Ablation Number 2

[Harfly]

Hi That’s me just home from having my ablation for atrial flutter today. The procedure went very well and was much quicker than the first time. Quick question this time it was a different consultant and he carried out a cardio version during the procedure, that didn’t happen the first time, would anyone know why the second time?

[BobD Volunteer]

To put you back into NSR. Maybe you didn't go out of rhythm the first time?

[Harfly in reply to BobD]

Ok thanks Bob. Feeling good but always read your posts and I know to take it easy!! 😀

[Kellyjelly]

So glad it all went well 😊I’m having ablation number 1 on Monday. Trying hard to control my anxiety.

Hope your recovery goes really well. Take good care

[ThinLizzy1 in reply to Kellyjelly]

I’ve just had one a week ago it really was a smooth procedure with no pain just a bit of non painful bruising around the groun. Read the info sheet on here it was really accurate. Slight sore throat for a day or two, bloating for two or three days.

[ThinLizzy1 in reply to ThinLizzy1]

Groin

[Harfly in reply to Kellyjelly]

Hi Kellyjelly. My first ablation was much longer but I was in really good hands. They give you sedation and pain relief so most can manage the procedure. My ablation yesterday was much quicker it was more a tidy up of the bits they missed last year, I would do it again if need be. Sending you positive thoughts 💭 for Monday.

[Kellyjelly in reply to Harfly]

Thank you 😊 it’s reassuring to hear stories of 1 ablation but even more reassuring to hear stories of multiple ablations. I hope you are feeling well today.

Take care 😊

[Jupiter33]

I was cardio converted after my ablation on Thursday. As BobD says, it's to put you back into sinus rhythm.

[Harfly in reply to Jupiter33]

Thanks Jupiter33 I just don’t think I was cardioverted first time. Oh well as long as it keeps me in NSR!

[jeanjeannie50]

When I'm in hospital, as soon as I'm up and able to, I read the doctors notes that are kept at the bottom of the bed. That's how I discovered I'd been cardioverted twice during one of my ablations. Thinking of it now, I wish I'd thought to photograph them with my phone so I could study them in depth at home.

Wishing you a speedy recovery and a calm heart.

Jean

[Harfly in reply to jeanjeannie50]

Thanks I have my notes for the GP so I am going to photocopy them so I can research the procedure I underwent, long may our hearts beat steady 💗

[Kingslip]

Hi Harfly. Cardioversion is performed when normal sinus rythmn can’t be restored by ablation. One of mine for flutter appeared to go well, and didn’t need cardioversion, it only lasted 36 hours and I was in flutter again. The only reason to cardiovert is because your ticker wouldn’t go into sinus on its own. Doesn’t make sense somehow. If they were mapping your flutter, and it was performing well, they should have been able to find the causative pathway, so I don’t understand why, if they had ablated it, they would need to cardiovert you. Once the offending pathway is ablated you should go straight back into sinus on your own. Anyway, here’s hoping you are still doing well and it doesn’t return any time soon!

Keep in touch would like to know how you progress. Good luck

Li

[Harfly in reply to Kingslip]

Many thanks for your helpful reply I am feeling not too bad today but had blinding headache yesterday and some visual disturbances. The doc explained that as I have hypertrophic cardiomyopathy that I am high risk of AF and flutter returning so will need to take it very easy although it might just be a matter of luck in my case. In addition he told me I have AV block and that I am 100% dependent on my pacemaker which I was surprised as in the past I have been able to pace albeit only about 32bpm without the pacemaker in my ventricle. Oh well every day is a school day 😀

[Kingslip in reply to Harfly]

Ok. That makes things clearer. Don’t worry about the headache and visual disturbance. It’s a side effect of the midazolam sedative and will resolve. It’s quite common. If you have AV block that means your AV node has been disconnnected from your ventricles and the pacemaker has taken over control of them. Most people have an escape route after ablation, yours is probably 32bpm. Maybe your hypertrophy is playing a part in disrupting your PM settings. Once set they shouldn’t go below base rate. Whilst pace and ablate won’t stop arrythmias going on in the atrium, they are not usually not noticeable any longer but some people do continue with beta blockers which sometimes reduce them. The main thing is that the ventricles are no longer at risk and can synchronise to produce normal sinus rhythm. I’m wondering why you are still undergoing ablations after an AV node ablation. You need to get more information from your EP or physiologists and ask why (if it’s a CRTP device you have implanted) the PM isn’t doing it’s job sufficiently to allow you to have a better quality of life. If you find yourself having to survive with a heart rate of 32bpm at times then something definitely isn’t right!!

Keep in touch

Li

[Harfly in reply to Kingslip]

Hi Kingslip, my understanding is they didn’t ablate my AV node just said I had AV block??? Perhaps a result of HCM?? Thanks

[Kingslip in reply to Harfly]

Not making much sense to me. If you have been told you are 100% pacemaker dependent. That usually means you rely on the PM to synchronise your ventricles. I do hope that something can be done to improve things, but as you say, it’s maybe complicated by the cardiomyopathy.

Do let me know how you get on. Will be thinking of you.

Li

[Harfly in reply to Kingslip]

Hi it says in my discharge letter “DDD pacemaker for chronic AV block”

My heart feels as though it is racing today but no headache!! Thanks

[Kingslip in reply to Harfly]

Just read some of your earlier posts. Did you go ahead with the pulmonary vein isolation ablation a couple of years ago? You mentioned they gave you 50% odds on success, but I take it the AF didn’t resolve completely and, that’s the reason for further ablation. Anyway from what you say it looks like you have a dual chamber pacemaker one lead in the atrium and one in the ventricle and that would account for the ongoing problems. Such a shame you couldn’t be offered the pace and ablate (AV node) as this is the only way of ensuring that there is a disconnect between the atrial activity and the ventricles. I can now see why you are still 100% dependent but still able to suffer with the fast rates and be aware of them. It sounds as though they are doing their best to help alleviate arrythmias and side effects of the drugs. Bisoprolol is a good drug for heart failure . I am keeping everything crossed that this latest ablation will have helped. It can takes some months before you know what the outcome will be in terms of whether it has or hasn’t worked. All the heart drugs seem to have rotten side effects. I was fine on sotalol for ten years before it stopped working. I have tried most of them and I know lots of people complain about bisoprolol causing breathlessness which isn’t much help if you already suffer from it without the drug!! Be positive and consider all other options suggested. Will be thinking of you. Take good care and keep me updated please.

Li

[Harfly in reply to Kingslip]

Hi I had the PVI ablation in June 17 and last Friday the ablation was for flutter, the consultant has said on my discharge letter the all 4 PVs remain isolated. The ablation in June 17 was a long procedure and my heart was a bit swollen so they couldn’t deal with the flutter. The consultant also said on Friday to stay on bisoprolol as it helps my heart contract. Many thanks for all your helpful information 😀

[Kingslip]

Hi Harfly. How are you doing at the moment? Have things settled a little? Been thinking about you and wondering how you are coping.

Li

[Harfly in reply to Kingslip]

Hi Kingslip thanks for being in touch. I am feeling really well, I have had a few runs of ectopics but nothing else. I am out walking most days and managing my 10000 steps so feeling very positive. I am still off work and going to take another few weeks before I go back to all the stress that entails meantime I am enjoying the lovely weather. Hope all is well with you 👍

[Kingslip]

Hi Harfly. So pleased you have improved. Hope all goes well when you return to work. Keep your stress levels down. I remember stress being one of my biggest triggers of the flutter. Just keep telling yourself that nothing is worth going into flutter. Count to ten and carry on! I am good, just returned from three weeks travelling. Lots of walking and climbing and, breathtaking scenery all round!! Still getting used to the fact I can do it.

Just brisk walking would always set off my flutter. I would either have to be cardioverted or suffer it for months at a time until it became permanent at 148bpm. Fingers crossed for you and take good care.