Change in nature of Afib after ablation?

[Graham194]

Hi. Just wondering if anyone has experienced a change in the nature of their afib after ablation.

I had my first ablation at St Thomas's in London at the beginning of last November. I've been ok till about three weeks ago when the dreaded AF returned.

Before the ablation my experience of AF was paroxysmal and a heart rate, even though erratic, very seldom above 90 bpm.

I decided to phone 999 this afternoon after putting up with AF for three hours with a heart rate of 160. I was feeling quite faint and breathless. The moment l arrived at the hospital my HR stabilised at about 95 bpm. I was sent home after having an ECG and chest x-ray. It's still high now at 80.

I can't tolerate beta blockers or anti arrhythmic drugs daily so take Flecainide as PIP. I took 200mg which must have done the job this afternoon. Now feeling quite worn out after the three hours in AF at 160 with a slightly sore chest.

I aim to get in touch with my arrhythmia nurse tomorrow to ask her opinion.

So, anyone else experienced a change in the nature of their AF after an ablation?

Thanks for reading.

[Snowgirl65]

My a-fib accelerated for three months after my ablation in 2019, then suddenly stopped for a year. It returned intermittently, but recently, after having Covid, it again is coming frequently.

[The_Lord_is_with_Us]

You're just outside the 90 day blanking period post ablation. Your heart should be fairly steady ... but I've read others who had episodes like yours that were one-off, then the heart went back into normal sinus without further issues. Perhaps you will be lucky, too.

However, it is well known by Electrophysiologists that many patients need a 2nd ablation to reach the high percentile rates of success. My 2nd AFIB ablation (after a failed 1st 9 months prior) gave me 10 years of normalcy.

Don't become despondent if they tell you the first ablation failed. It's not a complete failure. They just have to do a 2nd and build on the foundational work done during the first one. Then you will have the result you were hoping for.

At the very least ... until your practice sorts out what it is ... I would do everything to minimize possible arrhythmia returning: diet .... drink .... stress reduction .... mild exercise .... no alcohol ... no caffeine ... no stimulants of any kind ..... take magnesium supplements .... lose weight, if needed.

Hoping for a good outcome for you . . .

[Coco51]

I am sorry you are having this problem and the anxiety it entails. After both my ablations, I had AF pretty frequently for four months and quite badly, but then it suddenly stopped for about 10 months. It crept back after I tried to cut down on the flecainide I take. I get occasional episodes now. But it feels more muffled and slow after the second ablation and more manageable. Anyway, the EP says a third ablation might fix it completely. That's often the case if you have had AF for a long time and it has become persistent (that is non- stop) as mine had for 5 months. Your nurse should be able to help. But something has happened to me psychologically, I worry about AF less and that's part of the equation. I learnt self hypnosis which is a bit like meditation, from a qualified psychologist. It has made a world of difference. Something you might try?

[Diver2]

I’ve had 3 ablations. After each of the last 2 I had a new A Flutter. So now I have 2 flutters and Afib. They usually show up individually but can sometimes appear in twos. When all three show up it’s horrible..,. The music helps get rid of them then. Mostly I’m in sinus rhythm.

[acfxr12]

I am 75 days post Ablation. Before the procedure, I had many episodes of high heart rate and overall malaise and fatigue. however, the incidents were all pretty much identical, either extreme heart rate (185-260) or ectopic beats or runs of quick beats in immediate succession with two or three missed after the "run". I have an I watch, and that is where this information comes from, I need to note that during this period never once did my I watch note afib. After my ablation, especially the first few weeks, my "normal afib" as listed was not what I experienced. I would get runs as before but not in succession and my I watch actually had yellow writing confirming AFIB! I also had back to back heartbeats with missed beats as before, but now instead of 3 or four quick beats then a couple of misses it would be 8-12 quick in a row, causing lightheadedness, a warm rush over my whole body and then skip two or more beats. So, the answer in my mind is that post ablation, my heart is trying to do it's old beating or missed beating pattern, but the pathways are no longer there so it's trying new pathways and the results changed to the new "normal" during the "blanking" or healing process. I have noted that now that I am about three months into the blanking, the NSR is almost all of the time, and I get a ectopic here and there, generally when I get a high stress situation at work. I am of the hope that during the 3-6 month healing period all of the "issues" subside. I still have 80 bpm resting and 100+ BPM as an average during the day. I do take 250 mg of mixed magnesium every day, and if I know I am going into a high stress work environment will take another about 30 minutes prior.

So the short answer is YES, you (or I have) had all kinds of different beat/missed beat experiences since ablation. Hope this helps. Best of luck during your continued path to normalcy.