Despite an AV node ablation and A PVI I have gone back into AF..
My EP has said that he will offer me a last procedure in an effort to curb the breathlessness that I get from AF. This breathlessness stops me walking more than 5 metres and if I ignore the breathlessness and get on with my chores in the house after 2 hrs I grow so tired I have to sit down for at least 2hrs. I usually fall asleep at this time. I cannot do anymore until the next day which if I am lucky I will be able to drive to the supermarket around the corner and collect so groceries. So my life consists of struggle against this breathlessness. At present I am awaiting the report from my EP on this last procedure he will offer as he says that no matter what he does he would not expect me to stay in sinus because of my adverse reaction to most drugs not just the heart drugs, my age and the persistent AF . He has asked me to try to tolerate a low dose of Sotalol to try and control these beats and maybe feel better for it. I do not yet have details of the procedure only that it is a last ditch try. It will be done under a general anaesthetic and will take 3-5hrs. He is hopeful that if the Sotalol is successful I will not have to face this procedure which is risky.
Does anyone have any thoughts as to how to face a no future due to this very symptomatic AF?
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cali111
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If you have had an AV node ablation why is your pacemaker not controlling your ventricle? Yes AF will continue but your blood supply should be governed by the pacemaker which can be adjusted according to your needs. Sorry it doen't make sense unless something is wrong with the pacemaker?
I don`t know but there is a fault in the ventricles which affects the pumping mechanism of my heart which in turn affects my breathing. I am thinking that I will have to write for an explanation of this from my EP. As far as I am aware they tell me it is working as it should, I had it tested last June. What do you think I should be asking my EP because when I asked relating to the fact I was fitted with a dual chamber and not a CRT his reply was that CRT was fitted to people who had (His words) "large baggy hearts" which did not apply to me.
I shall be asking what this last ditch procedure involves but what else should I be asking? This EP was the second one I saw and I am not fit to travel now for another consult.
If the walls of the ventricle have become thickened for any reason then function may fall even if ejection fraction is still good as actual volume of blood pumped would still be lower than ideal so would ask about that.
Thank you. You have described my heart state though I have just had an echo and there r no changes from 3 years ago. My ejection fraction is normal. I was diagnosed with a thickening of the left heart muscle back in 2003.I don't have anything else wrong. I can lie flat,nothing wrong with my lungs, there was no doubt that when in sinus after the PVI I felt so much better. This what he is trying to achieve for me because I am so symptomatic.
So sorry to hear that Cali - as I think you know, because we have corresponded before, I was advised to have ReSynchronisation - 3 lead Pacing for AV node ablation to prevent exactly what you are describing - thickening of the LV which is why your heart is struggling.
From my limited understanding from information from my EP the combination of longstanding fast AF and the ventricles going out of sync because only RV was paced may cause the muscle thickening - and there are many other reasons for muscle thickening such as cardio myopathy so that is a question for your specialist - is this caused by AF or by another condition?
Which came first do you think, the HF or the AF? is another question I would ask.
It does sound as though it is the LV dysfunction which is causing you the breathlessness rather than the AF as if you have had an AV node ablation then your HR should be maintained and even though you may still feel the AF, it will not be AF that is causing the breathlessness - it’s the LV dysfunction.
In your shoes, I would consider the Sotolol and also be seeking a second opinion.
Thank you for that. I think the EP is of the same thoughts but he is one that prefers to go the safest route ie) medication. I expect to get his report at the end of the week and if it is not clear I will write to him. I prefer written word rather than spoken it is far safer.
An update to my previous post. Sotalol is a drug which affects the longQT part of the heart and alters the signal as it passes to the ventricles. As far as I can see it is used specifically for ventricle dysfunctional, and so I live in more hopes than he does because of the drugs sensitivity and also he has placed me on his list!
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