Day 4 Post RF Ablation

[clemsonwebdesign]

Day 4 post RF ablation. Everything went fine. Dr Daulbert and Duke Uni NC staff accommodated me and my family well. Dr stated he ablated all of my PVI and even did some ablation for a flutter he noticed. All of the anxiety and worries I had going into it were really pointless. The took me back. Put me up on a table in the EP lab. Showed me some of the equipment. Told me to take a few deep breaths. Next thing I know I was awake talking shit to the nurses in recovery.

The first 2 days I had some coughing and some chest tightness. The past two days the chest tightness has gone away and I feel great. I've basically just slept and played video games the past 3 days.

That is. Until today. This morning, I decided to clean house and do some chores. Get a little active. Its hard doing nothing. Around mid day I started having some sort of weird beats. It feels like the afib is trying to come on. I'll have 5-10 seconds of normal rhythm beats then some off beats. Took 1.5mg of ativan and that seemed to calm it (me) down.

Kind of off setting. Up till this point my my hearts been rock solid in a good SR. I know its expected to have some off beats or even some afib. I'm going back to being super lazy and hoping my solid SR comes back!

To anyone fretting the procedure. Dont fret it. I actually went into afib with rvr (160+bpm) during preops the day before my procedure was scheduled. I opted for a shot of morphine (to chill me out, help with the discomfort), some cardizem (flow my rate) and just to check in to the cardiofloor the night before The Dr ablated me while in afib, had to cardiovert me at the end of it but he felt confident everything went as planned. The entry site is hardly even visible. Just a little wound and a small circular bruise. Its not even really sore. The laying still for 4 to 6 hours was a breeze as well. I was so out of it. I was up and walking before I really even knew what was going on.

[BobD Volunteer]

Regardless of anything they may have told you, our advice is TV remote only the first week. Week two you may make tea. The more you pamper yourself now the better in the long run.

Go to AF Association and read our fact sheet (patient resources) on Recovering from Ablation or follow the link in our pinned post on the subject. There may be lots of surprises ahead so best be prepared.

[Morzine]

Hey no chores!! Rest!.....two weeks they say.....and after thst don’t start rushing around.....I found that the body tells you off if you do......onwards and upwards!

Sue

[Dawsonmackay]

You do realize what an ablation is? It uses heat or freezing cold to ablate/kill heart tissue. Inside the chambers of your heart. In the hopes of creating scar tissue that will block those errant electrical signals. How long does it take for the heart to heal? How long does it take the heart to form scar tissue? Certainly NOT five days! You have to be careful, more careful than you have ever been in your life. I know because I have had three ablations. Do not push yourself into doing strenuous/hard chores. No picking up any weight etc. Read the ablation fact sheets on this website for guideline. Really though, take care of yourself.

[clemsonwebdesign]

Ah. I just did the dishes and put away some laundry really. I'm not out hauling wood or doing yard work. This morning I washed my car (hose and a sponge). Nothing strenuous. 90% of my day consist of sitting at my desk. My EP says its OK to be active, just dont lift anything over 10lbs and to listen to my body. Hell. I was walking laps in the hospital the night after my procedure.

EP said the episode I had yesterday was likely ectopic beats or a short bout of afib. He said it was good it corrected itself and that it was normal to have some episodes. He also cleared me to start back my daily walking if I felt good enough (i take morning walks). I think I'll hold off on that and take you guys advice about being super chill.

Thanks for the input. I really hope everything does stay this smooth sailing. I really expected hell afterwards.

Check it out. This is my EP procedure summary. It states NO AAD but Im still taking my full dosage of sotalol. I am also taking Colchicine but today is my last day of taking it.

Anesthesia: General endotracheal

Estimated Blood Loss: less than 100 mL

Specimens: none

Electrophysiologic Findings:

1. The rhythm at the beginning of the procedure was: atrial fibrillation

2. Baseline intracardiac echocardiographic at images showed normal anatomy of the right atrium tricuspid valve, right ventricle, aortic root, interatrial septum, and no pericardial effusion.

-At conclusion, intracardiac echocardiographic images showed no changes and no pericardial effusion.

3.Transseptal puncture was performed (RF needle) ~4:30 using fluoroscopic, pressure and intracardiac echocardiographic data.

Pressures: RA: (10) LA: v=21 (17)

4. An anatomic three-dimensional map of the left atrium was created using the preoperative three-dimensional image of the left atrium

5. Ablation for atrial fibrillation included:

Wide area circumferential pulmonary vein isolation was performed encompassing both of the right veins and both of the left veins in an en bloc fashion.

Additional lesion sets performed included:

- -R anterior wall near GP likely; fractionated signal in AF and SR; connected to RPV anterior WACA line

Esophageal temperature monitored and location visualized with ICE too; 30 w limit on posterior wall (or 25 W with SF); ablation terminated if > ~1 degree C or 15-20 s on esophagus by ICE.

PV antra and ostia visualized by intracardiac echocardiography to avoid ablation inside ostia and position ablation widely at PV antra and along LA ridge

6. Cardioversion was performed. (200j to sr)

Conclusion:

1. Successful wide area circumferential pulmonary vein isolation

2. Successful ablation of fractionated signals anterior to RSPV; connnected to PV lesion set.

3. Normal ICD function (threshold <1v) and no change on fluoroscopy; device reactivated; VF duration increased to 3.5 s.

Recommendations:

Plans:

1) Post-ablation medication plan is:

Anti-arrhythmic drug: no AAD

Anti-coagulation: restart prior anticoagulant

Colchicine: No

Proton pump inhibitor q12h: Yes

[Gowers]

Just read your post - that is quite a detailed summary from your EP. Think I will ask my cardiologist for similar.

[clemsonwebdesign]

Held for exactly 4 months. Went into afib last week at 4am. RVR with a HR hitting 150. Afib felt the same as before ablation. Cardioverted one shock 100 joules. ER Doc insisted we use Ketamine for the drug to out me out. Had a near death "trip" experience. Was horrible. Never let a DR tell you Ketamine is safer than Propapol!