On Wednesday I finally managed to be admitted for an ablation. I was under the impression it was to be a radio frequency ablation, but turned out to be cryo ablation as the first step.
Things worked out as expected, and I had a good chat with the anaesthetist in the daycare ward and again in the cath. lab before the start of the procedure, and then he administered a little sedative prior to the anaesthetic. The next thing that I remember was waking up back on the daycare ward.
I am very surprised at how small and clean the incision is, in the crease of my right groin. Barely 8mm long, with a bit of a raw looking place at one end. However, the bruising is spectacular! Outside a clear circle about 2cm radius from the incision there starts a bright black and blue stain spreading up to 13 cm in some directions. That's some bruise! Initially I had a slight swelling in one place within the bruise, but that soon went down again as the blood was reabsorbed. There is almost no pain associated with this injury, which surprised me.
Also surprising is a pain I did not really expect. I have a sore throat, which I did expect, from the TOE procedure which accompanies catheter ablation, but what I didn't expect is the muscle aches and tenderness around my neck. I presume that this arises from the position my neck was stretched into, to facilitate the TOE procedure, and perhaps also from the posture I was laid in afterwards until I recovered from the anaesthetic. It is not any pain I can't easily accept, and I don't need any medication for it, but it was 'not on my radar'. Hence the title of this post.
Bumps in the road are to be expected immediately after an ablation. I was to be kept in overnight, due to my later position on the list that day, and following a session of AF in the small hours the next morning, I was put onto a radio monitor, and issued with a larger dose of bisoprolol than I usually use. That seemed to have no effect, so an hour later I was given a pair of 50mg Flecainide and told to take one. Ten minutes later the AF stopped. It seems to be very effective for me.
I have now had a single dose at 50mg twice a day added to my drug regime, and managed to get discharged at tea time the second day. The journey home was in a volunteer taxi, and the ride was somewhat cavalier and rapid as he was annoyed and wanted to get home. I arrived home feeling a little the worse for the journey, and using my Kardia found I had started tachycardia at 138bpm. Another (additional) flecainide stopped this, again in less than 15 minutes, and I retired to the sofa to watch some tennis. That night, I woke up in the early hours, again in tachycardia. I took another flecainide, and again it worked rapidly and I went back to sleep.
For those worried that I am self medicating, let me explain. The initial prescription was for two 50mg pills twice a day, and this was reduced to one when it was discovered how well a single one worked. I figured later that the additional one used as a 'pill in pocket' was therefore acceptable, when necessary. I've only used it on those two occasions, as apart from a brief run of AF just prior to pill time (I brought the time forward), I've not needed them again. Yesterday, no problems at all and today I'm feeling well. More tennis watching to come though!
My only remaining concern is a persistent problem with mucus, and a resulting cough, which feels like I'm starting a cold but obviously isn't as It varies with posture. This, I think, is another result of the TOE and soreness in the deeper part of my throat. I hope it resolves soon, it's a 'pain in the neck'!
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momist
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All sounds normal . My groin bruise extended down past my knee and resembled a Jackson Pollock paintng for several weeks. Use it as a guide to when your heart is begining to heal.
Sorry Bob. I got way too wound up watching Emma Raducanu just now - I'll try hard to rest for the remainder of today. Fabulous match though, I've never enjoyed a tennis match so much! I couldn't have chosen a better fortnight to sit around watching telly . . .
Well done momist, all done now, so time to relax and hopefully be spoilt rotten for at least a couple of weeks. The ride home sounded pretty grim but think yourself luck you weren’t in the back of one of BobD ’s racing cars!!
If you had a cardioversion during the procedure that would be the cause of the painful neck - I had two and my neck and shoulder took a few days to recover.
My understanding was they only do a TOE if you have not been anticoagulated sufficiently prior to the procedure........... it's certainly not usual. As for the bruising, I had none at the puncture site but my whole thigh, rear of my calf and down to my foot were heavily bruised and swollen and it took about 6 weeks for the bruising to go. As uncle Bob says rest, rest and then rest again. Best wishes.Ang
I did say that was "my understanding" thus implying it doesn't mean that it doesn't happen with some folk. When I mentioned it to my EP, he said it wasn't a usual procedure (I'm in UK) unless they thought there was an issue so fortunately, I did not require one at my ablation.
Not sure what difference an epidemiologist would have made, unless there was a public health issue, but I was just sedated too and they said it was just bad luck with the bruising.
Wow, that's harsh . Its terrible that you had a bad experience and its understandable that you are aggrieved but that does not diminish what momist has had to go through. I thought we were here to support each other.
Momist, good to hear that you were able to get your ablation. I hope it ends up an effective, long-lasting fix. As for the sore neck, during the procedure your head is placed in sort of a cradle, a hard foam brace that is part of restricting any movement. And you might have been taped down to it as well. Your arms and legs are also typically restrained—for obvious reasons.
Your cough from fluid in the lungs is likely from your anesthesia. Also, most all radio frequency ablations have irrigated catheter tips for temperature control, accumulating more water in your heart/chest (don’t know about irrigation for cryo?). I coughed up muck for a solid week post ablation.
I had irregular beats for the first 3-4 weeks but they gradually went away as my heart healed and the circuitry remodeled itself. Everyone should expect the same. Stay with your doctors’ recommendations on meds—the first couple months are complex and important. The best of luck to you.
Thanks seasicksurf , I fully intend to follow the EP's advice on the meds, at least for the first two months. I wasn't keen to go onto Flec, after managing without any for years and coping with the AF when it happened. Lately though, it's been hitting me harder and I'll now do anything to avoid it.
Yep, take it easy, take it easy some more. It's hard though, as I feel capable of doing much more than I probably should.
I had to take extra Flecainide in the first couple of weeks - so long as you stay within be the limit of 300mg in 24 hours you are fine. That said, I'm only 53 kilos so I've never taken more than 200 within a day. I'm wondering if the sore throat (I had this with RF ablation) is due to them going close to the oesophagus and diaphragm and causing some acid reflux. The latter will certainly make you cough.
Hi Singwell . I was very comfortable with my decision, as I must have read something along those lines about extra doses of Flecainide on here some time in the past. After the discussion with my EP about whether to take one or two at a time anyway, it seemed a no-brainer to take an extra one between dose times when my heart kicked off. His attitude seemed to be "we must keep it calm while it heals".
Yes, I have some reflux anyway, and after Ranitidine was withdrawn from service I've been on regular Famotidine instead. It seems to do the same thing quite effectively.
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