Symptoms after Flutter Ablation

[Boyatthood]

I had an ablation for atrial flutter on Monday and all seemed to be going well until last night. I woke this morning with some similar feelings as when I was in flutter. I fear I may have gone out of sinus rhythm back into AF but can't be sure. If I am having palpitations they feel very different to prior to my procedure. Phoned the Spire hospital who said I need to go back to my GP and get an ECG. Not helpful over a bank holiday weekend. If I have gone back in to AF I am wondering whether to resume bisoprolol to calm it down again. Equally I may also be panicking myself as these symptoms could all be a normal part of the recovery, its still early days. Any advice out there from anyone being post procedure and thinking they are back in AF?

[BobD Volunteer]

Have you read our fact sheet on recovery? All sounds normal to me.

[Boyatthood in reply to BobD]

The fact sheet from the Spire does not mention anything about having flutter symptoms after the procedure. I have just read online that you can experience periods of flutter and AF but the procedure could still be successful. When resting things feel fairly normal but when I walk I am now having very similar chest feelings to post procedure. I am not sure if its palpitations or not. I suppose I could check my pulse but only an ECG would properly clarify. Maybe all this is normal anyway!?

[Shcldavies]

Please read my posts following a flutter ablation in February

[Boyatthood in reply to Shcldavies]

Thanks, your blog is extremely helpful and a very reassuring read. Certainly helped my state of mind this weekend.

[Shcldavies in reply to Boyatthood]

Thats good, keep positive, if you want more comforting information look at Dr Gupata's videos on youtube, just type "yourcardiology" in the search engine

[Hidden]

From stopafib.org:“Many people experience some atrial fibrillation or atrial flutter following a catheter ablation due to inflammation of the heart tissue. For this reason, the first three months are generally considered a "blanking period" in which success or failure should not be judged.

Some folks have said that their afib following catheter ablation was as bad as before, or worse. That is due to the inflammation, and the arrhythmia is often different from that experienced previously. As the body heals and the inflammation resolves, the afib and atrial flutter generally go away.”

It’s clear that it’s far too soon after your procedure to expect everything to have settled down.

[Boyatthood in reply to Hidden]

Thank you that quote is very helpful. That certainly wasn't explained to me by my consultant. He was pretty much you can just get on with your normal life, have a drink, go for a run etc. The arrhythmia I experienced yesterday was certainly different, heart felt all over the place. It feels a bit calmer at the moment so hopefully this was an episode as part of the healing process.

[Hidden in reply to Boyatthood]

I would suggest ringing the consultant’s secretary and asking for more information on what to expect following your ablation- in particular what symptoms you don’t need to be concerned about and what symptoms you do. It’s very much the hospital’s business to provide this sort of information -sounds as if they have been rather remiss.

[Boyatthood in reply to Hidden]

Nothing in my discharge pack and only had five minutes with my consultant still in a semi-sedated state after the procedure. I agree will be on the phone on Tuesday.

[Hidden in reply to Boyatthood]

That’s a serious issue- hospitals are supposed to ensure that patients are given clear instructions regarding post-procedure care and this should not be provided when a patient is still recovering from sedation. I was told this by a nurse many years ago when I was given post-care information after having wisdom teeth extracted whilst still groggy from sedation; I could not recall the information. The nurse (at the local GP surgery) said that providing information to patients in this state was absolutely unacceptable.

It’s probably counter-productive to be too belligerent about this, but something along the lines of “I don’t want to make a formal complaint, but....” might be appropriate.

I would also make it plain that you are expecting a phone call from the consultant fairly promptly with the opportunity to discuss any post-procedure concerns. Not sure where you had the procedure carried out.

[Boyatthood in reply to Hidden]

Without naming it, it was a private hospital in Southampton. I thought my care had been great but on reflection the discharge and advice was not the best. I also vaguely remember the consultant saying he had to do a few more ablations than usual 'slightly more complicated' but it I was fine and the rest of the heart was fine too. I agree with you about post-op advice being given when sedated. I wish my wife has been there at the time and would recommend that anyone having this procedure insists they have a relative or friend in the room (if they can) when they have this conversation.

[Hidden in reply to Boyatthood]

It was also a private hospital where I was given advice on post-procedure care when still groggy from sedation. I would be inclined to have very strong words with them tomorrow.

[kitenski]

This PDF is very useful

healthunlocked.com/api/redi...

Also myself and others have found a Kardia very helpful to diagnose issues (the Apple Watch 4 can also take ECG readings if you happen to have one)?

amzn.to/2J0MLxQ

I had all sorts of A Fib episodes, a few flutters etc or the first month, it's only in the 3rd month post ablation that things have really settled down.

I'd be taking lots of rest for your first 2 weeks, before even thinking about exercise!

[Boyatthood in reply to kitenski]

Thank you, that fact sheet is really helpful. Wish that had been given to me from my hospital. Feel let down by them at the moment. I went out and did some short walks this week and think I have probably pushed it too hard. The consultant said I could go running this weekend as I normally do park runs- seems strange advice really! I am looking in to Kardia.

[kitenski in reply to Boyatthood]

I was very active, I think short walks are ok after a week, but I went slower than usual and kept a close eye on my HR, to keep it under 120bpm. I'm 4 days away from 3 months post albation, and am starting to increase the HR during runs/bikes, but keeping the volume much lower.

[Hidden in reply to Boyatthood]

Advice on exercise post-ablation from livestrong.com:

“Exercise: The insertion site from the ablation will usually heal in one week, allowing you to return to your normal daily routine. If your normal routine included regular exercise, you should start out slow. You should monitor your heart rate before, during and after exercise. It may be beneficial to use a heart rate monitor to allow you to watch your heart rate response with exercise. It is normal for your heart rate to increase as your activity level increases. However, you should speak with your physician to find out the safe heart rate zone he wants your heart rate to be in. He will also give you guidelines specific to your health status and procedure outcome as to when you may need to seek medical attention. If strength training is part of your normal exercise regimen, you should also talk to your physician about when and how much weight you should be lifting, specifically with the limb that was used as the incision site for the procedure. For example, if the groin was the site at which the catheter was inserted, he may advise you to avoid lower body strength training for a few extra days or weeks to ensure the complete healing of the incision site. Considerations:

It may be beneficial to talk with a cardiac rehabilitation professional for more guidance in your exercise program. These professionals are highly trained to work with cardiac patients after heart surgery or heart events. They can advise you on the proper way to begin exercising after your procedure, what vital signs you should monitor and how to progress back to the level you were exercising before. If you are a new exerciser there are also excellent resources to help cardiac patients in learning the basics of any exercise program.”

In the light of this, your consultant’s advice sounds thoroughly irresponsible.

[Boyatthood in reply to Hidden]

It does indeed seem strange advice. I am in my early 40s and normally enjoy running and moderate exercise but I am no athlete! I've taken it much more easy the last couple of days and feel better for it. I think my episode on Saturday may well have been triggered by over exertion walking too much on Friday.

[rosyG in reply to Boyatthood]

gentle walks would help the heart rhythm I think. just take things slowly. your heart has had an, albeit small, burn so rest is needed!!

[Boyatthood in reply to rosyG]

I agree and avoiding hills too.

[adabra1]

I would suggest you look into the Kardia home EKG device or something similar (don’t know if it’s available in the UK). My doctor actually recommended it to me. Works with your phone.

[Boyatthood in reply to adabra1]

I have now got a device, thanks to the wonders of Amazon Prime. On first take I think my heart appears to be in a normal rhythm which is reassuring. I am now 7 days post procedure. There are the usual chest aches added to heart-burn, bloating and gurgling sensations in the stomach. Whilst irritating these are not too unpleasant or painful. My heart feels more peaceful. Being more restful the last couple of days has helped I think.

[Boyatthood]

I followed up with my hospital my symptoms at the weekend. I expressed my disappointment at the lack of discharge info I received too. They promptly whisked me in to do an ECG which my consultant says is fine and that no evidence of any abnormal rhythm was seen. Good news. I discussed how I felt at the weekend and that over the last two days I have had two hot flushes with my blood pressure on the slightly high side. He didn't seen overly concerned. He said adverse symptoms over the weekend (Saturday) could though be a sign of Afib as flutter would have shown up on my ECG and would not come and go if it had restarted. He seemed keen that I should be doing normal things and shouldn't worry about exerting myself? This man loves to get me exercising! I qualified this by saying walking lots as opposed to going to the gym. He was keen on this. He said my options were to a) leave things as I had a happy ECG yesterday b) Monitor my symptoms 24 hours with a hospital monitor c) use a Kardia to capture anything unpleasant I feel and send it to him.

I have elected to leave things as they are, try to relax and use Kardia to record anything I am worried about. I have to say I am reluctant still to go charging about as if 'normal' as the consultant suggests though! I did have a lot more energy today but I am tired now. Walking briskly or elevating my pulse makes me very aware of my heart beat and it takes a little while to settle back to resting. The beat feels steady though- I think! I am obviously fearful of my condition converting in to Afib and strangely fear raising my heart rate will do this. I presume this is very irrational?! I don't know what Afib would feel like to distinguish it from flutter either. The unpleasant feelings I get are best described as 'bubbles' in the chest around the sternum.