Finally got my ablation done 😄👍 been told all went well. Hopefully won’t get any complications 🤞🤞🤞 just wanted to say firstly that If anyone’s not sure whether to have sedation or GA go for GA all day long in my opinion. If your generally ok with having other people messing about with your body then you’ll probably be fine as wasn’t extremely painful. Burning sensation in chest is rather painful and the resulting intense brain freeze but not unbearable. What I found especially difficult was the waiting and build up 😬 I hate things like this and if I have to have it done again (hopefully I won’t) I will 100% be going for GA.
Also wanted to ask about ectopic beats that I seem to be getting a lot of since op. I know this is fairly normal just wanted to hear from other ablators who have gotten this rather unpleasant side effect. Seem to be getting a good 5/6 every ten minutes or so. I know it was coming so not bothering me too much at present but not particularly pleasant, especially as I very rarely used to get ectopic beats, maybe a small run every couple of weeks or so. Would like to hear from other people who’ve had a similar experience.
Thanks guys
Edit:
Also wanted to mention that they went for the pvi which I’m not entirely sure if this is the norm as a first ablation? Was told by doctor before procedure that trying to pinpoint the specific areas of fibrosis is extremely difficult. He said the majority of rogue signals will be coming from the pulmonary vein area? So this is the area they treat and according to him this is successful 80% of the time on average. Did anyone else have this done and does this sound normal?
Thanks again
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Elli86
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Glad it went well and yes you are normal. As Sabine Ernst once said in a lecture "Ectopics are a good sign as they show that the heart is trying to go into AF but failing. "
That’s reassuring Bob thanks 👍 I like that viewpoint and shall cling to it 😂 I did go into AF right at end of procedure and they then dosed me to the gills in order to cardiovert me. I just remember waking up in a different bed. Why the hell they couldn’t do this for the rest of the op I don’t know but atleast it’s done now
I like so much the way you write! You should have been a writer, I suppose...
Some people have more sense for writing than the others! I really like the way you express your thoughts, always trying to make other people smile! I am on your side, and wish you a good recovery from ablation!
Thanks steelheart. Decent of you to say and very much appreciated. Not sure it’s true but I’ll take it none the less 😂👍 And thanks for the well wishes. Hopefully won’t be out of action for too long 👍
Elli, I burned my arm in one occasion, and it took 6 months to heal, under a very convenient conditions. Your heart is now burned and, please, do not be impatient, give it the chance to heal properly! You can not change what's been done, but you can influence the healing process. The heart tissue never rests, it is flexed all day long, so there is more time necessary for healing.
Yeah I totally agree steelheart and I’m going to do my best to recover as patiently as possible. Just got to strike up a healthy balance between resting and bringing money home. I’m having minimum 2 weeks off work but will take longer if I feel I need it and when I go back I’ll be easing myself in very cautiously 👍
Pleased to hear that all went well for you. I'm a bit confused when you say that you are a strong advocate for ablation under GA and then mention that the pain wasn't too bad ?! Surely you wouldn't be aware of anything if you were 'under?'
For the record I had RF ablation under sedation over 2 weeks ago...5+ hour procedure and had no problem with pain or recovery. I get a few ectopics but they don't concern me. They are far preferable to what I was experiencing beforehand.
You asked about PVI, it is normally dealt with on first ablation.
Im a strong advocate for GA because I was sedated and would not want to do it again unless under GA. It was bearable if not given any other choice but not an experience I would like to go for again in a hurry. The build up to it on the day, for me personally was a nightmare but as I said it’s done now and hopefully I won’t have to do it again 🙏
I get it now Elli ! Misunderstood ! We all seem to have different experiences. My first 2 ablations were under sedation, the third under GA and my 4th very recently under sedation. I felt dreadful after GA whereas with my latest sedation I was aware but felt no pain at all even though it was a marathon session. I guess I was kept well tanked up !😁
What can I say jalia you must be made of stronger stuff than me 😉
Not much scares me but to be completely honest I was crapping myself the whole day. Just getting myself in the operating theatre was a win for me so I’m bloody surprised I managed to get through the whole thing. I hate not being in control of something when it involves my body so having someone shove probes up my veins into my heart was terrifying. Wouldn’t have bothered me at all really if I knew I was being put out. 100% going for GA next time. Just not worth the stress for me
I felt similar to you before my first ablation n London in 2009. I had procrastinated for about 2 years prior. It was only an episode of heart failure , brought on by my long AF history and then followed a couple of months later by yet a further hospital admission and 'emergency DCCV'that finally led to my decision to go ahead.There was very little information available at this time ( this forum did not exist) and most of mine came from US websites.
I can recall being advised by a Cardiology SpR I came across in 2008 not to rush into having an ablation as there were still lots if improvements to be made in this field. That didn't exactly help my decision ! I note that this doc is now a 'top man'in this field in London .(no names, no pack drill !
Very annoying but probably the right advice at the time? Has probably come on leaps and bounds since then from what I can gather. To be honest I was told the same thing by the “specialist” I dealt with at first locally but he was dead against it. Told me I could end up with a pacemaker and he would definitely not advise it. Good job I didn’t listen to him and did my own research followed up by a private consultation with someone I found after plenty of research. So glad I did. Hopefully was the right decision. I feel it was. I’m only 35 and I don’t want to spend the rest of my life on drugs. Not for me unless no alternative.
Absolutely . At 35 you want to be rid of this ! I was 48 when first diagnosed and that was considered young by many. No comorbidities. Its been a very long eventful journey . I do hope yours was successful.
Oh right ok. Well glad your doing well now atleast. Did they not give you anymore in depth info on exactly why 4 have been needed or do you not want to know?
Well it's been 8+years between no 3 and my latest 3 weeks ago and have needed many DCCVs in that time. I have had pretty thorough ablation so this latest was an attempt to see if anything else can be done . Since then new mapping techniques have become available . After my five and a half hour marathon under sedation I was not in a fit state to ask questions !
I look forward to my 3 month assessment with my EP when all will be revealed!! Meanwhile I'm surprised and pleased that I'm feeling so well and feel very positive.
No i totally get that. I was in no state to be asking questions either. Mine was 4.5 hours but felt like an eternity to be honest. Felt almost like a really crap dream with coming in and out of consciousness and waking up for the bits I really didn’t want to wake up too
Great News !! glad all went well - we are here if you need any support post-op ... perhaps you would like to share you journey with us? if you are interested, please contact info@afa.org.uk. Take care, Tracy
Our patient services team are always here to listen and with their consent we can highlight individual experiences of those that have been through a procedure or have something in particular, they would like to share., we have found it helps provide support and advice to others, especially if they are facing a similar situation? Please do not hesitate to contact me on info@afa.org.uk if you would like further details.
I had ablation a little over 3 months ago under GA. Pulmonary Vein Isolation, like you, but with a right atrial flutter line. My doctor said the same thing about rogue circuitry and PVI as yours so my ablation was PVI. He said he adds flutter ablation line in right atrium because about 20% of his ablation patients were coming back with atrial flutter. He just does the right atrium flutter ablation line now along with PVI as a matter of (his) standard.
I had ectopic beats and a couple very brief AF events after my ablation, as well as irregular pace. All this lasted for 5-6 weeks as the heart healed and the circuitry remodeled itself and then--just disappeared. All is fine now, except for bradycardia which I believe to be due to beta blockers he's put me on.
I was particulary attentive to the "results" for several weeks, but as symptoms fade, so did my worry. I go about my business now without conscious attention. I'm sure you'll follow the same course. All the best to you.
All sounds very positive. I’ll be well chuffed if I’m virtually symptom free after 6 weeks. I’m not holding my breath though as I know it can take most people on average a year to see full results.
How old are you mate? Is bradycardia a fast paced beat? How comes your dr put you on beta blockers? Were you not on them before?
I’m 64. Bradycardia is a slow beat (mine is now in the 40’s). Doc put me on beta-blocker because some of my triggers for getting AF episodes before ablation were associated with adrenaline push (sudden heart/oxygen demand, nervous excitement situation, etc). Beta blockers keep heartrate from spiking which triggered me sometimes. I was not on beta blockers before because they made my heartrate too slow. I was on lisinopril for bp for years. Might be back to that for Bp soon.
Blimey 40s is slow. My heart rate on bisop before op was 55/56ish. It’s gone right up to resting 85/86 now. Feels like I’m having trouble sleeping because of it and obviously the host of other problems that come with the op, like being virtually bloody impossible to get comfortable day 1 after op. Talking of blood pressure, that was another reason they kept me in over night as mine dropped really low. Think it went down to 60 odd if I remember rightly. Not sure how low that is but it made me feel absolutely rubbish. Got to remember to check on that again at some point and make sure it’s staying up consistently
Agree the build up and anticipation was the worst part of all. I too had PVI X4 on Friday 13th 😱 under local anesthetic. However, the op itself apart from feeling the freezing on the heart PVs was all OK!! Bit of wincing and hiccupping but all good! I would definately go for local anesthetic again rather than GA.
Who treated you at St Barts.
My consultant was Malcolm Finley. He was excellent and talked and encouraged me through the cryo ablations as he was doing it!
Good to hear from you. I remember you commenting on a previous post that you were going for your cryo ablation around the same time as me. All went well I hope?
My consultant was dr vinit sawhney and to be honest he did not fill me with any confidence pre op. He wasn’t particularly a people person shall we say and when I asked him about recovery, after fumbling his words a bit he said I see no reason why you cant resume normal activity the following day, to which I said exercise as well and he said yes. I was kind of flabbergasted by this to be honest but my focus was solely on holding myself together and getting into the theatre without jumping out the window and legging it 🤣
I suppose everyone has something that scares them and this for me is pure nightmare becoming reality. I exercised a few demons getting into the theatre to be honest. Pain was bareable but the whole mental side of things was too much for me. Hated every second I was in there. I’m normally very good at keeping cool and ignoring emotion but I found this EXTREMELY difficult. Being left on your own on the ward with nothing but your brain for company and a very long wait ahead of you is pure torture for me.
BUT it’s all done now and if I have to go again ill just insist of being put out and I’m happy to go for another. Hopefully won’t have too 🤞🤞🤞
How you doing now? Improving? I’m finding getting any sort of rest bloody tricky. Absolutely shattered as I only slept around an hour through the whole night I was in there and couldn’t keep myself asleep last night either. Finding I can only sit up in bed at night and this is driving me crazy as I can’t sleep like it. Worried about going on my side as I know this can set my ticker off and it feels extremely tender at the minute so don’t even want to think about that
It's not something to be enjoyed having an ablation but I had been waiting for over a year to have this procedure so I said to myself "bring it on"! The quicker the better was my over-riding thought so that took care of any anxieties! Recovering very well, sleeping great, wound is healing up quite nicely, lots of bruising coming out too! Managing the stairs ok- left foot to heavan right foot to hell!! 😁 It takes time to recover - you will get there!
No it’s definitely not something to be enjoyed 🤣 however I do think the overriding feeling would have been one of excitement as to what was going to happen AFTER the op IF I had gone for GA. The wait was just too long for me to have ga so I had to go for sedation in the end. It is what it is and it’s done now so all good from here hopefully 🤞
Good to hear like your doing well. Sounds like you had a better consultant than me. Just hoping mine wasn’t the newest apprentice as he seemed pretty young and didn’t have the depth of knowledge I was hoping for when asking questions. Just hoping he knew what he wasn’t doing and didn’t mess me up internally. I know they had issues getting up my right hand groin vein and they had to go in my left as well. I remember when the nurse tried to take off the device keeping pressure on wound on right hand side later that evening the blood just gushed out so something went wrong there. When I asked the doctor yesterday morning about it he just said that sometimes it happens that they can’t get the probes down one vein. Again just hope it all went well and he’s not just trying to cover his tracks.
I was 'just' sedated for 2 ablations and full GA for third. I could not remember any of all three procedures but for the GA my lips and throat were sore for a week after.
Sounds like sedation is different for different hospitals?
Hi local lad. Yeah to sounds like that may be the case. I was most definitely awake 🤣 definitely dosing in and out but I felt all the bits you wouldn’t want to feel. It’s not so much pain for me it’s the thought of what they are actually doing that gets me. The thought of probes being forced up your veins, which I could feel, and then popping into your heart, which I also felt was eating me up. Then the Burning in my chest and resulting brain freeze was not exactly enjoyable either. It’s all a mental thing for me. The pain wasn’t particularly bad but the thought of what was actually happening was torturous. Can’t stand it. The really annoying thing was that my heart apparently went a bit haywire at the end and they had to up the dose of sedation and cardiovert me. I don’t remember a thing about that and didn’t wake up until an hour later in a totally different bed not knowing what the hell had happened. If they could dose me up to the point I was completely out then why the hell didn’t they do this to begin with?
Elli, they used midazolam on me, for sedation......apparently you can chat away.....but have no memory of it after !
I had GA for my main PVI ablation as the first time they tried PVI (under sedation) my heart stopped twice (asystole). Apparently a bit of a handful if 'just' sedated !
I’ve got absolutely no idea what drug they used I just remember waking up and the nurse saying you’ve been out for an hour and explaining to me what happened. All the while I’m sitting there trying not too throw up and feeling like I’ve got 15 rounds with Mike Tyson. Wore off after they poured some lovely drugs into my drip 🤣 just wanted to be dosed up to the gills and left to sleep but just couldn’t drift off after that and obviously nurses coming in every half hour checking on you. The more I think about it the more I feel like something didn’t quite go to plan as I was being checked on pretty regularly and they kept me in over night as a precaution and I was only supposed to be in for the day. Trying not to dwell on that and just focus on getting better
Plenty of chilling on the cards for sure. Spent 3 hours trying to get my head around minecraft with the kids yesterday which was interesting to say the least 🤣 plenty more mind blowing experiences ahead I’m sure. Hoping after this first week/few days I might be able to get up and about and maybe try and get a decent walk outside in. Really don’t want to push it though just want to give my body a chance to heal.
Did you have pretty regular ectopics first few days? General feeling of sensitivity and weakness in the chest? I know everyone’s different but trying to get an overall picture of what to expect over the coming days and how fast I should be doing things. How long before you started getting up and moving about properly?
just the occasional very short blips, just a second or two, even now. I just relax , few deep breathes and it settles. But no af or flutter now. I I was back at work after 6 weeks.
I’m getting very regular ectopics. Not bothering me too much just take your breath away when they happen. I know they’re to be expected and I’m not expecting miracles in the first week so it’s all good. Just wondering how your body dealt with it all.
Do you still take any medication? That’s one thing I’m hoping for is that I can get off all meds. For me if I’m still taking meds in a year then I will feel like the operation was a failure. Won’t be the same for everyone of course but for me personally I did this to get off meds in the long term. I wasn’t coping too poorly on the meds and was getting back into a decent enough exercise routine but knew that long term meds is not how I want to continue my life, so went for the ablation. But if I have to continue meds then what was the point?
6 weeks 😬 hope I’m back sooner than that. What do you do for a living? I run an electrical business so really need to get back ASAP. Not gonna rush it by any stretch but need to get back as soon as I can really.
Glad everything went well for you! At the moment all sounds as it should be. I'm registered with Barts and may ultimately have to have an ablation with then. Barts gave me the 80% figure too and they say that they have better than average outcomes for ablations. In terms of preparing you for the procedure and looking after you following it, how would you rate them? As they are a teaching hospital, is there any involvement of students in the procedure?
Not really sure how to reply to this as barts have an extremely good reputation which is why I chose to go there. Personally I was not blown away with my consultant as I said in another comment on this post. He did not fill me with confidence pre or post op with his answers to my questions. The main consultant I dealt with originally was superb but unfortunately he wasn’t involved on the day and haven’t spoken to him since my initial consultation. I’m really hoping the whole student thing is not true as if this is the case I feel like the consultant that I dealt with on the day may have been one or atleast VERY early on in his career.
To be 100% honest if I wasn’t such a nervous wreck on the day and not totally focused on getting myself into the theatre I probably would have thrown some more strongly worded questions his way and may have ended up cancelling and using a different consultant. The fact he told me I would be able to resume normal activities the following day, including exercise threw up alarm bells and especially now that I know how I’m feeling physically right now. Again my mental state at the time was one of trying to hold it together and get myself in the theatre. Should have questioned him more looking back and wish I had but not a lot I can do now. Just got to look forward and get myself better.
Nurses were great overall and look after me pretty well. Apart from one extremely arrogant nurse who fortunately I only dealt with briefly. She wanted me out the room in the morning sharpish and even woke me up after I’d had zero sleep in order to try and kick me out. I then told her she needed to removed the catheter in my arm and she ripped the tape off and pulled the catheter out sharpish. Wasn’t happy that I wanted her to change my dressing on my leg either. If I wasn’t so tired, weak and weary I would have told her in no uncertain terms to go away and get me one of the other very decent nurses that I’d been dealing with up to that point.
Would I go back? Yes I would because I’m aware of their reputation and know that some of the country’s top consultants work there. This time round I would be insistent on knowing who will be carrying out the operation and will be a lot more probing with my questions if in doubt. I know what to expect now so will be in a totally different mindset also it’ll be done under GA so won’t be worried about it at all to be honest. Will just make sure the right person does it next time.
Good Morning Elli, glad that all went well for you and I wish you a speedy trouble free recovery. I'm booked in at the Royal Brompton on October 4th for my first ablation.
Thanks billiam. Same to you as well. Hope it all goes well for you. Just make sure you ask right questions on the day and are totally happy with your consultant on the day before you go ahead.
Good Morning Elli, no, I'm not bothered at this moment in time, I'll speak to them a week before the op and get it all sorted then. I hope that you recover well. Cheers. Bill
I had my ablation 2 weeks ago under GA. No chest sensations, groin bruised but not a problem. Mine PVI too, cardiologist said same about pinpointing v. difficult. Ectopics: pre ablation I got ectopics after exercise or AF occasionally. 8 ectopics a minute would be typical (I have a Kardia 6L and took a reading after most exercise, I swim bike run). Since ablation I have had very very few ectopics, one or two in first 4 days, none since.
Thanks for feedback splash. How’s your recovery going 2 weeks in? Was it your first ablation? I’d be intrigued to hear how you progress and when you decide to get back to exercise. I was doing an hour on my static bike at quite a good pace, for me currently atleast, and doing light weights also in the months leading up to ablation. Was just starting to get some form of fitness and shape back and am keen to be able to get back to it but obviously not wanting to push my luck in the slightest. How you finding it so far?
Recovery good. Resting HR was 60 before, now 72 but falling I think. Just doing some walks - started with very short now up to 3 miles. HR is 95 for gentle pace (4 km/h), 105 for fast (6.4 km/h), similar to pre ablation. I hope to do first bike and first run at 6 weeks after ablation, just 10 mins max and very slow. I figure heart and or link to brain have had big hit otherwise RHR wouldn’t be up 12.Hoping to get to leisurely cycling by 1st week in Oct then I’ve got 3 month cardiologist follow up 1st week Nov.
No AF yet and no atrial ectopy (my P waves are ever present!).
How many weeks in before you started walks then splash? My rhr was 55/56 before and is currently up to 85/86. Hoping this will drop quite drastically over the coming weeks. When I used to do a 6/7 mile walk once a weekish my hr would get up to around the same as yours, 100/105/110 depending on gradient. Slow paced general walk would float around 80/85/90 again depending on gradient. I’m only 35 though and by no means anywhere near fit since AF took over my life 😫 used to get my ticker up to 130/140 bpm when on bike for around an hour and not have too many issues. Felt great after as well and REALLY hoping I can get back to this as soon as possible. I used to do kickboxing and absolutely destroyed me when I had to stop. Now I’m just happy getting my fitness buzz from any avenue I can to be honest. Although most attempts highly unsuccessful. This last few months have been the first prolonged exercise I’ve been able to maintain. So again hoping to get back ASAP.
First walk 4 days after (1 mile), then 8 days after and daily since. I never used to monitor HR until I got AF 2 years ago. In 2020 I had AF 5 times, twice lasting 3-5 hours self reverting, other 3 momentary. Cardiologists said ok to train but limit HR - ease off at 160, stop at 170. My HR would hit 160 at 5m 22s/km pace - my 5km race pace was 4m 48s/km. This June I started getting AF at crazy slow cycling speeds.
4 days seems a bit too soon for me currently but see how my body reacts over next few days and go from there I suppose. Was going to give it a solid weeks rest before trying anything such as walking outside etc. Just need a really good sleep, hopefully I get one tonight and then I can see how I feel
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Ablation Day
Ectopic Beats
Ablation at St Bart’s 
A LOT of pain after ablation!
