Hi all, I had an ablation at the start of September 2019 through my works BUPA cover after a number of years dealing with AF through medication. I came off my meds and everything has been rosy for the last year. I’ve been exercising regularly and effectively leading a pre AF life. Then on Monday I had an AF episode during a game of football. I took flecanide I had left from pre ablation when I got home but it didn’t help get me into NSR so after a few hours I phoned NHS 24 and was told to pop up to A&E. bloods were fine and I ended up having a cardioversion under sedation and have been in NSR since (no medication). I’ve got an appointment with my specialist on 1st December but the cogs in my head are spinning. Was the ablation a failure and if so how have I managed a year with no issues? Previously it was hard to maintain rhythm even under medication. Does anyone with experience of something similar have an idea of next steps? Assuming no further ablation and that I stay in rhythm when can I go back to exercise and how far should I push it. My concern is not knowing how hard I can go, knowing flecanide won’t fix it and being a burden on the NHS every time I go out of NSR. Thoughts welcomed.
Ablation failure? 1 year on - Atrial Fibrillati...
Ablation failure? 1 year on
For me, ablation was always designed to improve quality of life. To reduce the frequency of my attacks of fast AF/flutter and/or reduce the intensity.
January 2019 was my last major ablation. I came off medications Summer 2019. I have only had two PAF episodes since. One was as a result of taking sudafed last winter during a period of persistent heavy colds.
In that respect, the ablations (all 5) have worked. The gap between PAF episodes has increased. On both occasions they have not required cardioversion - (I am up to 22 of these).
Prior to January 2019, episodes were happening 6 weeks apart or a few months apart. Never longer than a few months. They were also of such intensity my BP dropped, my HR was batting regular and irregular at 160+ bpm (think the highest captured was 210) depending on the flutter or the AF.
I'd like to say I'm now living a pre-AF life but in reality I'm not. I'm still losing the weight I've gained in the past 7 years since this all started. I am no longer drinking caffeine (maybe 1 full fat cuppa a week). I have reduced sugar and salt. I am still in the same physically and mental demanding job (7 miles on my feet at work 2 days a week, 2-4 on school runs when not at work) with adjustments to hours, duties and shift patterns to accommodate what Occupational Health are calling a disability for management purposes. I don't escape into the peak district as often as I used to (primarily because I now have a 3 yr old) but I'm not on any medications nor am I seeing an EP regularly.
I think in some respects, as disheartening as it seems to write this, you can' ever really return to a "pre AF life" without making some adjustments to ensure you don't slip into AF - be they lifestyle, medication or work related.
Im 15 months post abalation, and i'm still on Beta Blockers i try and exercise and also play football, but when i play football i find the short little bursts of runs you doing (i play 5 a side) really put a demand on the heart so i've stop playing football but still manage to do cardio exercise and try and keep an eye on my heart rate
It’s a mix of 5aside and 7aside that I do. Going to be gutted if I have to give it up 
Have you been playing regularly since your abalation? Without any problems you going to have to take things easy when going back to exercise I personally would not play football all until you build up again by doing cardio on a monitored basis
Yep playing regularly other than during lockdown. Ironically felt the fittest I’ve been. Dropped 2 stone since my ablation. Other than the first time I experienced AF 6 years ago, exercise was never a trigger so my mindset has taken a bit of setback. Can’t really justify going to A&E just because I fancy a run around 😞
Maybe stick with the type of exercise where you can keep an eye on the heart rate? I realise not a welcome suggestion to someone who likes social sport 😕
Can I ask how bad was your AF before your abalation?
First incident 6 years ago. Came and went within an hour. Nothing for 2 years then straight into AF that didn’t clear without cardioversion. Then I went on flecanide and bisoprolol and was good for a year but then it started getting more frequent. Extra flecanide would usually get me back into NSR but I was concerned re upping the dosages which is how my ablation came up just over a year ago. This is the first time flecanide hasn’t solved the issue since my first cardioversion.
Everyone has their own story with A fib, so this is part of mine. I am an fitness freak (or I would like to be one). Almost every time I see my cardiologist I ask about exercising and the safety of doing high intensity stuff. Always, besides time to recover after ablations, he has encouraged me to do as much as I can/want.
My EP was also pro fitness.
I know diddly squat about meds, but what I gleaned from my cardiologist was that flecainide good for rhythm and Bisoprolol for rate, and exercise triggers tend to start their mischief by affecting rate, so Bisoprolol before flecainide but if the latter meds helped you before it is hard that they didn’t do so now. How disappointing for you. Back to the consultant?
Yep back to the consultant on 1st dec. can’t come soon enough.
Hubby has AF and had numerous ablations - they always ‘worked’ in that he returned to NSR but it didn’t stay. We were told in some people the ‘urge’ to irregular beat is stronger than regular. He now pacemaker dependent which sorted the problem - for him
A phrase used by an EP during a patient day presentation on this question and of why some people need multiple ablations comes to mind - we burn, by ice or fire, patients heal.
My second ablation lasted 3 years.
The other thing to add, is that the body is really good at telling us when it has had enough. Whether that's an increased fatigue, muscle aches or in our case a flutter or an AF episode. The trouble is, I for one took a long time to listen to it because I didn't want my life to change, I thought it'd be OK and the ablations would take care of it.
But I also had to help myself and get over the fact that 17 mile walks in the peaks on days off were beyond me. That I couldn't go out and have a few drinks at the pub quiz without paying for it. That I couldn't sink a few cans of coke on the same day I'd had a few cups of tea.
There comes a point where you have to help your body out..... everything in moderation.
You are so right, and accepting that is the hardest thing and probably the longest to come to terms with.
Of course this could just be AFIB breaking though and not actually anything to do with the football. What kind of ablation did you have and whereabouts in your heart?
So I was told that they dealt with the common areas in my heart but not specifically where. Specialist said they could be more targeted if required again. In terms of type it was a cryo ablation which is as much as I know. Previously with AF every other instance apart from the first has been upon waking up.
I believe Cryo ablation is mainly used in pulmonary vein isolation (PVI) (I had one)
oklahomaheart.com/content/c... for a description with diagrams.
Not medically trained but I understand that Cryo ablation can miss areas in the vein if the vein is not perfectly round so you can get a breakthrough where the scar is not formed properly . These can be identified and "touched up" using RF ablation. If you are on BUPA for this I would get back to your EP ASAP to see if this can be investigated/ corrected first before lamenting on the end of your 5 a side career! How often a week and for how long do you play? I used to play 1 hour twice a week. IMO this is NOT endurance exercise - one of my mates used to go for a cycle ride and only come back 12 or 14 hours later after riding 170 to 200 miles. I count that as endurance! (He was only 30 at the time)
I played until I was 44! I wish I had not stopped so early now, just speaking about is makes me want to play, but I am way past it at 60!
How were you diagnosed? You are quite young for AFIB. is there a family history? I assume you had ECGs /echocardiogram and your heart is structurally OK.?
Well the first time I had an incident in hindsight was playing football ironically. Passed out in the middle of the game. I went to hospital but they didn’t find any issues so assumed I was run down. 2 years later I went straight into AF upon waking up and it didn’t resolve itself. I had a cardioversion and spent the next few years on pills slowly increasing the dosage because it kept breaking through, until my ablation. I’ve had all the tests done and my heart is structurally sound. No history in the family of heart issues although there is high blood pressure which I know has links to AF. I’m always near the top end of the normal scale when I take my blood pressure.
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