markflint
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I may remember this wrong, but around a month before I got mine somebody else on this forum got a pericardial effusion during a Natale ablation. He only ablated areas showing up generating arrhythmias for me, too, but that meant going into the LAA, and that's a place most EPs don't dare to go. My EP, who was fine with me seeing Natalie and considers him one of the best, did comment that he, in his words, "ablated the sh** out of you." He wasn't saying that was a bad thing, just a big thing. -
I kind of thought the same thing as Daisy, but was going to wait before coming right out and saying your guy doesn't sound like he's a big dog when it comes to treating AFib. If I lived in Texas and needed another ablation I would go to Austin and have it done by Natale. I don't like the man, and he pushes the boundaries, which means he takes risks, but he's a savant with the probe. Mark
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It's understandable to be upset, but those symptoms probably don't mean your ablation was a failure. You are in what is known as the blanking period, and your heart is well and truly pissed off about being messed with. During the blanking period scarring will form and close off the ability of misbehaving cells to cause AFib. The unknown is whether the EP got all of the miscreants. In the meantime, if the AFib is intolerable, they may try a stronger antiarrhythmic med, such as amiodarone or Tikosyn (dofetilide). These drugs can have serious side effects, and tikosyn requires hospitalization for a few days to monitor to make sure it doesn't have the side effect of QT interval elongation, which can be serious. I would only take drugs on that tier if the AFib was intolerable, or I were in AFib after the blanking period -- and I'd be scheduling a follow-up ablation ASAP to get me into NSR to minimize time on them. Your EP should have given you information about the blanking period as part of your discharge, and you also should have been told to stay on the Eliquis. Not having you on anticoagulants is a pretty serious error. Mark
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Yes. They can induce AFib. https://www.mayoclinic.org/tests-procedures/cardiac-ablation/about/pac-20384993#:~:text=Sensors on the tip of,where to apply the ablation.
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This is the important part. Really important. Mandatory if you want the best chance for success. There are people here who have had multiple ablations that failed to get the job done. It may take more than one, and in my case, which was complicated, took three. Your EP should have thousands of ablations on the books, and share his success record -- which should be defined as NSR unaided by antiarrhythmic medications after the blanking period. I would be as diplomatic as possible, but do not worry about offending anybody when pushing for this. You have a right to put your future in the hands of someone you trust to get it right. --Mark
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oThank you! I really appreciate your reply and it is reassuring that I can manage the anxiety by other means. What do you think is the best bp med when you've been diagnosed and also need to lower your blood pressure? Or did you just take the afib meds that were prescribed?
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I was prescribed metoprolol, a beta blocker that lowered blood pressure and kept my heart rate down. Didn't like it because it decreased metabolism and also caused fatigue. I got off it as soon as I could, and got the doctor's OK to take it "PIP" (pill in pocket; the medical term is PRN, “pro re nata”.) I did take it a couple of times when my heart rate got up to 140 or so and didn't come down while I was out working in the desert by myself.
I have a home blood pressure cuff. When I am in a hospital or doctor's office it goes up to 150/160 and everybody wants me to get on a med. I tell them I will record my bp at home several times a day first. It always comes down to the 125/75 neighborhood.
With the help of the forum I have been able to find ways to stay healthy with minimal meds. One thing I learned: I never fill out the prescriptions they give me at the ER before reviewing them with my doctor. A lot of ER docs seem to be really pill happy.
Walking and just being out in nature is one of the best things we can do for anxiety, and it helps blood pressure. If you can't get outside, meditation is easy and definitely helps.
If they do put you on an anticoagulant, I found Eliquis to be the best for me. Minimal problems with bleeding and minimal side effects. I don't like having to take it but I have seen what a stroke can do, don't want to take that gamble!
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This really helps and I so appreciate it!
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Thanks for your response. I have never had medical significant medical issues and take no prescription drugs, which i detest even though I know everyone else takes them. I am a an active 66 and weight 130 at 5'7" and I think that drugs really effect me strongly. I guess I will have to bite the bullet and find an EP cardiologist. I live in Yakima WA so I will probably need an excellent recommendation for Seattle or Portland. (2-3 hrs away)
That cardioversion 4 hours into my first ever AF event was really a bit scary and now I am obsessing over doing anything like taking the dog for a walk or playing golf. I am wearing a fit bit and constantly checking my heart rate. Do any of these meds get rid of anxiety? Again, I have always been against pharmaceuticals, so I am at the mercy of folks like you that have experience! Thank you so much. I feel like I have someone to confide in!!
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Unfortunately, many of us have gone through anxiety as we get to know our AFib. In my case it ramped up my blood pressure so much that I had two unnecessary, in hindsight, ambulance rides to the ER.
It's important to keep in mind that AFib is a chronic medical issue, not a death sentence. The accelerated heart rate can get us thinking this is the Big One, and then our anxiety drives up blood pressure. There are anti-anxiety meds, but agree with you about keeping prescription meds to the absolute minimum. Meditation, relaxation exercises, walking outdoors -- all of those can work just as well and are free, with no side effects.
You will find a lot of resources on this forum, including recommendations for a good EP in your area. I traveled to Texas for my second ablation, and, as it turned out, a needed third "touch-up," but by going to a top-notch EP I increased my chances for success. I have been in normal rhythm since the last one, and am gradually returning to my pre-AFib self: active hiker, bicyclist, backpacker and horseback rider. I know there are no guarantees, but right now I'm a very happy camper, and at my age (73), every day of decent health is a gift. I owe most of that to this forum, where I got the information I needed to find appropriate and effective care.
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