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Ablation plus 3 weeks

Shcldavies profile image
15 Replies

Started to feel better 10 days after ablation, improvement continues but a lot slower than I had been led to believe by the EP, that said GP and Cardiologist say nothing unusual. Off Bisoprolol and digoxin for over 2 weeks, resting heart rate gradually increasing from 52 to 64 today, rate of increase slowing down, hope it will stay around 66 and not go any higher. BP seems to have levelled out at around 130/75. Still quite sedate lifestyle but have spent full day with family around shops and regularly doing housework (never thought doing housework could be so gratifying). Heart in NSR but at times pulse rate will suddenly increase to 90 to 120 with very little exertion, can go to 85 when just sitting (don't know if this is normal or a symptom of heart recovery). So all In all quite happy with progress but still very concerned things will go pear shaped as EP said that the ablation could not cure the MAT but should not have a problem with Flutter again, so will have to continue with meds. Not sure when I will need to start meds but for now pulse and BP are OK. Going to start being a bit more active to see how I get on. Any advice on when to start meds again would be much appreciated, I am considering starting the Bisoproplol if/when my resting pulse rate goes above 80 or BP over 169/90, still undecided when to start the Digoxin.

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Shcldavies
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15 Replies

My advice would be to discuss any changes to your medication with your GP.

Shcldavies profile image
Shcldavies in reply to

Thank you, yes I have, the EP then the GP have told me effectively to self prescribe, the GP said to start with the Bisoprolol 1.25 if my heart rate or BP went too high and gradually increase to 5 as I see fit. I just did not ask what too high really is and when to start the digoxin. Have an appointment with Cardiologist on 24 April and will ask these questions then, I just wondered if anyone else had this form of treatment and how they managed.

BobD profile image
BobDVolunteer

You obviously have not read our fact sheet on Recovering from Ablation. See pinned posts. We produced this for all the reasons you note and yes raised heart rate post ablation is one of many things we warn about. You have a lot of recoverying to do yet so please go and read. Everything is normal!

Shcldavies profile image
Shcldavies in reply to BobD

Thank you, I am afraid I have read the fact sheet many times and it has given much comfort and confidence after what the EP said. I am not really concerned about my recovery, thanks to the fact sheet, just a bit unsure now I have been given the responsibility to self prescribe my meds (within limits). I should have clarified with the Doc what too high really meant as I am now a little unsure when I should start and I really do not want to start if I don't have to, then it's worst if I start them too late. I don't think I am the only person on this forum to have been told to self prescribe the meds and was interested to see what others had done.

BobD profile image
BobDVolunteer in reply to Shcldavies

My only advice would be not to get hung up on numbers . Try not to self check too much and just go on how you feel not what your heart rate might be. I remember years ago constantly checking with my machine and admitting once I only started to feel better when the battery went flat.

Shcldavies profile image
Shcldavies in reply to BobD

Yes I know that is good advice and I do try. I am probably using the self prescribed meds as an excuse. My head says one thing and my heart (pardon the pun) another. I have reduced to checking when I get up and again when I go to bed only, I do also very occasionally check my Fitbit when I have done some exertion just to ensure I am in NSR as I do not feel just right in the head when doing the slightest excertion.

Kellyjelly profile image
Kellyjelly

Hi Schldavies,

I have been following your ablation story over the last few weeks and I’m so glad that you are starting to feel better. I haven’t had my ablation yet so I’m not much help with the questions you have asked but i do think that this is a good place to ask them especially if you have also consulted your EP and GP. I think that you understand that ultimately the decision is yours. I would be the same, it’s helpful to know if other people have been in the same situation and what they did and if it helped. Hopefully someone will be able to give you more advice than I can.

Hope you continue to feel better and your recovery keeps going well 😊

Shcldavies profile image
Shcldavies

Thank you I have also been following your posts. I will offer some advice on your ablation and that is the wait and worry leading up to the ablation is the worst, and then there is no garantee it will be 100% successful. I still believe that even if it does not work fully/forever it will, worst case make things much better and best case cure you for the foreseeable future. The speed of recovery is possibly not as good as you would hope for but much in line with what people say in this forum and the fact sheet. You will worry about it, you will have funny episodes afterwards (nowhere near as bad as before) you will have to take it a lot easier than you think for weeks and you will get frustrated at not being able to do much at all. BUT you will feel really good literally minutes after its done, your heart will recover in time and you will have the knowledge that the EP has done the survey, seen first hand what is wrong and fixed what he can (hopefully all of it) to improve your quality of life. Remember these Cardiologists and EPs are the experts they know much more than we ever will. Would I have another if it improved my quality of life - Yes, but I would make sure they gave me the sedation/painkiller earlier, as the support team were a little slow with mine for some reason.

Kellyjelly profile image
Kellyjelly in reply to Shcldavies

Thank you so much, that has been so helpful. It’s so strange that you have mentioned taking the pressure off success or failure of the ablation.

I had my pre op assessment over the phone yesterday to save me going back as it’s quite a trek. The nurse was incredible and the biggest message she left me with was that no matter what happens even if the EP can’t ablate the most important thing is that he will be able to see once and for all exactly what is going on in my heart. No more wondering. She kept steering my fears back to the EP study and how valuable that is and that the ablation is the treatment.

I am so grateful to you for taking the time to tell me all that. It really helps.

I wish you the very best and hope you keep feeling better and better. 😊

Kellyjelly profile image
Kellyjelly in reply to Shcldavies

Avma, read Schldavies reply to me. It’s so positive and I thought it might help you too.

Shcldavies profile image
Shcldavies

Your welcome, please keep us informed on your progress.

Petrified profile image
Petrified

We must have had our procedures at the same time (I had ablations for AF and for flutter). My EP advised staying on same meds for 3 months (Apixaban 5mgm X2, Flecainide 250mgm & Bisoprolol 5mgm). I'm not due for review for 3 months and if all well hopefully will just stay on the Apixaban. I'm not going to check any of 'the numbers'. When I was first diagnosed I was constantly checking HR & BP and I think it increased my anxiety. The slightest change made me wonder 'why' and I'd wait and check again!!!! I felt much better when I stopped. Like you I'm taking it slowly - difficult as I prefer to be on the go. Keep well and fingers crossed - travel hopefully

Shcldavies profile image
Shcldavies

I think your doing the right thing, hope your recovery continues. My EP also wanted me to stay on the same meds but my pulse rate went too low so the Doc said to stop, now off them nearly 3 weeks but I have been told start again if pulse rate or BP increases too much. Keeps us informed of your recovery.

avma profile image
avma

Hi,

Why does your EP says, he can’t ablate the MAT? I have AT and they are going to try to ablate it. Are you going to have to stay on meds for the rest of your live for the MAT or will they ablate it later on?

Shcldavies profile image
Shcldavies

In truth I do not know and await my Cardiologist (not the EP) appointment on 24 April to find out. What I do remember is that the EP did at least 3 ablations (that I was awake for), afterwards he said that I did not have Aflutter (which laid me low in December and had to have a cardioversion for) and he believed the Aflutter I had was caused by the Flecainide he prescribed 3 months earlier (not sure this was right as I had suffered some bouts of Aflutter occasionally for a few years before I started on Flecainide, whilst on just Bisoprolol 7.5, although these episodes did not last long). The EP said I had multiple areas inside the right atrial that were "active" and "ceotic" which he could not ablate (I believe that the machines used were not the latest and were unable to identify the sources accurate enough - I believe the more modern machines can now do this). He said the MAT would be treated by medication and told me to continue with the Bisoprolol 2.5 and Digoxin 125 until seen by my Cardiologist. A week after this, following 4 hrs of an arrhythmia and a normally low pulse rate of high 40s with many ectopics, the GP then the Cardiologist told me to stop all meds, and to self prescribe up to the limits given. This worked for 4 weeks, then my pulse rate and BP increased slowly over a 4 day period (pulse rate 85 BP 160/97) so I started to take Bisoprolol 1.25 (very low dose) and this worked pulse rate 69 BP 125/74 ever since and improving steadily but slowly since.

I believe (my theory only) that too high a dose of Bisoprolol or Flecainide can morph the AT into Aflutter, that initially my MAT was caused by electrolyte unbalance (whilst it was confirmed that I had a structurally normal heart, for years earlier I had been consuming 3 bottles of wine a week drunk far too much strong coffee and taken PPIs daily). I had not changed my lifestyle until just 12 months ago and then only gradually. As it takes months to get your electrolytes back in order, the gradual increasing of the meds whilst at the same time my body/electrolytes was fixing itself, combined to cause the more regular tachycardia and the new Aflutter. After speaking to my Cardiologist I hope to try coming off all Meds and providing my Pulse rate and PB are still good staying off the Meds - over optimistic I know but it is something to aim for.

I believe that if you have single source or just a few sources of AT an ablation will most likely be successful providing they can initiate it and ablate during the procedure, which they can now do over 90% of the time. I would warn that the initial cause of the AT (which may also be an electrolyte unbalance) should also be removed/remedied/treated in order to stay AT free. Finding out what it is can be difficult as electrolytes in your blood can be fine but there can still be an unbalance in your cells which generate the signals to your heart. The right amount of Potassium, sodium, calcium, iron and the magnesium to orchestrate it all is essential to the foci in your Atrial to work right (that is you don't want to trigger them unduly as this causes AT).

Doc knows best but is not always right. In your case I am sure the the AT can be ablated, they will not try unless there is a good chance of success. Even if it cannot be ablated (which is unlikely) it is far better to get the EP study done in order for the Doc to know exactly what is happening and what the best way ahead is. This is understandably a worrying time for you and it won't get much better until its all over - the morning before was particularly bad for me and then there is the recovery which can also be a bit worrying at times. BUT it will be worth it and remember EVERYONE worries before this procedure you are not alone!

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