Well - as some of you will recall that after suffering PAF for over 25 years, I had my 5th ablation (4th AF ablation) last Thursday 8th September after having had it cancelled at the last minute on 16th August.
Actually it ended up that I also had an Atrial Flutter ablation on Thursday so that is now 6 ablations. For those of you who like a good read here is what happened together with some answers to questions I asked of the EP Cardiologist.
I am very allergic to the glues from the pads and stickers that are all placed on me so I was very pleased that the doctors took this very seriously. The photographs I provided showing the Urticaria last year were a great help in making them understand the severity of my problem. I was given the antihistamine Piriton and steroids intravenously and also they applied a liquid dressing called ‘Opsite’ to all the places where the pads had to be adhered.
These preemptive actions had a significant effect and although the Cardioversion pad has left a very clear mark on my chest the itching is only very slight. I cannot tell you what a relief this has been as I suffered so badly before.
The anaestetist gave me a 'premed' of Diazepam before the anaesthetic was administered - I was sitting up chatting at the time. I remember nothing from that moment on whereas I normally have been very aware right up to receiving the anaesthetic injection.
This has been so much better for me than the sedation I had 3 times.
My Ablation procedure started at 09:00 and I woke just after 15:30, so it was 6 ½ long hours that I spent in the Cath. Lab.
As I have posted before, because of my previously cancelled ablation I was to be treaed by an new EP Cardiologist at this hospital. My new Cardiology EP has come down to our hospital from St Barts London so I met him for the first time on the day of my ablation.
With me having had 1 Flutter Ablation and 3 AF Ablations before, obviously a lot of work had already been carried out to resolve my AF. One of my previous discharge letters stated ‘difficult case’.
The discharge summary I received last week stated that I had a heavy burden of scar in my left atrium (from previous ablations) and that 3 veins remained isolated. However there had been a reconnection of my Left Upper Pulmunary Vein (LUPV) so they re-ablated the LUPV. In addition it transpired that the Atrial Flutter ablation that was carried out 7 years ago had reconnected so this was re ablated. Also a new mitral line was ablated - not too sure of this one bit too technical for me.
During the procedure I went into AF a couple of times and had to have a DC Cardioversion each time then they administered IV Flecainide. My EP Cardiologist said to me afterwards that my heart very readily slipped back into AF during the procedure (nothing new there).
The upshot of all this is that I have now been in NSR since Thursday and in my opinion it has been a more stable rhythm than I can remember having for some time.
I know it is very early days but I am more confident this time than ever before and I am beginning to believe that this time it has been successful. On the two most recent ablation procedures I had, I was back in AF the following day albeit it did ultimately revert.
Realising that a patient should be prepared to go back into AF in the months following the procedure I asked the EP Consultant for his opinion on how long I should wait until I should consider it a success and I mentioned that I had read that some say up to 6 months. He said that this was no longer the considered time scale and that the internationally accepted length of time is now 3 months. He also said that in his professional opinion, with the advancements of technology in this field that have taken place in recent times, that even after 6 weeks it should be possible to make a reasonable assessment of the success or failure of the procedure. This is because of the advancement in mapping techniques in recent years.
For those who have asked the question "how many ablations can I have' my EP Consultant said that in my case, if the AF returns it is still conceivable that I could have yet another ablation (6). We are all different and it is very much an individual matter I am sure.
Right now I feel very optimistic (not something I have felt for some time). I am very tired mainly due to lack of sleep and I now need a lot of rest. Also my waste disposal plumbing has not settled yet after a day of starvation and lack of liquids but that will soon be fine I am sure.
My EP Consultant was very easy to talk to and although I was only put on his list last week he has now ‘adopted’ me.
I cannot speak any more highly of him, he filled me confidence with his professionalism from the moment I met him just before I was taken to the Cath. Lab. He also gave me quality time for discussion when I returned to the ward (although I was still a bit in fairyland – luckily my wife was there and listened to every thing so has filled the gaps for me).
My new Consultant has told me is staying at our hospital, which is brilliant as far as I am concerned.
Hope you have not nodded off to sleep reading my jottings - mind you that is exactly what I am now going to do.
Fate is Inexorable.