This past Wednesday I had an ablation done to correct my paroxysmal a-fib. As soon as I woke up I found myself in normal sinus rhythm, but my resting heart rate was a good 30-40 bpm above normal. My EP told me this was expected and that my heart rate would drop as the heart tissue healed. My heart rate was always what sent me into a panic before the procedure, and now that it's higher it's very uncomfortable.
I'm now on a slew of meds, including Multaq and the anti-coagulant Xarelto. The Xarelto is what freaks me out. I just feel so fragile being on it, as if I can't even accidentally bump myself on a wall for fear of bleeding. They only have me on these meds for a month then my EP suggested I take aspirin indefinitely thereafter.
Before the ablation I was only taking Atenolol to help with tachycardia. I went ahead with the procedure because I was ready to be med-free.
Are those of us who have had an ablation at that much higher risk of stroke that it would necessitate taking aspirin for life?
If anyone has a similar experience I'd love to hear it.
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jmv_nyc
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Hi there. Yes, what you say about heart rate is very familiar. Mine went up after my ablation and I found it very odd and unsettling to have such a fast pulse. Two months on it has slowed and I no longer notice it feeling weird, although it is faster than it used to be.
My experience with drugs is the opposite, as my anti arrhythmic (flecainide) has been reduced, but I was already on a high dose plus a cocktail of things I'd rather not be taking - especially warfarin. My dislike of warfarin is partly related to my ability to acquire injuries. The bleeding thing, it turns out, isn't as bad as one thinks it will be. If you have some small bump you will probably gain confidence.
I'll leave it to others to comment about the other issues you raise, although I imagine it's your a fib that makes you at risk of a stroke more than the ablation, even though after the procedure the heart needs time to adjust.
Re the bleeding, I've been on Warfarin for a few years now and I'm a livestock farmer. I knock myself all the time and it to be honest there's not that much difference between what happens now and before Warfarin. Just takes longer to heal and I'd have a plaster on for longer, not found it a problem. I also trapped my hand quite badly in a cattle crush last year and wow did it hurt. That blew up quickly as it filled with blood on the back of my hand. I went to A&E who just cleaned it up and sent me home. Again it just took longer to heal.
Obviously, if you're on anti-coags and have a serious accident then you'll need special attention of some sort. I wear a Warfarin plastic bracelet I got from Amazon just in case. Makes me feel a bit safer.
I've been on Xarelto since the beginning of April and I much prefer it to Warfarin. I no longer have to go to the clinic for INR tests and I have not had any side effects. I felt a little anxious for a week or two about possible coag problems but that has passed.
I sometimes cut myself when shaving but there is no dramatic bleeding, the cotton wool works just as well and a bit of pressure soon cures the problem, maybe I should use an electric shaver anyway.
I hope my experience of Xarelto may help you a little.
Hi, I am also on Xarelto and like Torry, I have had no problem. When I was on Warfarin my INR readings were so unstable I had to go to the Clinic maybe two to three times per week! Such a time consuming drug but of course necessary. So I give thumbs up for Xarelto as far as I am concerned and I am always knocking myself but then I have always bruised easily and it is no worse now. So try not to worry.
I went onto Dabigatron last October for the same reason, pre-ablation and had a very similar reaction to you, ie: I wanted to come off all meds and was concerned about bleeding. I don't think it is until you do cut yourself or bang yourself that you realise that, as Koll says, you don't notice any difference in the healing time. I had to put pressure onto my foot after quite. Deep cut for longer than I would have done without the anticoagulant but not significantly longer. The chances of you having a serious accident with a major bleed is now no different to prior to taking the anticoagulant.
Can you work out what exactly is it that concerns you about taking the anticoagulants? If you can do that and then work out a plan of what you might do about it, it can help to reassure yourself that you will survive.
It is interesting that the perception is initially fear of bleeds, where the risk of a significant bleed is negligible compared to the risk of severe or fatal stroke when not taking an anticoagulant. I am +3 months post 2nd ablation and have now accepted that although I am not having any symptoms I will probably continue on anticoagulants for at least a year, if not for life.
Incidentally, there is a higher risk of stomach bleeds and ulceration with aspirin, which is an anti platelet, not an anticoagulant.
The faster heartbeat will lessen over the next 4 weeks or so, worrying will not help and may increase your heart's sensitivity so if you can find relaxation methods, gentle exercise, meditation, mindfulness, CBT, believe or not knitting helps, anything that distracts your thoughts and relaxes your body will promote healing.
Again an excellent post there CDreamer . Re fast heart rate mine was around 85 for quite a long time post my third ablation but took about 6 months to settle down to the normal 70 ish and six years later is around 60.
Re aspirin unless you have a secondary cardiac condition I fear your cardio may be a bit behind the times as current best thinking is that you should be on anticoagulation or nothing. Aspirin has the potential to cause harm --stomach irritation and bleeding -- whilst providing very little protection from stroke. If your ChadsVasc score suggests protection then it MUST be anticoagulation.
I was put on warfarin pre and post op, The side effect for me was I stared feeling the cold so much more, I was the one turning up the heating in our house, a complete role reversal believe me ! fortunately after a few months I attended a post op review and was told I didn’t need to take it, but if I had to I would rather that than risk a stroke.
Hi my A - Fib Ablation was on 13/05 . I have been taking Xarelto for 6 weeks B4 & I am still taking it . I gave no problem with Xarelto at all . I have had 1 rare complication of the PVI Ablation my Vagal Nerve has become temporarily paralysed ( my stomach stopped working ) I am sure that they will have this sorted out soon - it's already underway . Please don't be too worried about the Xarelto you'll be fine xx
Hi my stomach just stopped working & I had sudden severe bloating , pain & vomiting bile ect . Urgent trip to A & E , CT scan showed major problem with my stomach , urgent gastroscope done & stomach emptied of food & muck put on a erythromycin drip to get stomach moving & free fluid diet then motility tablets & diet slowly changed to a light diet .unfortunately had a set back today it didn't like the meat I had for lunch - protein was to heavy for my stomach & it blew up again so back on the drip & free fluids again - hoping to go home 2 morrow I have been in hospital to long for me
My heart rate was fast after my ablation at the end of last year and it took a good 5 months to reach the low 70s . At my post ablation review my EP warned of the dangers of not being anti-coagulated even though, so far, the ablation has been successful.
It does come as a terrible blow to find yourself on lifelong medication (surely that only happens to other people!) but warfarin is not usually a problem and is a (quality of ) life-saver for us.
Indeed it's very hard to accept having to be on some sort of medication for the rest of my life when I'm only 34. I went ahead and calculated my stroke risk at this site mdcalc.com/cha2ds2-vasc-sco... and I'm "Low Risk". I'll definitely be discussing this further with my EP.
I hope those of you that are experiencing complications get things sorted out soon.
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