I am almost 4 weeks post ablation and I Can’t stop worrying that I am going to develop an atrial esophageal fistula. I know it is considered a rare complication but ever since my EP mentioned it when going over possible complications of ablation I have had so much anxiety about it. I currently am suffering from nausea (causing low appetite) and dull chest ache and am worried that this is the start of symptoms of an AEF. I must sound so ridiculous, but is there anyone that knows much about this? It says that they don’t happen after 2 months. I am going to drive myself crazy worrying about this for another month.
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Finnblu
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There is nothing ridiculous about your upset, I completely understand your concerns and anxiety. Anxiety is sometimes worse than the actual facts of our conditions. If you are really anxious I would contact your medic. Is there an arrhythmia nurse at the hospital where you had your procedure and can either reassure you or ask the consultant a question on your behalf. I am not medically training but would have thought any issue would have raised its head by now four weeks post procedure.
Anxiety is a demon to deal with and sometimes is not wrestled to the ground even when facts in support are put forward. I think being proactive and seeking support and answers perhaps input from your GP regarding anxiety overall may see you through this upseting episode. Thinking of you. Best wishes.
Knowledge is power - I too was freaked out by the thought of an erosion in my oesophagus so I looked up the symptoms to know what to look out for. I discovered that nowadays EPs take steps to prevent such an event including prescribing PPIs after the ablation, or Ranitidine in my case, so the chances of a normal healthy person having one are very very rare. Secondly the symptoms are very noticeable and include fever and a sensible person wouldn't ignore them. Your symptoms are normal post ablation feelings and as long as they don't get progressively worse you needn't worry.
Piece of advice for the future - if you are anxious about a worst case scenario make sure you have the full facts. I don't mean that in a nasty way at all - when I was a child I heard about tsunamis and used to lie awake in terror in our holiday beach house listening for a monster wave. Adults told me not to be silly but more info about tsunamis would have been helpful 😀
My EP didn't mention this at all. I know how hard it is not to worry . Can you try some meditation or deep breathing? There are heaps on youtube. If nothing else it will distract your mind for some of the time.
You don’t sound ridiculous. It’s natural to be anxious. Have you mentioned it to your doctor?
As you say, the chances are too small to be likely, though. If I were you, I’d try hard to put it to the back of my mind, I’ve had persistent stomach problems since my ablation for flutter, symptoms that seriously mimic heart problems, in fact, but, after various tests including a cardiac stress MRI, it seems my heart is fine. The possibility seems to be that my hiatus hernia has flared up, perhaps owing to the ablation instruments going through the same small space as does the hernia and oesophagus.
One thing I’ve had confirmed over all this is the unbelievable power of mind over matter and, being an anxious person, I now certain that anxiety plays a major and rather uncontrollable role in our illness.
Hi Finnblu, i am so sorry you are suffering from anxiety.... i know only too well what that is like. Maybe you can consider taking an online course of cognitive behavioral therapy to help you..... that and taking deep, slow breaths and maybe walking out in nature should help to calm you.
I have found in my 61 years of life that the really bad things that have ever happened to me were the things i never thought of to worry about, and the things i did worry about never happened.... so what a waste of worry time i've had!
I am working on my anxiety, feeling better but not cured yet.
Something someone said to me once was that none of us get out of here alive, so make the most of what you have whilst you still have it.
xx
Check with your medics, but I believe that if this was going to happen, it would have done so at the time of the procedure and would be caused by the EP puncturing the atria/oesophagus. It’s not something that would develop afterwards. I suspect that this would be a serious complication which would need treatment in intensive care.
Many people seem to have the symptoms you describe post ablation due to irritation of the vagus nerve and oesophagus which lie in close proximity to the treated areas. Ask for advice on this and please stop worrying about something that hasn’t happened.
Concentrate on your recovery and I hope you stay AF free.
Pat x
p.s. reply based on knowledge from nursing background. I haven’t had an ablation as my AF controlled by meds.
I was an in patient for ablation for 5 days. When I went home I then had to be readmitted 3 days later (with extreme chest pain and difficulty swallowing) to 'exclude oesophageal injury following RF ablation'.
I was put onto pureed diet, nothing hot to eat/drink, many meds and tests, ecgs, echos, X-rays, CT scan, barium swallow etc. I was eventually discharged being told by a radiology consultant viewing the barium swallow test results that I looked 'far too well' to have suffered a fistula/hole in my oesophagus.
If you do have this damage you will be critically ill as your food will be leaking into your abdomen through the hole and causing sepsis, you would be unable to even stand let alone function normally.
My diagnoses were pericarditis with effusion and oesophagitis caused by the burning. Pretty painful and on going for several months but if you are improving I think that you are just getting ablation recovery effects. If the pain deteriorates or continues contact the hosp or arrhythmia nurse. I contacted the arrhythmia nurse who with the consultant, got me to do a swallow test with a glass of water whilst on the telephone to them and they then fast track admitted me through A&E for further investigations. I was in hosp for another 6 days.
Dare I say that GPs are not really up to speed with these ablation complications and I feel that it was certainly better to bypass them and contact my arrhythmia nurse (or consultants secretary) direct. Details should be on your discharge notes given to you on leaving hosp. A call will most likely calm your anxiety, these complications are very rare and I was only the second case my consultant had ever seen.
That must have been a very difficult time for you ' 5days as an in-patient is unusual. Did you have GA or sedation? My cardiologist told me if possible he prefers sedation as the patient can indicate if they are experiencing pain while the ablation is taking place. Thank you for the information regarding fistula damage.
Onto table in cath lab at 9am, GA, 5 hour long procedure. In recovery unable to pee, was cathetarised and then the pericarditis pain was so severe I had i/v fentanyl and didnt know anything for a while. Back to ward at 5pm to lie still until 11.30pm to allow groin wound to heal. Chest pain so severe on 2 hourly morphine, BP & heart monitor alarms going off every 15 mins, terrible night! On trying to eat a little breakfast pain became excruciating. Moved to side ward and on day 5 discharged home. Pain worsened again and readmitted for another 6 days. Still get the pericarditis pain 11 months on but on a positive note I have remained in NSR.
Thank you so much everyone for your support. I can’t tell you how much having a community to turn to when I am scared and anxious helps. I have been in touch with my EP’s nurse and I have an appt with my cardiologist today and will make sure I leave no stone unturned. Hopefully I will come out of the appointment feeling a bit more reassured. All of your posts have helped me greatly. Thank you!
I saw my cardio and spoke to the EP. I had an echo and blood work and all came back fine. They seem to think that my symptoms are not related to the ablation, but I can't imagine that they are not because I didn't feel like this prior to the ablation. I am 5 weeks post-ablation and still feel awful. My heart seems fine, most of my symptoms are not heart specific - nausea, headaches, fatigue, feeling weak in general, dizziness. All of these symptoms come and go and trade off with each other making it difficult to know how I am going to feel one day to the next. I can only work from home right now, there is now way I could go to work and interact with people for 8 hours straight. I really think my nervous system took a huge hit and is now unable to regulate itself. Anyone else ever experience these symtoms still at 5 weeks in?
Are you feeling better? I’m two weeks out and still exhausted and also worried about fistula. They didn’t give me antacids (forgot) so now I’m even more worried. They just started me on them. I get the anxiety....it’s bad before the procedure...you can’t wait for it to be done...and then there’s more!
Hi there. I am feeling much better now. I am at 8 weeks out from the ablation but it took me until about 6 and 1/2 weeks before I started feeling better. I was not put on antacids either after the ablation and I had such bad stomach issues after the ablation combined with the anxiety and fear of fistula I was a bit of a mess! They did put me on antacids 3 weeks ago and it helped a lot. I will come off them next week. I am finally able to go back to work full time and actually think I can finally see a light at the end of the tunnel! This recovery has been much harder than I ever imagined but am so thankful I am finally feeling better. Through this all, my heart has been great. It really has been the stomach symptoms, headaches and the anxiety that made it so hard! I hope you are feeling better soon!
Thanks for replying—so good to hear you’re doing well! It is harder than you’re led to believe (at least for some of us). The doctor just called back and told me I don’t need the antacids! He thinks my upper right side abdominal pain is unrelated to the ablation. Don’t know what to think anymore. Just want to stop thinking about my body!
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