When I was first diagnosed with persistent AF back in 2014 I was first prescribed Bisoprolol with a starting dose 1.25mg. This was progressively increased over 3 to 4 weeks to 3.75mg and then 120mg of Diltiazem was added, all designed to reduce and stabilise the heart rate. I remember telling my cardiologist that I was feeling like s**t (not my exact words) and he seemed genuinely surprised. His logic was that without medication, I was experiencing all the normal symptoms associated with AF but now that heart rates had reduced to an acceptable level, the symptoms from AF and the side effects from the medication should all but cancel each other out. Great theory, but didn't seem to relate to the reality of what I was experiencing. Fortunately, after a relatively successful CV I was told to stop (progressively) the Bisoprolol but to continue with the Diltiazem which I am still taking to this day.
At my six month review with my EP (not the same cardiologist) after my first cryoablation (done in July 2016), we talked about reducing or possibly even stopping the Diltiazem but he suggested that I monitored my blood pressure first. Due to a slow, gradual return of AF episodes, the Diltiazem continued. The reason for bringing this up is that I am just over 2 weeks past my second ablation (RF) and still feeling pretty good. At the moment, my blood pressure is around 120/65 and pulse rate is lower than before the ablation at 55 bpm or so. Although so far, there are no signs of any AF, ectopics or palpitations, I still feel occasionally slightly breathless and I'm not sure if this is all part of the recovery process or if it's caused by the side effects of the Diltiazem trying to control AF which, at the moment, isn't there. On the understanding that I will not be making any changes to my medication without EP approval, I would be interested to know what you good people think......
It may be the drug still FJ but for what it is worth I get breathless most of the time and have no AF since my third ablation in 2008. I do wonder sometimes if this is a result of the extensive work done inside my heart or am I just so unfit these days. I was never able to run as a child and when I raced bikes I was always in the slowest group so maybe just anno domini .
Good evening Flapjack, I am very pleased to hear that you are making such good progress..
I can't comment on the Diltiazem as it's not one of the drugs l am familiar with..I can however identify with breathlessness as for a good 12 months following my Ablation in 2015 I would be short of breath on the slightest incline and have to rest to get my breathing under control again..
I read Jonathan Crick Cardiologist respond to forum member about breathlessness following Ablation he kindly answered and by email sent me breathing exercises which l practiced to perfection over several weeks..These helped tremendously and are now second nature...It seems l was just forgetting or had forgotten to breath correctly...
I hope this helps you and wishing you a speedy recovery...
Carol.
• in reply to
Very helpful Carol and thanks for your kind wishes.....
This isn’t related to after ablation care but to the Myasthenia. I used to get really breathless and never knew what caused it and when AF struck I was terrified I would stop breathing, as my Myasthenia was so unstable it was real possibility breathing faster and more shallow is a symptom of impending crisis. I was working with a Neurologist-physio at the time who worked with all sorts of neuron patients, many with heart problems. He suggested I purchase a ‘power breather’ that atheletes use to increase their vital capacity. I was a little skeptical but did and starting very slowly practised 5 mins x 2 a day. It worked!
He explained that we intentionally exercise every other muscle in our body but forget to exercise our intercostal muscles, evidently our diaphragm is a very large, strong muscle and is unlikely to fail, but the smaller muscles do need exercising - deep, slow, long breaths do that. The power breather means you breath against resistance which therefor builds muscle faster - not sure I would use in early stages after ablation but certainly the breathing exercises should help.
Once upon a time back in the nether, nether land when physiotherapists used to visit you the day after an op and give & supervise you doing your breathing exercises, I then first learned the importance of correct breathing.
That’s interesting CD, I remember as a young lad I used to suffer quite badly from asthma and I went to hospital for breathing lessons which I recall were rigorous but they successfully dealt with the asthma. Ironically, I assumed it was the asthma returning when I was first diagnosed with AF.
At the moment, I think it’s far too close to the ablation to draw any conclusions. It’s more likely caused by the anticipated excitement of meeting so many of the gorgeous young ladies in Exeter next week....😉
+1 from me for how interesting that is CD. Curiously, my aged father used to tell a story how, when he was a child, a friend of his saw a doctor for his asthma. This was in Paisley in Scotland, and must have been early 20thC. before the NHS. The doctor prescribed trumpet lessons, and they appeared to have good effect. Bagpipes have also been a suggested treatment for weak breathing muscles!
Hi Carol so glad you received help ,could you kindly tell us how to do the breathing exercises please. I too suffer with scarey breathlessness. Cheers Gladie. Xx.
It is breathing in to the count of eight holding breath for a few seconds and then breathing out again to the count of eight.
Jonathan Crick is a Cardiologist and a member of this forum and every informative ..I PM'd initially for help as l had previously read his response to another Forum member..
It's takes a while to get into the rhythm but eventually it becomes second nature.
My father, who lived to 90, regularly hiked and walked and used to breath in slowly, hold for the count of ten and breathe out slowly. When he couldn't get out (and the weather had to be really bad for that to happen) he would RUN up and down the stairs at least ten times. He did all of this until his final three months.
Carol, could I please have a copy of those breathing exercises Jonathan Crick Cardiologist, emailed you. Breathing doesn't appear to come naturally to may anymore!
This was sometime after my Ablation in 2015 he did ask me if opportunity arises to pass on information on forum..If you private message him l am sure he will be happy to help ..
If l still had email l would forward to you but unfortunately l don't..
If l can scroll down and find past messages to him l will - but doubtful they will go back that far..
My theory is we all go through such turmoil and stress prior and post Ablation consequently all our bodily functions are messed up including breathing..
When we are stressed we talk rapidly forgetting to breath slow and deliberately...Not forgetting breathing apparatus during procedure..
I know what's it's like to be struggling to climb a slight incline fighting to breath as do so many others on here..
Another way is to look at Jonathan's previous posts to others..
With a heart rate of 55, it would seem there is room to reduce/eliminate the Diltiazem without it going too high. That might, just might, improve your breathlessness symptoms. I know you won't take my advice and will refer to your medical team
Interesting re breathing. Abdominal breathing. ( put hands on abdomen and when you breathe in try to push them away) uses less effort. Most men use abdominal breathing ,ladies less so. Breathing using intercostal muscles is taught in Pilates. Put hands on ribs a d try to push them away when you inhale.
Amazing the difference when you think about breathing. Breathing out for a little longer than breathing in, also causes relaxing serotonin to be released I believe. So counting can help.
I had ablation in January and February 18 and an currently off all drugs since may 15 2018.
I was on diltiazem 200mg from mid July 17 to may 15 12018. It made me breathless, exercise intolerant, gave me brain fog and was always tired. 4 weeks after I stopped taking it I felt a lot better, brain a lot sharper, nowhere near as tired, an the exercise intolerance gone, although I am nowhere near as fit as i was 2 years ago.
However I still do have a bit of breathlessness often when I start doing something. I reported this last week in another reply to a post: if I walk up a could of flights of stairs or push/ manoeuvre my motor cycle into the garage or pick up something heavy. However if I go for a run I can do 5.7 miles in less than 50 minutes . Of course when running I am breathless anyway, but I know why then and it feels normal.
I am not sure what this is, whether it is a consequence of my ablation, unfitness in other muscle groups not used in running, or something else.
I have no knowledge of the drug you are on so can't make any comment. However your heart rate and blood pressure are amazing. I wish mine could drop as they are definitely not impressive. I think being breathless is par for the course, certainly at this stage in your recovery. I was given a lecture about making sure I breathed deeply enough. Good luck with your continuing recovery.
Since my AF returned I have been put on 120mg of Diltiazem again. I am having less breathlessness since I started (and no noticeable AF). I realise this doesn't prove anything but that is my experience.
The breathing exercises that are being described are what we do as warm up at choir. Singing is very good for improving breathing. When I was having lung function tests at the Royal Brompton it was recommended. Sadly I cant get to my choir often enough for it to be too beneficial for me. Bytheway don't be put off a choir by thinking that you can't sing. You'd be surprised and most have no auditions.
I found one problem with your post FJ and that was as I practiced your breathing techniques I kept falling asleep I was so relaxed!!😄
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