing. Since I started the higher dosage of 120mg Sotalol (for over a week now), I felt low energy, some small dull headache and my heart rate drop to 48/49 more frequently (even through out the day it rise and fall in the 50 - 60 range).  Even with higher dose of Sotalol, AFib still come and go without any pattern. I would think from 80mg to 120mg, it will make AFib episodes less often. So is it because the body resistance to medication rise as the dosage rise?  I hang my hope on the catheter Ablation. But not sure why, I do not feel that optimistic that it will cure me.

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    Josh
    Maryland
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  • 7.  RE: Catheter Ablation - what to expect ?

    Posted 05-04-2021 04:48
    Hello everyone,

    I had my Catheter Ablation 3 weeks ago (April 14 2021).  Other than one bad episode on April 20 when my heart rate went >150 BPM for over 60 minutes ( I took 2 Sotalol 80MG and took 2 hours to settle back to lower 80 BPM), I am doing fine. I keep my finger crossed that I will remain AFib free.  I returned to normal physical activities like mowing lawn, bike ride and moving heavy subjects without issues. I am thankful that I decide to go for the procedure.

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    Josh
    Maryland
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  • 8.  RE: Catheter Ablation - what to expect ?

    Posted 06-16-2021 10:40
    I had my PCV ablation on February 11th. My story is more about how an unforeseen complication can be overcome and how expunging fear of failure can be helpful in negotiating the blanking period. I am 76 years old and had Afib in increasing frequency and duration for six years.
    During the procedure I was under a general anesthetic and intubated. All went well, and I was sent home the same day after the five hour session with a sore throat from the intubation and a bit of anesthetic hangover. My heart rate was a somewhat elevated as expected, The next morning I was feeling well, but as the day progressed I began to feel worse and in the evening I had some shortness of breath and was plagued by lassitude. The next morning I woke and could not get out of bed nor catch a good breath. My wife took my BOL and it was 72%. I ended up in the emergency room with "community acquired" severe bilateral pneumonia. Also my heart was going nuts, with atrial flutter and a resting rate that ran from 90 to 135. Normally it is in the mid 50's. I was a sick puppy in the ER and Step Down for four days. Naturally, the severe pneumonia complicated everything. However, no Afib.
    Coming home from the hospital I was drained. Then the PAC's started. With a vengeance. Hours of looping bigeminy beats, with stand alone bigeminy beats between sessions. This went on for two weeks, though subsiding ever so slowly. My cardiac electrophysiologist put me on a low dose of flecainide which helped. He was concerned that the pneumonia stress had and was interfering with normal recovery and healing. In all this time, no Afib.
    February turned into March and March to April and the PAC's continued to diminish. By May they were countable per day. No Afib. In all this time I never let myself think the procedure was a failure and blamed all my ectopic beats on complications arising out of having the induced pneumonia immediately after, and the healing process being interfered with.
    Today and hopefully long into the future, I have PAC's that are not unusual for someone my age. From the day of the procedure, I have not had an Afib session.

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    Joseph Carnahan
    Alton TX
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