This AF business is really well described as a journey. The situation now is that following the fitting of my pacemaker (CRT-D paced at 80/130 bpm) the risk involved from any further syncope was greatly reduced which was obviously to the good but nevertheless I still didn't feel much better. As posted previously I was scheduled for a AV node ablation since pacing was only effective 65% of the time. Post ablation my heart rate was set at 90bpm with 2 further pacing adjustments planned stepping my pacing after a month down to 75bpm and then at the end of another month down to 60bpm. The ablation procedure was was not unpleasant/painful, the small wound in my groin healed in a few days but disappointingly I still didn't feel any better although I almost immediately (withing a week) lost about 5lbs in weight (bonus) as my kidney function improved a little due to better blood flow (I think). However, the great improvement I was led to believe would follow did not materialise; in fact I felt worse, out of breath at any minor exertion and I felt although my heart rate appeared regular it seemed to do this in fits and starts heralded by a heavy beat followed by say 5 or 6 regular beats and then perhaps another heavy beat followed by 20 to 30 regular beats, then back to 5 or 6 regular beats and then perhaps hours of regular rhythm, very odd and disconcerting. For example I had a dental appointment, managed to park the car probably around 500 yards from the practice down a fairly gentle slope. The return to the car was very difficult, I had to take 3 rests, was heavily out of breath, my legs ached, I almost sat down on the pavement at one point despairing of ever getting back to the car!
The walk from the hospital car park to the Cardiology was at least level but about the same distance as the dentist but I was only mildly out of breath when I got there. At the pacing clinic my pacing had improved to 85% after some discussion with the nurse specialist she reluctantly accepted ("but you have been fitted with a top of the range device, and your pacing has improved") that I actually had felt worse since the ablation procedure. She didn't like me to question her about anything really; I think she just wanted me to lie still, be administered too and to leave, strange. Anyway, having finally accepted that I felt worse than ever she adjusted what she referred to as the "sensitivity" of the pacemaker as well as reducing the bpm down to 75. By way of a small test when I left the clinic I strode boldly for the car and was pleasantly surprised that I was hardly out of breath at all! Since then I think I have steadily improved to the point that I can now spend 4/5 hours in my workshop (hobby woodworker) with no ill effects, so it would seem the adjusted "sensitivity" has done the trick. BTW. the nurse told me that those heavy beats were ectopics induced by my ventricles which were interfering with regular pacing from my pacemaker which in turn was why my overall pacing was 85bpm rather than approaching 100%. My next pacing clinic is due in a little over a week, so something to look forward too!
Pace and Ablate - start of my journey
Still in AF 25 days post ablation.. do I take Amiodarone?
AF & AV node ablation confusion 
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The AF journey continues...now ablation
