Ablation worries

[Sueheart]

Wondering if anyone has opinions on why ablations don't always work. I had ablation number two done in April and already feel it is going to fail. I have started to get what I can only describe as tiny blips, as if my heart is going to launch into full blown AF. So far it hasn't happened but worry it's going to any day now. Anxiety doesn't help. Advice gratefully received. Thank you

[SRMGrandma Volunteer]

Hi Sue, Sorry to hear that you are having anxious feelings, but we all can understand that. It is easy to let the anxiety win. I am a huge believer in staying optimistic. Optimism changes your body chemistry for the good and keeps the stress hormones away. Stress hormones are part of what cause disease....heart disease for sure. Ablations can fail for different reasons. The more experienced the EP, typically, the higher the success rate. Sometimes not all errant connections are ablated, or new bad pathways for the electrical system form. It has been shown that ablations are most likely to be successful when accompanied by a healthy lifestyle change (or maintenance) including a diet packed with fiber, fruits and vegetables, plenty of rest, adequate exercise, and stress management. Remember, the blanking period is 3-6 months and your heart is still healing. Think good thoughts, breathe deeply, relax and anticipate staying in NSR.

[Rellim296]

It might be that EPs, keen not to overdo things, may tend to stop if it seems like enough and hope for the best. A bit like adding salt - you can always add more.

Surely you will begin now after three months to feel the benefit of this second ablation and the little blips may not be anything to worry about.

It's disappointing if an ablation doesn't eliminate AF, but I feel it's worked well if one sees an improvement, even if AF still lurks once in a while.

[PeterWh]

Agree with both @SRMGrandma and @Relim. Certainly some EPs such as professor schilling have reduced the power used in ablations due to additional (other) benefits.

Additionally our bodies are all different internally (as well as externally). Also our rates of healing, reactions (drugs, healing, environment, etc) are also different as is evidenced on here.

Yes skills and experience are factors but I suspect that has been mitigated due to technology developments and mapping that are now available. Unfortunately with ablations you cannot do Which? type tests and comparisons as you can do for equipment and services.

[pip_pip]

From what you say you seem to be experiencing ectopic beats, which from what you say, may well be due to the intense anxiety. Which is much the same problem I get when my anxiety is over the top. If you can get the anxiety and concern on to a lower level, you might well find a lot less of the blips. This is a regular problem which ablations cannot address. It is feasible you might not have another AF episode, thanx to the ablation, but the ectopics can feel more uncomfortable than AF. Certainly they can feel like you are going into AF. Ectopics are harmless, but don't feel harmless.

I might be wrong here but worth checking out

Destress

Phil

[Brckie]

I've had 3 ablations and I feel the 3rd one as been more successful. I've seen on here that someone else as said healthier life style. I now go on regular walks, started dancing and joined slimming world. Start by little changes and I'm sure you'll start to feel much better about yourself. Xx

[KipperJohn]

Perhaps it's better to focus on the amount of time you are in NSR than AF? Since my second ablation in May I've had two periods of 24 hours or so in AF. The rest of the time I'm in NSR as far as I can tell- with the odd flutter now and again. So statistically I'm in NSR 99'.9 percent of the time. The heart is obviously still recovering and., personally I believe the older one is the longer it's likely to take. I see my EP in September but I doubt if either of us will make any judgement then.

Enjoy the time you have in NSR . There are plenty of worse things to worry about - easier said than done but staying positive and getting on with life seems to me to be the best antedote. I am a naturally anxious person myself so overcoming that is probably equally important in the management of PAF.

Good luck.

[Sueheart in reply to KipperJohn]

That is a really good way of looking at the AF challenge, thank you. I need to get things into perspective. I have indeed been in NSR since April and appreciate this. Looking at the amount of time in NSR as percentage is useful as before ablation 1&2 I was moving towards persistent AF which was no joke! Thanks again

[Buffafly]

I still get little blips, fast runs and other weird feelings sometimes but 7 months on from my ablation I am taking no meds except for Xarelto and I feel much much fitter and more energetic so that is what I concentrate on. I hope you feel more confident soon 💖

[Carolewick]

Its true ablations don't always work first second time. I needed to have 3 ablations to stop the AF.I know it is a constant worry. Its 7 months since my last ablation and so far so good. During the period after my last ablation I had lots of extra beats and runs of extra beats. That went on for about 5 months and has gradually got better. I feel your anxiety and worry. I felt sick with worry. I am beginning to get my confidence back. It may be that your heart is just going through a healing process and that after another couple of months it will settle down. You can't help the anxiety as we are always thinking "what if" I really hope everything goes well for you. Best wishes Carole

[CDreamer]

Hi Sue, interesting question, I have a theory and it is only a theory - based on my own experiences and following this and other forums for the last few years. We have all heard of the vagus nerve which is known to trigger AF - well this is part of the autonomic nervous system - automatic because we don't control it via thought.

Anxiety goes with the territory with AF - I am not an anxious person but I used to get sensations within my body which I would normally equate to anxiety just before an AF episode - I still get them now and don't go into AF by the way since my 2nd ablation.

What I have discovered is that traumatic events - physiological (accident, fall or car crash for instance) or psychological (anything which caused you intense upset) which may go way back into our past - can and often does damage the autonomic nervous system. When this happens, the body stays in high alert state which our body react to by causing disease or dis-ease - anxiety & panic attacks are the most obvious but often autoimmune system also goes into overdrive - often causing autoimmune diseases. The most commonly known autonomic dysfunction is PoTS and I certainly had this all my life but there are others.

My experience is that I still get these sensations - feels sometimes like excitement but more normally anxiety - I get the odd thump or two as well - sometimes ectopics but often not. What I have done is work on the 'worry thoughts' - so you don't increase the overload on the autonomic nervous system, CBT, EFT (works well for me), Mindfulness, yoga, exercise and any activity that gives you pleasure works - because pleasure creates endorphins and they counteract the stress hormones such as cortisol, adrenaline etc.

Once you know and believe these are just sensations because you body's system have gone a 'bit off kilter' and then just accept them as bodily sensations and get used to them - you then deconstruct the whole viscous cycle which may sometimes trigger arrhythmias, but anyway makes you constantly anxious which puts you at higher risk for returning AF.

Sleep is also important so if you don't sleep well, consider a sleep study as sleep apnea is one of the main reasons for AF returning after initially successful ablation along with life-style such as diet and exercise.

The ablation works by 'blocking' electrical charges by causing a wall of scar tissue that the rogue signal don't cross - but if you heal quickly or incredibly well scar tissue doesn't form. If the person ablating misses even small areas then the signals will get through. That would be the 'official' version which is also an explanation but you wouldn't know that until after you had experienced an AF episode, so work on the anxiety, hope for the best and go out and pleasure yourself!

I'm with Kipperjohn - enjoy the time in NSR and focus on doing things you enjoy! Enjoy.

Best wishes CD

[Sebhel in reply to CDreamer]

Interesting! I too have been wondering about the not so famous vagus nerve and as I have other problems than just my AF that may be linked to it?

I had never heard of it before, but overheard vague ( is the word vague linked to vagus?) mentions of it during my appointments with various cardiologists and doctors.

Each time I did ask for more info but they did not seem to have much to say about it or the possible link with my other problems, one of which btw involves bleeding?

Anyway, sorry to digress, my message is that where I used to worry a lot, time passes and I have got used to living with AF, somedays not even thinking about it! This cool forum with all of you SHARING EXPERIENCES and gaining knowledge has played a big part along with time in making me accept it all calmly

My only concern now, is not forgetting to take the tablets regularly!

Many thanks to All

Best wishes

[CDreamer in reply to Sebhel]

No, vague is nothing to do with the vagus nerve, LOL. It is sometimes called the wandering nerve and is a large nerve connected to the autonomic nervous system which passes through the stomach and very close to the heart.

This link shows diagram and brief explanation of what the autonomic nervous system is and what it does.

sunscientific.com/What-is-A...

[Rich3]

I had my first ablation in May, I had two attacks in the following two weeks and in the next few weeks small episodes of sudden accelerated heart beats which didn't come to anything, as time passes these have become less frequent, I think it's probably part of the healing process.

I try not think about it too much healthy food and walking helps.

I think the reply from SRMGrandma is good advice.

[RichMert]

Hi Sue. You are at heightened awareness level 1 at the moment which I think is normal for all of us that suffered from AF for a long time prior to ablation. I have had 2 ablations and get 6-20 second runs of either Tachycardia or Ectopics. These are few and far between but, we are now pre tuned to detect the first signs of irregularity. You are only 3 months in which is the minimum time for the scars to crust up enough to act as a barrier (please excuse my non technical speak).

Give it time.

[traveler65]

Hi Sue--measure the tiny blip with a bp monitor thaqt shows abnormal, if any heart sinus rithym

1st of all that was only 3 months ago. It can take awhile for your heart to get used to behaving normally. Mine took 8 months for it to be in normal sinus rythm all the time and for my pulse to go from 90's to 62 at rising in the am. It is good to keep a journal, write all your bp and pulse numbers from an omron monitor, and write what drug, supplement and food was eaten at what time. A bit much to do, but then you can determine your progress and also what works and what doesn't. Stress and anxiety can trigger abnormal heart behavior because the stress causes autonomic nervous system dysregulation. Try to be calmer ( i know this difficult) Try listening to Mozart symphony number 40 in G minor--it has scientifically been proven to relax you. A class in qi gong meditation will also cause autonomic homeostasis (balance)>.Also, what drugs, if any are you taking. For ex. if you are taking sotalol-sotalol throws magnesium out of your body. Magnesiium deficiency is an afib trigger. If you take supplemental magnesium ( magnesium glycinate-relaxing; magnesium L-threonate- more energizing, passes the blood brain barrier-so your brain's mitochondia get some ingredeints for making atp to process all it's metabolisms etc0- if you use supplemental magnesium due to the loss from sotalol--you need to take it 3-4 hours before you take the sotalol--otherwise sotalol will bind to the supplement and become relatively inactive. Again, if you take too much magnesium it can kill you--as in your heart will slow too much. You also need to keep your potassium and magnesium up but not too high. If you take sotalol ( a drug I find extremely helpful to me very low dose), and your magnesium gets too low , also potassium too low-- you will go out of normal sinus rythm; this can also happen with sotalol if your magnesuium and potassium are too high. When this happens on sotalol you can go into torsade des pointes (very rapid sometimes fatal ventricular contractions)--not to get scared. This is just a delicate balancing act that can be accomplished.

then you have triggers---certain things trigger afib /or abnormal sinus without rapid heart rate and lowered bp: for ex: magnesium deficiency, potassium deficiency (try potassium rich foods),

alcohol, caffeine, chocolate, sugar, processed foods, salt ( or too much salt); anything you are allergic to; asthma bronchodilator meds; cortisone; aspirin; NSAIDS ; ;large macrolide antibiotics ( ex: Biaxin or azithromax); and quinolone antibiotics (ex. levaquinj; cipro.', avalox, anything ending in --floxin.) artificial ingredients. If you use herbs and spices when you cook--great for health and flavor-- you can look up the detailed ingredients of each herb and spice--they contain alot of minerals and sometimes 1 of them may aggravate the afib or clash with a drug you use. For me, I find if I do not eat enough protein I go into abnormal sinus rythm. You can take your blood pressure with the best l OMRON bp monitor: it will show your abnormal sinus rythm as an icon of a shaking heart. You can find your pulse pressure (difference between the systolic and diastolic)-- if it is 20 not good -you want the left ventricle to be pumping enough blood to all parts of your body. around the 40's is better. You can determine your mean arterial pressure-- add the systolic and diastolic and divide by 2. It has to be above 65 for all parts of your body to be getting enough blood. For me I find good is 80's--90's. Going back to exercise--you can't just sit around but you can't just go run on a hilly trail in the woods or lift a heavy weight at the gym. This needs to be a gradual thing.

Think of it this way: when your afib got bad enough for you to notice symptoms, by then your heart's architecture had changed--your left atrium dilated; your left ventricle started to work too hard etc. But how long was this change going on before you noticed anything or it showed up on an ekg at a wellness check up? maybe a long time. Now when you stay in normal sinus rythym, your heart can remodel itself back into a normal architecture--your whole body remodels itself everyday-- a tiny bit--depending on what you do to it. So, this takes time. Remember you are a partner with your ep in improving your health so you have a lot of power to make yourself better.

[traveler65]

One thought--when I was first recovering from ablation - I sometimes had abnormal sinus or ectopic beats-- I put on some classical guitar music by Andre Segovia- closed the lights- lied down on the couch and listened to it for the whole hour of the CD- after that the "blips" were gone- my bp was lower, my heart rate was lower and my sinus rythm was normal-- stress is really bad for you. as you can see I cannot spell rthym, but my heart is okay and yours will be too.

[Sebhel in reply to traveler65]

It has been said that our appreciation of music is linked to its beat and our heart beat. Which is good if we find what we enjoy.

The other need we all have is to have a laugh

LOL