I recently had a 7 day holter monitor fitted which showed sinus rhythm throughout with a very occasional isolated ventricular ectopic beat and brief run of ventricular bigeminy and trigeminy.
This was not mentioned at the 12 month review last month, just in the discharge letter some couple of weeks later.
It was also explained that the risk/benefits of continuation of warfarin were taken into consideration with any outgoing co-morbidities .Therefore the risk of continuing any warfarin or an anticoagulant is higher than the benefits of the successful Ablation.I had intra-abdominal bleeding some months ago when my INR was 7.5 and admitted to hospital and antibiotics administered I have been off Warfarin since then...
My question is could anyone explain what the first paragraph means.I read/answered Finvola's very interesting post recently which touched on the subject briefly.
HI Carol. I had a 48 hour monitor myself last week which showed very similar results 6 + years after my ablation. Not seeing my EP till next year so no idea what it means other than there is still no AF which is good news. I do feel lots of these little blips but apparently no ill effects and an echocardiogram done again last week shows no dilation or thickening, no valve problems other than "trace regurgitation" and an EF of 70% so I guess it'll live a bit longer.
I add that this was all instigated by my EP in London who I think just wanted to check up on his handiwork.
On the second point Dr Gupta was one of the speakers at Sunday's HRC Patient Day and appeared to say that continuation of anticoagulation even after successful ablation (the changes made by AF to the heart surface can still allow clots to form apparently) was good but also that it was a balance between risks. It was also stressed that this decision had to be the patient's not the doctor's.
Dr Gupta was my EP who performed the Ablation and we discussed together the pros and cons of anticoagulant and consideration was given to my particular circumstances...I made the choice myself after carefully consideration.
Thank you for your reply Bob -keep yourself well and carry on with the good work.
Carol - I'm not medically qualified in any way, so this is my understanding of these Pvc's. Everyone gets them, drugs don't control them, they come singly, every other beat (bigeminy), every third beat (trigeminy) or sprinkled randomly. I've had them every 6th beat too, always starting when I am reading or relaxing in some way. Apparently, the signal starts in the ventricle, rather than with PAC's which originate in the atrium.
I have mentioned them to both my EP and cardiologist without it exciting any interest, so I assume they are benign. iF they don't bother you, that's great, but if you are concerned about them, why not contact your physician or his/her secretary asking for information about them?
Incidentally, mine have stopped in the last couple of days - I've been trying to relax and have been drinking coconut water for magnesium and potassium - perhaps it works.
I had bigeminy 20 years ago as a young but work stressed A&E nurse. After in depth tests was informed it was benign and just a quirk of the heart responding to my excessive caffeine intake and stress - they disappeared whilst I was asleep after becoming more and more frequent throughout the working day. I was told to keep fit as they also disappear with exercise and stop/reduce caffeine, which I did with good effect. I had occasional boughts since but not frequent and usually related to overdoing life - but tend to occur when resting after a busy time rather than during the rushing around.
I now have paroxysmal AF with atrial ectopics regularly.
I read that you are awaiting your Ablation so I expect you are feeling very apprehensive .Personally I don't see any other way forward when meds have stopped doing there job and giving up everything that we know are triggers. In my own case caffeine, Alcohol, Sugar and Fructose oh and chocolate too!
I have had no AF for 12months now which has been great even if it were to come back tomorrow it has been well worth it.So hopefully you will have the same results.
I wont say Good Luck as that sounds as if you are going to need it but just look forward to being AF free and be assured that you have made the right decision.
Carol.
Thank you Finvola,
I wasn't sure whether these extra beats were a precursor to AF so reassuring to read yours and Bob's interpretation.
I have joined the magneseum fan club also -and must say I feel the difference....
Hi carol , I recently had a 72 hr monitor on after having ablation in July , I did have a run of these normal then faster beats which I'm hoping were recorded on the monitor , it was about 4 weeks ago now and I've heard nothing back from the cardio clinic , I seem to get these most evenings as I sit down to relax , I see my ep next month so will be asking what it means , I'm still on flec bisoprolol and warfarin cheers Paul
Hi Paul,
If there was reason for concern one would hope that the Hospital would have notified you by now although maybe a 72hr monitor was not a long enough time to have picked up any irregularities...Either way a follow up consultation should be the norm.
Three months is not enough time for your heart to recover- it was 8 months at least or maybe longer before my heart recovered from the Ablation last August -and during that period I had all sorts of sensations going on-so no cause for concern as your heart is still very angry at taking such a battering-If you haven't received a follow up appointment soon don't delay in contacting your EP's Secretary for advice-one thing I have learnt is to not sit around and wait.
If nothing was recorded on the 32hr monitor then a 7 day loop monitor may be the next option.
Every EP is different -I was taken of all medication 5 days prior to Ablation and touch wood still meds free.
I have reduced my size of meals as find that a large meal is still a precursor to the heart throwing a wobbly- Although not AF just these irregular beats that I spoke about yesterday.
Hi Carol. Lovely to hear from you again. We missed you. It is good to hear that your A.F. is still at bay. You may have read that I am awaiting a 2nd ablation so fingers crossed for me. I am not worried about the procedure this time but it still feels like a big deal so I will be glad when it's over. Did you ever get your canal boat? X
Hi Dedeottie,
Nice to hear from you too and nice to have been missed.
Yes,well I was very disappointed for you when I read you were down for another Ablation remembering how scared we both were the first time around and you seemed to be doing so well.Hopefully its just a bit of tiding up the loose ends so to speak but do take it easy this time around and no dog walking the first week.
Dr,Gupta was my EP and you will have heard him talk at the conference last week end.I have had 12 months AF free and no meds so I count myself very lucky and to think I refused the first offer of an Ablation more fool me.
The boat well there's a story. Whilst being AF free other health issues set me back (oesophagus and fibro) Although I have just last week been on the Bridgewater Canal on a friends boat ...but never say never.
Well you know what to expect now and wont be as scared the second time now don't forget to take the AF survival kit with you.!!!
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