AF Association
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Who said it was easy?

I just had my first ablation. And I must say it was the most grueling and torturous experience I have ever had. I woke up feeling great. But once the anesthesia wore off, I had the worst chest pain I had ever experienced. Each time my heart beat, it felt like there was a knife slicing through my chest. And my heart rate is accelerated right now. I have to rest sitting up because my chest and neck will cause great pain if I try to lie down. Who ever said it was easy and that they would do it again must have gotten super lucky.

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All in the hands of the EP I'm afraid. MY three were all painless apart from a slight ache for a day or two.

Try to rest as much as you can.

Raised HR is quite common by the way.

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I would check with the hospital if you have such pain as so many people have said it was only slightly uncomfortable- best to make sure all is in order

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Easy. No. I felt like I had been hit by a truck and was black and blue at my lower region from them entering through my groin. Weeks later battling with an Pulmonary Embolism. It is all managing your risk. Hope not to go through ablation again. Why I had it done early. Good luck.

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Yeah, my neck is killing me.

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You probably had a cardioversion, I had a very painful neck for a few days.

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You mean while under anesthesia?

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Yes, I had two. I didn't have the heart pain though, that doesn't sound right.

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“Rider on”. Did u have breakthrough afib, missed beats? In the 3 months? Also, what made u aware of yr PE?

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After ablation had only a few AF events until I healed completely and 9 months until I regained normal low regular resting heartbeat. PE - I called my EP Doc and spoke with nurse 7 days following ablation about the inability to breath, except shallowly, especially not at all when while lying down. I live alone. They recommended an immediate visit to the EMERGENCY room. Had I waited any longer I would be dead now as within that short time frame I arrived ER I was suffering greatly and was whisked away post haste. Extremely scary and put the AF far back on the worry scale when breathing was problematic.

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I would get the neck thing checked out. That doesn’t sound normal. Mine was a piece of cake in the grand scheme of things but I’m very good at relaxing myself and breathing through the what felt like 100s of times that they paced my heart. I was tired the same day and took it easy, but was back to better than normal within like 2 days.

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Wishing you a speedy recovery - hope you feel better soon. You must voice any concerns to your medical team, and also try to 'listen' to your body to see if you can do anything to help yourself, even little things like finding the best way to sit or lie. Good luck :o)

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I do hope you feel better soon.

I have had 7 ablations with minor aches and pains afterwards.

My opinion is that what you are describing is unusual and I suggest you get this checked out as soon as possible.

Pete

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It is unbelievable that you experience what you said. Mine was literally painless except for the cut at the entry wound. Even that was really not really painful!

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Hello

I think you intended to reply to ncernaa

Pete

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Hi Pete! I’m curious to know if your seven ablations have helped you? Also are you still taking medications , too? I’ve had only two ablations, but not much help, and not so crazy taking meds since I still get episodes. So wondering if it would be worth having more ablations. I have had AFib for years, first ablation was done four years ago. Thanks.

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Have a read of the post Ablation “Success” that I posted a couple of days sgo.

Pete

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Thank you pottypete!

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dear pottypete..my EP said he never heard of 7 ablations...not on his table...1 maybe 2 the most how many can one have ??? Scary God bless good luck

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Yes I am the exception but it has been successful. I had one for Atrial Flutter, 5 for Atrial Fibrillation and 1 for Atrial Tachycardia over a period of 7 years.

There are many examples of 3 and 4 ablations for AF that have been reported on this forum.

What happened with me was that the first time they decided only to address the Flutter yet I had AF when they were doing it. This led to 2 more ablations for AF.

2 years later under a new EP it was noted that I had multiple reconnections and it was considered very possible that they could deal with this for me.

In the end I had yet another change of EP due to my then EP moving and I then was under a new EP who had come from Barts and with new 3D mapping equipment they were able to sort me out.

After having AF for 26 years I now have had the longest period free of this curse since the Atrial Tachycardia ablation last August.

Thanks for your kind words.

Pete

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Well super for you. That great.

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Yes but it has been a long and rocky road and every time I get an Ectopic beat I think it’s back again. Years of having AF has taken its toll on me mentally.

Pete

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I've had three ablations and certainly had no pain during or afterwards. Though they did make me feel extremely tired for a few weeks after the procedure.

What you are experiencing doesn't sound right at all and you need to bring it to the attention of your medical carers as soon as you can.

I'm guessing you may live in the US, as we do tend to get more reports from people there who have the same painful experience as you.

Hope you soon feel better.

Jean

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I am sorry you had this experience - as Bob says - all in the hands of the EP and anaesthetist. Most I had was what I would describe as mild ache afterwards. Certainly don’t remember taking painkillers after day 2 and only a couple of Paracetamol on day 2.

Either you are super sensitive, which some people are, or there is something wrong. Perhaps get checked out if you are in that much discomfort. Neck thing could just be from lying flat and still during the procedure.

The higher HR is normal and will come down in time - annoying but just needs some patience.

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So sorry you are having to deal with pain. I have had 2 ablation and never had any pain or real discomfort. I would talk to Drs. Office soon as the others already suggested. Feel better

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I'm sorry you are going through this. Please let us know how you do.

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I live in the U.S. and have had two ablation, neither one with any pain (except headache after the first). Even sent home and not kept overnight after the second.

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So sorry you have had an awful experience and do hope you get some help through your recovery. If still in pain or worried make contact with your EP as soon as possible please don't suffer as you have been. Best wishes for a return to better health.

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Same comments as many others : I had two ablations a month apart this year. No real pain certainly had worse at the dentist. No pain afterwards either although I could feel something in my chest for over a week the second time. (

If your pain continues then I would call back to your EP to discuss.

Regards

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I've had 3 ablations in the U.S. and had little discomfort after. With the first 2 I was back to normal after just a couple of days, with the third I had some mild chest discomfort the night after the ablation and a killer headache but the next day all was well. However my third ablation did not work, I was back in afib within 10 days and it never cleared, so a total fail. I would call your doctor and let him know how you're feeling.

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I would call the EP and ask. If really that bad go to the ER at the hospital where the ablation was performed if they have one if can not get the EP or staff on the phone. Better to have it checked then be sorry. Higher heart rate within reason can be normal after an ablation. Neck could just be from a bad position during ablation. I did have some chest tightness afterwards as well heart was a little enlarged from all the crap it put up with. But if very painful chest could be something else maybe get it looked at if can not get EP or staff on phone fairly quickly.

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Sorry you had such a bad experience. I've had 2 looking towards a third and have never had any issues.

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Today I am feeling a little better. At least I am finally able to lie down completely. The pain I feel in my neck though is pretty intense. And I have to be really carefully when sitting up or lying down. It feels as if I was dropped on my head. I am hoping that in a couple of days I will be feeling better. My heart rate has dropped into the mid 80's. So I feel better there.

What is the best way to recover? Any diet tips to help my body feel better?

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In my experience the only thing is lots of rest. Just because you have not had visible surgery dosn’t means that your heart has not been through a lot. An ablation comprises numerous radio frequency burns. Just imagine how painful it would be on the outside.

Pete

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I had my first ablation 1 month ago with a VERY experienced EP and had the exact same situation. No one can tell you that the post-op recovery period is easy, because every procedure is a bit different and so is every patient. I can say that I have noticed a pattern of patients that report little to no post-op pain as needing multiple ablations, and those who have a more difficult course usually do not. There are many factors when considering the success rate of ablation, but I do find this pattern interesting. Remember that at a minimum, you are having four pulmonary vessels deeply burned/frozen, 1-2 punctures through the atrial wall, possibly additional atrial tissue burned/frozen and quite a bit of hardware in your airway including an endotracheal tube, TEE, esophageal camera ad esophageal temperature probe. These cause great chest pain in and of themselves, and are there to prevent atrio-esophageal fistula. You also most likely will have bilateral femoral lines and a radial arterial line, and you receive some nasty cardiac drugs while under.

I had tremendous pain the first 48 hours, then was HIGHLY uncomfortable for another 7-10 days. I also had the transeptal migraine for 14 days that no one told me was possible. The fatigue was awful, and I a still having shortness of breath. I too was very worried about these symptoms and felt a bit lied too because the surgery was supposed to be 'a walk in the park'.

This is a big surgery. When you break it down anatomically, it's almost comical that any physician can speak about this like it's the same as having a cavity filled.

As an ER physician myself, I absolutely advise you to continue to be checked by your doctor and closely monitored. Also ask for colchicine if you are not already on it as it greatly reduced cardiac swelling and will help your symptoms a lot.

It is normal for your heart rate to increase by 10-20 BPM post-op. This should cease within the blanking period. I suspect that a lot of your pain is referred pain from the instrumentation shoved down your airway and esophagus.

As a side note.... Wen I went back to work, I decided to watch an ablation. It became very clear to me why I felt like crap afterwards. It was barbaric.

I've been in NSR since my surgery. Despite everything, I would do it again as it is the only chance for cure. So give yourself a break, see your physician and know that this too shall pass!

Sending cyber hugs....

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I had one that burned and did alcohol infusion in the vain of marshal. Did have the chest tightness but not pain. Yes I needed a flutter touch up but that procedure was long and got rid of the afib hopefully once and for all.

So I wouldn't say a procedure needs to have pain afterwards to work. Discomfort is normal but outright pain really depends on the person and procedure not the outcome.

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I'm reading some interesting studies that are on the fence about this, the running theory being that if the burns aren't deep enough, cardiac tissue re-grows and the surgery is not successful which can be directly related to the amount of discomfort after the surgery. Obviously, there are many, many factors that decide the outcome. And truthfully, this is still a relatively new surgery with new research being released monthly, so it is difficult to predict outcomes. As a doc, I obviously became obsessed with this and have immersed myself in research. It also depends on the type of ablation you get as well.

Like I said, I think the majority of the chest pain is not from the ablation, but from all of the hardware placed into your esophagus, which runs directly behind the atria. The smaller the airway you have, the worse the pain will be, and more s for women as we have much smaller airways than men.

I hope you stay in NSR!!!! Sounds like your ablation was a success which is wonderful to hear!!!!

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My EP has written a paper on the issue of the efficacy of differing degrees of pressure used in ablations.

Pete

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I would LOVE to read it. I'm really obsessed with this topic now. Can you post the info? Thanks!

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Yes, the doctor prescribed sucralfate and colchine.

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Hello Quilafizz

Here is a link to the paper.

I hope it works

qmro.qmul.ac.uk/xmlui/bitst...

Pete

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I, too, had alcohol infusion in the vein of Marshall which was for perimitral atrial flutter and in Bordeaux, France. Where did you have yours done as you are the only one, other than me, who has recently posted about an ethanol infusion?

If I remember correctly, you have also posted that you have had 5 ablations in one year. Were they all in the same country?

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Thankyou for sharing your experience. It helps me to know you are a physician and chose ablation. Im on the fence post about it, as a retired RN, you know what great patients we can be!!! My EP has asked me to consider it so I am

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You have to ask yourself what your quality of life will be with A.Fib. As you know, A.fib begets A.fib. From all of the research that I have done, eventually, the A.fib will become worse and the medications will become less effective. Once the arrhythmia becomes permanent, ablation isn't going to help and your options become much more limited. There are great results with the Cox Maze and mini maze surgeries if you fall into this category, but those are open heart surgeries and who wants to go through that????

What I have learned about ablation is that you need a thorough assessment of your A.fib and only go to an EP that does several of these EVERY week. I know many EP's that have no business doing ablations because they rarely do them and do them for arrhythmias that have no chance of being improved or cured by the surgery. That's a lot to put your patient through for nothing.

My A.Fib was very paroxysmal, 1 episode every 9 months that lasted about an hour, very rapid, then as A.Fib does...started getting worse. The antiarrythmics stopped the arrhythmias, but at 45, I don't want to be on blood thinners and cardiac medications forever only to find out that I've missed my window for a curative surgery.

This is a surgery and is not a walk in the park, but neither is living with a nasty arrhythmia that will get worse. There is undisputed evidence that eventually A.fib worsens and usually can progress to cardiomyopathy , stroke, multi infarct dementia and heart failure. Oh-and don't bump your head or have a fall while on those blood thinners....

And yes, I was TERRIFIED to do this. My husband had to peel me off the floor and bring me to the hospital the day of my surgery. But It is the only option for cure and you need to fight for your health!

Find a really experienced EP. Have your A.fib, atrial size and valves evaluated. If you are a true ablation candidate-go for it!!!!! Pain heals!

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Ironically, after I posted my response to you, Im now in a fib!!! My last one was 11 mo apart, this one only 3 weeks. Maybe God is sending me my sign. My EP is at University of Missouri in Columbia Mo. He is assistant professor, I really like him but will look further in to his experience. Thankyou so much for responding.

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Oh No!!!!! This is what happens. It starts intermittently, then becomes more frequent and with each episode, causes more damage. If your EP is an assistant professor at a teaching hospital, he is definitely good! Tomorrow morning call his office an make your ablation appointment and get rid of this - you have too many things to do with your life than worry about this. I'll cheer you on the whole way!!!

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I will do that. 2 yr ago local cardiologist diagnosed me, lone a fib, put me on sotalol, which I hated. Struggled 4 mo, had to go prn at work... finally insisted on seeing EP, who put me on PIP of flec/ metoprolol which I loved. I did the life style changes, episodes got further apart, less aggressive but now it seems the tide is changing. I will keep you posted. You have encouraged me more than you know. Thankyou and best wishes with your recovery💜

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Quilafizz, as a physician yourself, may I ask what's your expectation about ablation? We see everywhere is saying afib is not curable, and all treatment including ablation are only in the purpose of improving quality of life. You mentioned 'cure' in the above post. Does mean you consider it as a cure? I ask just because I'm only 37 and I really hope I can live long enough to see my young kids grow up into their 30s. But knowing ablation doesn't provide a cure, I just don't know what to expect in the upcoming 30 years if the ablation fails.

So far I had six episodes, and they didn't get more frequent (knock on wood). Should I head for a ablation? I know the medicine industry always says earlier the better. How long have you had afib before you did the ablation?

Any information will be appreciated.

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Hi and sure!

The goal of early ablation to lone or paroxysmal AF like yours is CURE. Not treatment, CURE. Yes, you can cure A. Fib, but here's the sticky tricky part- that depends on A LOT of different factors. Primarily the length of episodes and how long you have had them, co-existing cardiac problems, atrial size and amount of (if any) atrial remodeling, co-existing other arrhythmias like PAF or SVT/WPW, and most importantly, your Electrophysiologist. In a nutshell, the more episodes that you have and the longer they last, the less likely you are to have a single ablation cure. Second and third ablations really increase success rates,but who wants to go through that?

A.Fib is staged like cancers are these days. Stage 1 is early, with short and infrequent episodes like yours. These are the best candidates for first ablation cure.

There is so much to know. I would like you to visit what I consider a really educational website:

StopAfib.org

I think you will find an abundance of information there to answer most of your questions.

In your case, I would DEFINITELY have an ablation.

My situation started in my early 40's. I came home from an ER shift and was falling asleep when I went into rapid A.Fib for an hour. It converted by the time I got to the ER and my workup was normal. This happened about every 9 months: Rapid A.fib out of nowhere lasting 45-60 minutes, and went on for about 3 more years as they could never catch it on a Holtor monitor. Of course, it never happened at work, which would have made the diagnosis. I saw cardiologists several times and was totally blown off, yes, by other physicians that I worked with! After 4 years of this, it started to do what A.Fib eventually always does...become more persistent with faster rates that last longer and cause more damage.

In August of 2017, I was having 1 hour episodes every 2 weeks, which they could never catch. So, I went on Amazon and purchased a Kardia monitor for $99. It saved my life. I was having very rapid A.Fib (185-200bpm) with long pauses. I took the monitor strips to a very experienced EP (electrophysiologist) the next day and he immediately started me on antiarrythmics and blood thinners and we scheduled an ablation. Scheduling the ablation takes few months as you have to either not tolerate the meds or still have arrhythmias while on them in order to qualify for the surgery.

Even if the meds work for you, eventually they will become less effective and you are really young to be on blood thinners for life. So, you just 'fail' them.

The surgery for me was rough, but remember that you will heal and pain eventually stops. If you've had 6 episodes of A.fib, you officially have A.Fib and it will get worse and you are at risk for a stroke. This will not go away. I know..I had a mini mental breakdown when I was told that.

You sound like a prime candidate, so please get evaluated by an experienced EP and go to the website mentioned. (StopAfib.org)

Good luck to you- there is a cure!!!!

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Thanks for your prompt and detailed reply! Really appreciated! My afib was diagnosed in last August after two months of extreme anxiety and panic disorder. I'm still in the mental breakdown status struggling with daily life. However my afib only happened when I was sleeping. I once hoped it would go away by its own (I bet everybody wishes), but as I got more episodes, I gradually lose hope. It's excited and grateful to see a physician saying it can be a cure for lone afib. I'm so sad the medical field always claim afib as incurable, to make it worse, progressive. So by reading your reply, I can see some light in the tunnel.

I've seen two EP and they both offered ablation. But i've been putting it off as being told it's not a cure. And yes, I've been reading info on stopafib.org and all other support forums and groups, as well as tons of studies and trial reports. Thanks for encouraging and glad to see you have great outcome. I think it's time to put my life back on track.

BTW, J thought you should have EKG machine and lots of pills at home as an ER physician, no? Just kidding. I bought an AED one week after I got the first afib episode. I was scared to hell.

Thanks again for your kind reply!

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Your EP's are telling you AF can be cured? True, in many cases it cannot, but you are a stage 1. I would see a different EP if that's the case. The goal of stage 1 AF is cure. There is an 85% rate of success after 5 years off all meds, which means your basically cured.

Where are you located?

My AF only occurred while I was at my most relaxed or sleeping, which is classic for vagal stimulation from the pulmonary veins, and VERY treatable.

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I meant to say,'Your EP's are telling you AF CANNOT be cured?"

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Not only my EP but all medical studies and trial that I have read. It’s frustrating to see those stuffs. I’m in California.

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Were you on antidepressants? I began having afib after trying to get off the meds.

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No, I didn’t take any antidepressant before afib.

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Sounds like my story. I am 37 year old male. I used to be very strong and fit. A model of health. But unfortunately I was given antidepressants to help me sleep. I have had insomnia for over 10 years. That was the biggest mistake of my life. When I tried to get myself off of those drugs I had terrible side effects- chest pain, anxiety, palpitations, panic attacks, etc. I didn't know what was happening to me. I thought I was going to have a heart attack. The doctors would look at me and run a few tests, and tell me I was fine. They couldn't believe that someone my age, who had my body, could have any heart issues. It took a month, and over a dozen visits to hospitals to finally catch the afib.

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There is a lot of research out there now regarding AF in athletes, which I think caused mine. The average age of people who are avid exercisers with AF is now 35. The theory is that we put too much strain on our hearts and have now caused extra electrical pathways. There is an interesting book written by an EP called the Haywire Heart. You should check it out.

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I have been an avid mountain runner for over 40 years now, I have been surprised how many of my fellow running mates have developed AF.

I have asked many of them if they knew they might get AF later in life, would they have stopped running. The answer is always a resounding no, they enjoy the exercise too much.

I have now had an ablation, that appears to have worked(6 months ago), and I am back out doing 2hr runs 3 or 4 times a week. No regrets about the running, or having an ablation.

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I am 37 also. I think the hardest part of all this is I am single. So I worry about my future. Will I be able to marry and enjoy my honeymoon, or will I experience weakness for the rest of my life?

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It’s hard at our age regardless single or married. I notice many, again, many people at our age had anxiety/panic disorder or were going through extreme stress before the first onset of afib, including myself. There is clearly a strong link between the psychology and the heart. But none of my cardiologists or EP agree anxiety/panic could cause afib.

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Yes, true. I was going through a period of extreme anxiety for a period of a couple of weeks. That, plus lack of sleep and withdrawal from antidepressants, was a perfect storm.

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You are in the recently diagnosed-post ablation zone right now. I'm not far behind you. I thought my life was over. I am an ER doc, AVID scuba diver, yoga instructor, work out everyday, always on the go, traveling and partying constantly kind of person. I went from that to being constantly anxious, depressed, unable to work and basically bed ridden. Then I pulled my head out of my ass and decided to fight. If this ablation doesn't work, I will go in for a second. I will take meds, whatever it takes. When you get it early like we have, your chance of cure is very high. You are panicking right now. It would be abnormal if you weren't. Theses a shitty disease, and you have to give yourself time to cope with what it means and what you can do. It will get better, I promise.

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I know the feeling. Prior to the ablation, I was not really nervous. I was just putting the thought of it out of my mind. But once I was on that hospital bed, being pushed into the operating room, I began to have a panic attack.

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When did you have the ablation? Did you have it soon after your first onset? How are you doing now?

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Yup. Exactly my thinking - if it only gets worse, and eventually pills won't work you are in the Risk Management zone. I went from an AF event and CV only every 16-18 months to every few months and made the decision to get it done since I had no other co morbidity issues and in fighting shape. Better when younger than wait wondering when it will be too late to take advantage of the procedure. MY EP was wonderful and young but had done over 400 of them and gave me a 85% rate of single Op success rate - have to have it done once. Only time will tell if he was right.

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It sounds like you are having breakthrough PAF. Are you going to have a second ablation? Maybe better to get it now while the tissue re-growth is thin and fresh.

Did you have any arrhythmias or ectopic beats during your blanking period?

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Maybe the reason why people who experience little pain after ablation tend to need repeat procedure is the following:

A person who experiences great pain during an ablation, is more likely to take better care of themselves post ablation, since they never want to experience something like that again. So they will be extra careful to make sure they allow themselves time to recover. They will also be more strict in their diet.

Someone who doesn't experience pain during ablation will probably be more likely to rush into their activities, and is not as strict in diet, etc.

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I think you make a really valid point. Most people I've spoken to are hard core exercisers and are forcing themselves back into the gym or running within 10-14 days post ablation. If you are trying to wipe out extra electrical pathways, I don't think stressing your badly burned and inflamed heart by exercising is the way to go. With the exception of a 30 minutes daily dog walk and being on my feet for my ER shits, I'm not doing any exercise until I'm out of my blanking period. This is your heart, let it heal!

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I was in a lot of pain during the procedure despite midazolam, fentanyl and paracetamol to suggest it’s a painless procedure is wrong. We’re all different. You prob will be expected to feel sore after but if you have a lot of pain etc you need a medical examination ( some obs doing ) and decent pain relief 👍

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The only problem, pain, I had was a bladder infection from the catheter....

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Sorry you had such a bad experience, but just for balance, mine was completely painless. Could be the EP, or your particular condition. Mine was done under sedation and used 3D mapping, I don't know if that is relevant

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