I had my AV Node Ablation on Thursday 1 Feb. It all went well and now I am back home.
My CRT-D has been set to 80bpm and in 2 weeks time they will adjust it down to 60 bpm. I have been told to stop the Amiodarone and wean myself off the Bisoprolol and I imediatly decreased it from 7.5mg down to 5mg.
Thing is I still feel very breathless and lack of energy. Is this normal? Am I being to impatient? Have I reduced my Bisoprolol by too much?
I just wondered if anyone else has had a similer experience.
T'is very quiet this evening Ogilvie but great news about your ablation. I'm no expert on AV Node but if the ablation bit is similar to more conventional ablations, then all sounds fairly normal at this early stage but then add the effects of medication change, so I'm sure there is nothing for you to worry about. Hopefully others with more direct experience will poke their heads above the parapet before long.....just take it easy for a couple of weeks and great news.....
My husband had an ablation in October and has only just recently got back to his old self. Don’t rush things. Listen to your body. I suspect you will feel tired and worn out done days but it’s part of the healing process . Do be patient and it will pay off.
Good to hear that it went well. Resting will be important for the foreseeable future. Best advice is to reduce the bisoprolol VERY slowly so that your body has time to adjust.
I had av node ablation several years ago, but unlike you was not encouraged to come off meds straight away.
80 beats per min sounds quite fast but I suppose it depends what you are used to. Probably coming off the amlodapine and reducing bisopralol both together might make you feel lethargic. As Flapjack says it is still early days and your body has to adjust.
I'm afraid I don't fully remember how I felt, also because some of my meds are for high blood pressure I am still on them.
My advice is don't worry it will take at least 2 weeks to settle down and then they have to make sure you are comfortable with the heart rate. It took some time for me to discover that 70 was the most comfortable rate for me, although it has recently been increased. If you continue to feel breathless give the pacing unit a ring, vthey are usually very helpful.
My dad is only on warfarin and candestatin. They took him off his meds straight away. Although he was only on those two plus valsartan (I think that’s what it was) I think you still feel the AF symptoms at first then they’re meant to go away. I know with my dad it’s the pump that’s not very good. He is seeing the heart failure nurse next week and will probably increase the candestatin to 16mg. Are you on any meds to help the pump function?
Hello Again,
I’m still on diuretics, Anti Coagulants and Ramapril – I’m weaning my self off Bisoprolol. I’m going to be interested to hear how your Dad gets on once they have reduced his BPM.
My wife say’s I’m too impatient – she is probably right, she usually is!
Ogilvie
• in reply to
I like your wife!!!
It needs to be a very slow process coming off bisoprolol, otherwise blood pressure and heart rate could get quite squiffy (not a medical term but you can guess what it means)!!
You did say in your post that your Doctor asked you wean yourself off bisop????
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To be precise, the EP told me to talk to my Doctor about weaning myself off Bisoprolol but I didnt want to wait a week beforte I saw the Doc so started the ball rolling by dropping it 2.5mg. My BP and BPM all appear normal and I will be checking with the Doc this week.
I'd consider discussing with your consultant coming off the ramapril rather than the beta-blocker. That would keep your BP low whilst slowing your BPM as well.
I think this is all related to my CRT-D pacemaker. As I have no AV Node my heart would stop, it's only my CRT-D pacemaker that keeps it going (currently 80bpm but soon 60bpm)
I'm guessing that I no longer have any need for a Beta Blocker hence the reason I can come off it - but I will check.
Beta blockers do have other functions as well as slowing the heart rate naturally so using them and ramapril does seem a bit OTT. Could I suggest you discuss with your consultant the merits of reducing it to just a beta blocker vs just ramapril as he/she obviously know far more about your actual condition (such as why you needed a pacemaker in the first place) then we do. Good luck anyway - I think the tiredness will improve once you're on the correct medication.
My husband at first was constantly taking his blood pressure and counting heart beats. It’s all quite natural I think but the consultant told him to stop doing that and since then he hasn’t given it a second thought. Your wife is right. Don’t rush things !
All that I am going to say is please be patient. This is a marathon, not a sprint. I am like you, really keen to reduce meds. But my EP grounds me. He says you know how you are feeling and I will work with that but slowly, piece by piece. So after being in SR for over 2 years, after 4th ablation, he agrees that I can stop Losartan. 6months later if all stable we will look at something else. I am really impatient but overiding that is the fear of going back into AF. I know that your situation is different but I think youll get the gist...
5mg Bisoprolol is still a fairly large dose, i'm sure you will feel better when you reduce further, but do it slowly! (speaks from experience)
I was on 12.5mg at one point and could not function! even on 2.5 mg I felt washed out and breathless. I'm on 1.25 mg now and feel much better. Hope to get off it totally at some point
Thank you all for your reply’s. As ever the knowledge within this blog really helps.
A quick update, I was at the Doctors today and….
Essentially, I am feeling tired and breathless because of the toxic drugs I have been on for months, in some cases years. I will continue to feel ill until the drugs (Amiodarone and Biprorosol) have drained from my body. 100 days for Amiodarone and about a month for the Bisoprolol.
The Amiodarone I stopped immediately after the Op and after discussions with the Doc I will be weaning myself off Bisoprolol at 1.25mg a week whilst building up my use of Ramipril, which for me has less side effects.
I go back on the 28th to have my Pacemaker (the Love Machine, as I call it) reconfigured for 60bpm (currently 80 bpm), so, fingers crossed.
Thanks again for all your comments and helpful advice. I hope it has helped others in the same position.
I was and still am in Permanent AF. The CRT-D / AV Node Ablation does not stop AF it just makes it less of an issue – the Atriums still clatter away but they don’t drag in the huge pumping chambers (Ventricles).
The AV Node Ablation now means that my Ventricles are controlled by the CRT-D unit and to date I have not had any of the horrible AF Sensations. I’m still breathless and tire easily however that might be more to do with the toxic drugs that are now draining from my body.
What do you have? You mention an ICD but does it have a pacemaker built in as well? Is it a single or dual chamber unit?
Hi, Sorry to hear that. I have just had a dual chamber ICD with pacemaker implanted I had a weeks zio test last year that showed some VT as well as AT. I wasn’t responding to meds and the decision was taken to do the implant so that they could increase the meds and stop me going into bradycardia. I’m currently pacing 90% of the time but sotolol is not working. My hr is currently 152bpm and I’ll go to hospital again tomorrow so that they can manually put me back into NSR. I’ve been told that if the drugs don’t work I’ll need another ablation to kill the right atrial completely (after 3 ablations it’s badly scarred) but an AV Node ablation has also been suggested. I’m confused at the moment - I keep on having 1 procedure after another and nothing seems to work I’m going to ask to come off the Sotolol tomorrow - it’s not preventing arrhythmias and not stopping them either. Really appreciate you taking the time to respond.
You may want to check to see if you have a CRT unit implanted. There is some good info about these things on Google. They are meant to make a huge difference.
Like you I had one failed procedure after another. I was offered the choice of increasing my drugs or having the AV Node Ablation. Not really a choice as I really wanted off the drugs.
They did detect a 3 second burst of VT. I have been told that having a CRT - D pacemaker should help improve this as well.
Yes I do have a CRT unit but I must admit it all happened v quickly and I need to do more research. At the moment it’s only programmed to go fire at 240bpm but they may set it to pace for fast beats as well as slow. When they did this 2 weeks ago it initially pushed my heart rate higher so they are worried that it could keep pushing it up until it fires. I’m really apprehensive about this as the 6 month driving ban will have major consequences. Anyway - thanks again and I’ll let you know.
I had my pacemaker inserted on Feb. 8. How long did you wait after yours to have the av node ablation. Just received letter from NHS that I won’t be considered for mine until after 3 months! First time I was told that there was such a time between procedures. Are you glad you’ve had it done? Meds were not working for me so felt I had little choice but of course now it’s stick with them for a few more months
I had my ICT implanted on 6 Feb but I’ve been told that the leads need to settle before any further ablation so it’ll be later this year before any further procedure.
My CRT-D unit was fitted on 31 Oct 2017. On 20 December 2017 I had a device check, which went well and I was moved into the queue for the AV Node Ablation. At the time I was told it would be a 32 weeks, so I made a formal complaint and ended up getting it done on the 1 Feb 2018….. about 12 weeks after implantation. They left my heart beating at 80 and they will reduce it to 60 on 28 February 2018. It's a comforting feeling knowing that my heart is beating normally and I do feel it is getting stronger.
You ask if I am happy I had it done. Well, I really felt I had little choice. The drugs weren’t working and just made me feel so ill. . I am in the process of weaning myself of Bisoprolol and Amiodarone and I’m hoping that with the reduction in toxic drugs and a heartbeat of 60 I will feel a lot better.
Now - I’m just on warfarin and Sotolol. I’m under 2 cardiologists (1 EP and 1 hereditary heart disease) - the hereditary consultant has suggested either sotolol, metoprolol, amiodarone (but mentioned side effects) or failing that AV Node ablation. I’ll discuss tomorrow hopefully.
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I’m going to ask to come off the Sotolol tomorrow - it’s not preventing arrhythmias and not stopping them either. Really appreciate you taking the time to respond.
Post pacemaker implant and AV node ablation 
AV Node Ablation
AV Node Ablation Adjustments
