54 days post cryo-ablation update

[Madscientist16]

I had a cryo-balloon ablation on November 5 and have been posting to share my journey. I have been feeling good besides daily ectopics, until Christmas day. That familiar tachycardia, the feeling of a frog flipping in my chest, the sudden dizziness, breaking out in a cold sweat and the sudden urge to urinate. My episode only lasted about a minute, but was terrifying nonetheless. Was my AF back? Did the ablation not help? I know that I am still in the blanking period so this can happen. I have been taking good care of myself, despite the temptation of overindulgence this time of year. I am just hoping this was a blip in my recovery and nothing more. Wishing you all a Happy New Year and a calm heart for 2020.

[absolutepatsy]

I had a couple of these blips during my recovery from cryo ablation, I believe I caused it one episode of AF trying to lift a heavy dog into my car (stupid, I know), I felt the strain as soon as I tried to lift him and then went into AF a couple of hours later. It lasted for hours and I thought I had ruined the ablation and was so disappointed with myself, however, I was wrong because I reverted back with flecainide pip. The second time I went into AF was after eating a curry, I woke up in AF but again reverted after a couple of hours and never looked back, touch wood. These episodes were within the first 4 months so be patient and keep going as it takes months for the heart to heal and create the scars necessary to stop the signals getting through. All the best for the New Year.

[Madscientist16 in reply to absolutepatsy]

Thank you for your reply. How long ago did you have your ablation?

[icklebud99 in reply to Madscientist16]

1 year and 7 months ago.

[Dawsonmackay]

I have had those frog flipping chest thumping experiences since my ablation. Sometimes I am woken from sleep because of them. The only thing that calms it pretty quickly is deep breaths. Deep breaths which sometimes goes on for several minutes. Let the lungs take over...

[Hidden in reply to Dawsonmackay]

This is the sort of thing that puts me off ablation. If I am fairly asymptomatic and get episodes every two months or so, will an ablation really do much to help? It could even make things worse and will probably eventually fail. Yet I have been advised to have one. It sounds a horrible procedure and basically rarely works.

[bantam12 in reply to Hidden]

My thoughts exactly, I'm on the waiting list for one but the more I read the more I think it's the wrong treatment for me, I can't put life on hold for months while I "recover" and even my EP said it probably won't work or would need doing again and again, so what's the point 🤷‍♀️

[wilsond in reply to Hidden]

I have had several discussions with my EP Proff Osman on this ,and have come off ablation list due to big improvement in symptoms for exactly the reasons you cite .I remain on his clinic list for review on March but seems right decison so far. I use flec and bisoprolol as a PIP. X

[Hidden in reply to wilsond]

If you don’t mind my asking, did he suggest not proceeding with the ablation or did he respond to your request? The issue for me is that I don’t want to act irresponsibly- two consultant have, after all, said an ablation is necessary or the condition will get worse. At the same time this seems to be a sort of generic assessmen. My inclination is to go ahead with the ablation, but the worry-apart for the procedure itself- is that I may wind up worse than before with, possibly, new ayrhytmias and frequent ectopics.

[wilsond in reply to Hidden]

No I dont mind at all. What happened was that there is a very long waiting list 12 to 18 months,during which time my afib and flutter went into reverse following radical lifestyle changes and flecanide. In clinic appt we discussed this,and my kardia evidence was included ( I email them directly to him) based on this he gradualky weaned me off flec to see if i could maintain,which I did.

We then had alengthy discussion a few months later (May) where i asked if ablation was life saving,he said no and also its about making you feel better. The arrthymia still occurs with afib but the message to the brain is interfered with so we dont recognise them.

So,as my quality of life is good and I am not now debilitated as I was at diagnosis in 2013,he said he woukd still do it if I wanted but i wouldnt feel much different.

I am under no illusions that it might come bavk,and then thats a different arena. I see Proff O in March to review again. I may ask about the ablation for flutter which I do get fairly symptomatically but rarely.

For people who are laid out with afib flutter etc I can see the benefit,Im not anti ablation but am happy to continue with flec and biso as PIP and of course my apixaban.

Hope this helps!

Lifestyle changes include losing a lot of weight,reducing stress massively,extreme attention paid to nutrition,getting slowly fitter...and trying to keep af in perspective. Pm me anytime xx

[wilsond in reply to wilsond]

Sorry for typos,using my old glasses as cant find proper ones! Also hate touchscreens!

[Hidden in reply to Hidden]

I see a cardiologist pending an ablation for my Svt, I feel the same as yourself,at 72 will it affect my independence, I would not want to be a burden to my family. I have had 8 attacks in 3 years. My last was 2 weeks ago, I have ectopics and discomfort after eating my main meal and some short runs of svt. After reading people’s thoughts on here I,m wondering if I should risk it. The ectopics and long pauses won,t be cured by the ablation and they bother me more. I also have a leaky mitral valve.

[Hidden in reply to Hidden]

I think I read that ablation for SVT has a better success rate than AF, but I am not sure. I think you should have a long conversation with your EP about this.

[Buffafly in reply to Hidden]

I don't think you can say 'rarely works'. If that was the case I don't think NICE would allow such frequent expensive procedures? This forum is mainly for people who are in doubt about some aspect of their treatment, whether ablation or not, or those who are anxious or disappointed about the outcome. I've lost count of the number of people who have been posting daily about their worries/bad experience but now we never hear from them. Where I think things go wrong is that doctors may allow unreasonable expectations - I've realised that after 15 or more years of PAF plus other arrhythmias, with a leaky mitral valve, poorly lungs and a couple of other issues it wasn't likely that an ablation was going to be a permanent fix for me but I wouldn't want to put anyone else off, and hope I haven't. I do think though that maybe doctors should manage expectations better.

[Hidden in reply to Buffafly]

Rather than “rarely works” I should have said “often does not rectify the condition over the longer term.” I agree that doctors should manage expectations better; in particular they should provide a more accurate estimate of the probability of success with a clear definition of what “success” means (some doctors refer to “success” as meaning something like “the procedure was carried out without any operator errors”). If they are not able to give an accurate probability they should be able to give one with, say, a 90% confidence interval.

[bantam12 in reply to Hidden]

My EP did tell me the ablation may not work and confirmed it in the follow up letter so it doesn't give me much confidence. They won't give me any meds because I have bradycardia so I'm possibly stuck with no solution 😕

[Madscientist16 in reply to bantam12]

Sorry to hear that.

[Madscientist16 in reply to Hidden]

My EP was able to give me a 85% confidence based on my current health, lifestyle and testing results. I still would have done it with a lower confidence for just the chance that the ablation could make my episodes less frequent and less severe.

[Dawsonmackay in reply to Hidden]

You need to read a little more before you just blindly state that ablation "basically rarely works." Days without Afib is better than days with Afib. I have been Afib free for nine months now and every day is a blessing not to have it. Before my third ablation, my ejection fraction was close to 30 and as one doc informed me, anything below 28 and you can just drop dead walking down the street. So, no, not, rarely works,

[Hidden in reply to Dawsonmackay]

The “basically rarely works” was careless wording on my part. For AF on a first procedure the success rate has been *claimed* to be about 65% (some hospitals claim 70-75%) but a recent study claims that this is an overestimate and the figure is about 28%. The risk of a serious complication is given as 7.9%. From the Journal of Interventional Cardiac Electrophysiology:

“The patient population was comprised of 200 consecutive patients who underwent ablation (133 men; age 56 ± 11 years). Atrial fibrillation was paroxysmal in 92 (46%). Success was defined as absence of symptomatic AF, off antiarrhythmic drug (AAD) after a single procedure.

Results

After a follow-up of 26 ± 11 months, the single-procedure long-term success rate was 28% with an additional 7% of patients demonstrating improvement. After including repeat procedures in 64 patients, the overall long-term success rate was 41% with 11% demonstrating improvement. Further subgroup analysis of 48 paroxysmal AF patients considered to be optimal candidates for the procedure, revealed a long-term success rate of 69% with an additional 4% demonstrating improvement. A major complication occurred in 7.9% of patient.”

So it’s necessary, according to this study, to have repeated procedures to get to 69% success. This means, in turn, that you run a greater risk (7.9%) of a serious complication. The risk for a single procedure is about 4.5%.

[thumpthump in reply to Hidden]

Hi, I rarely had AF episodes (probably count on one hand since diagnosed last year) and only used my pill in pocket once, that said I still opted to have the ablation.

My EP advised the sooner it’s done the better chance of success, rather than wait until my AF is more established. Also I really didn’t want to be on daily heart drugs either.

Hope this helps.

[Madscientist16 in reply to Dawsonmackay]

But no real AF episodes then? When was your ablation? I used the deep breathing when this "blip" occurred. It never worked for my other AF episodes however.

[Dawsonmackay in reply to Madscientist16]

March 4, 2019. On March 7, 2019, went right back into Afib and then on April 2, 2019, naturally reverted and been Afib free since then. I contracted pneumonia around April 20 and took antibiotics on April 30 thru May 9. Hacking, coughing, having few fights at the OK Corral (my heart-flip-flopping) and decided to get into deep breathing exercises. Sometime in the night, had the fights going on in my chest and kept up deep-breathing and magnesium supplementation.

[Madscientist16 in reply to Dawsonmackay]

Thanks for your reply. May your heart continue to behave.

[Dodie117]

I had my first and only ablation in November 2013. Had lots of palpitations etc in first 5 months. Then nothing. Free of AF since. I was very symptomatic and having 4 to 5 episodes a week lasting 5 or 6 hours. So maybe not for everyone but for some it’s a lifesaver. I have my life back.

[Madscientist16 in reply to Dodie117]

Thanks for your reply. So glad things are better for you. That is why I went ahead with the ablation. I wanted my life back. Cheers.

[Dodie117 in reply to Madscientist16]

Good luck🍀

[Madscientist16]

I am hoping for a good outcome for now, knowing that AF may return later. If it does return later, I am hoping, that because of the ablation, it will not be as problematic for me as it was before. Cheers.

[estrennen]

I had an RF ablation on Sept. 26 (3 months ago). Prior to the ablation I was having Afib episodes every 3-4 days that lasted for a day or more each time. I have not had Afib since then but did have PVCs quite often for the first 2 months. I still have PVCs a few times a day, but less frequently than before. I have a Kardia device and can clearly see that I am having PVCs, so that's reassuring. I would be thrilled if they would stop altogether, but even if they continue, it's still better than Afib. I'm a runner and have been able to get up to 5-6 miles of slow running 3-4 days a week. Thankful to have most of my pre-Afib life back.

[Madscientist16 in reply to estrennen]

I am happy for you. Thank you for your reply.