Failed ablation?: Dear all I would... - Atrial Fibrillati...

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Failed ablation?

scotthongkong profile image
14 Replies

Dear all

I would appreciate your wisdom here. I had my AFib cryoablation one month ago to the day. I started out feeling a bit better but after the third week my heart rate is rarely getting below 100 and reaching up to 130. I feel like I am getting Fib/Flutter (both) I am breathless and feeling generally worse (if that is even possible) than a month ago. I wake up each day thinking I will improve but alas not. I was warned that my Flutter might get worse post ablation and may need a second one. I am so upset and over this. I felt like I had a chance to get better and stronger and back on the tennis court and hiking trails. Any personal experiences appreciated.

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scotthongkong
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14 Replies
Dawsonmackay profile image
Dawsonmackay

Have you read the post- ablation fact sheet? You need to read it. See right hand column of this site. Ablations take time to heal, and, depending on the heart, you may need a second ablation. I had three. Take care of yourself. Try not to worry. I know it’s hard to do.

scotthongkong profile image
scotthongkong in reply toDawsonmackay

Thanks Dawsonmackay. Just read the information sheet and it was quite reassuring. Perhaps I am more normal than I thought.

Desanthony profile image
Desanthony

Please read the post ablation fact sheet on this site. Ablations take a long time to get right and there is as I understand it a 3 month blanking time where anything can happen with the heart rate and then it will settle down. I jsut went to a pre-ablation talk last Thursday and was speaking to someone who had had an ablation just a month ago too and he said although he was able to go back to work he was not feeling that great at times - still breathless when walking on the flat and still having irregular beats. IF you read the leaflet on this site you will find that this is quite normal.

Take care of yourself

scotthongkong profile image
scotthongkong in reply toDesanthony

Thank you Desanthony.

Lien-Ju profile image
Lien-Ju

Hello there, 1 month is too soon to conclude anything. From my experience I have had to wait 8/9 months to see real improvements.

I used to practice sport maybe 14 hours a week and I've noticed how ablation changed my recovery time/activity tempo. Take your time and wait until the end of the blanking period.

If you have any questions don't hesitate.

Julien

scotthongkong profile image
scotthongkong in reply toLien-Ju

Thank you Julien.

Check this out.

heartrhythmalliance.org/res...

It’s not unusual to need a second RF ablation after a cryoablation because the expanding balloon used to treat the pulmonary veins can miss tissue if the they are irregular......

scotthongkong profile image
scotthongkong in reply to

Thank you very much FlapJack.

tcpace profile image
tcpace in reply to

My wife can vouch for that. The cryoablation was a good start (apart from phrenic nerve damage that eventually resolved). She then had a RF ablation (under GA which I recommend). Touch wood, the AF ablation seems to have sorted things out - no AF for a couple of years. I think the cryoablation is good for pulmonary vein sources of rogue cells while the AF enables the EP to go in and chase down the remaining rogue cells.

jeanjeannie50 profile image
jeanjeannie50

It was 9 years ago that I had my first ablation and I can remember asking one of the registrars before the procedure, how long it would be before I could climb mountains again. He told me it would be a matter of a few days and I was delighted! However, rather than days it was months before I had energy again and I still had PAF. So I can understand your disappointment now and honestly think it may be to do with how bad your AF was before you had your ablation. Would I be right in thinking that an attack before would last for a matter of hours and not days, but afterwards the extreme tiredness seemed to go on for ever?

About 4-6 weeks after my 3rd and last ablation I needed a cardioversion to bring my heart back into sinus rhythm and I'm wondering if that's what you need now. I would contact your EP's office or your AF nurse and let them know how you're feeling.

Please let us know how you get on.

Jean

If your HR is constantly above 130 bpm then I would contact your EP to discuss. They may see you earlier than your 3 month assessment

bobpitt profile image
bobpitt

Hi Scotthongkong

I can only pass on my own experience. I have PAF and Flutter, which became almost constant, and my H.R running at 130 to 140 most of the time, My meds were changed from Bisoprolol to Verapamil to try and control it but failed, so now use it as PIP only. last Saturday I had a flutter Ablation in Oxford and am back in NSR. HR about 60 now.

The flutter ablation the EP says is the most successful type and the lowest risk, the decision was taken to try this first and see then if the PAF is still a problem and whether I could live with the symptoms. So that's the route I have taken.

Early days yet but it seems to be working.

cuore profile image
cuore in reply tobobpitt

I find your case most interesting in terms of procedure. By my calculation, your ablation was on Feb. 15. Your ablation is less than a week old, and thankfully you are in sinus rhythm. Will it remain there since your PAF was not addressed? I am not an MD, but the literature I read states you have a high chance of the AF firing up. You say only the flutter was addressed and not the PAF although you say your PAF became almost constant which I am interpreting to be almost persistent.

Your EP is referring to ablating in the right atrium -- cavotricuspid isthmus which my EP told me has a 94% chance of success. But, there can be flutter in the left atrium called peri-mitral atrial flutter which is hard to ablate. My EP used ethanol injection of the Vein of Marshall which is a much more advanced technique.

I find most perplexing, " if the PAF is still a problem and whether I could live with the symptoms. " My understanding is that AF begets AF. So, if the AF was not blocked would it not then fire up again? Also, is your EP saying that you should live in AF by saying," whether I could live with the symptoms? "

There is a "Star trial" that concludes ablating less is better, but the trial dealt with ablating the AF but not doing extensive ablation. (The trial states an advantage to not doing extensive ablation) It would be interesting to know if your EP is following that trial but mixing flutter and ablation , or which trial? Also, why would your EP want you to live in PAF and have it go to permanent?

Again, I find your case most interesting and one which we can learn from. Do keep us updated by posting.

bobpitt profile image
bobpitt

Hi Scotthongkong

Thanks for your reply, I meant to say that the flutter had become persistent not the A/F

The A/F comes and goes sometime 2 to 3 weeks without it.

On my last E.C.G tests it showed Flutter and not A/F so that was why the decision was taken.

The flutter is very simple and I was under less than an hour, and was home the same day.

I had a cryoablation last August at London Bridge Hospital which went wrong and was not completed but I did suffer a Tamponarde putting me in an ITU unit for 4 days.

So you can understand my reluctance to go for a 4 hour A/F ablation again,

The E.P said if the symptoms for the A/F are become unbearable then he would preform an A/F ablation.

I must be very lucky as I do not seem to be effected by this Curse, that causes other people problems. However I will keep monitoring and if it gets worse then have the Ablation.

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