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AF returns after 2nd ablation

stoneyrosed profile image
76 Replies

Had my second ablation done five weeks ago unfortunately AF returned last Tue lasting five mins and then self regulated. Two days later it returned again this time lasting 15 mins again stopped and returned to NSR without any meds. I asked the nurse cardio if it happens again should I return to flecanaide 50 mg daily or just try and ride them out? Is response was either try ride them out or take the flecanaide if AF becomes bothersome. I am thoroughly dissapointed and I am hoping there is someone out there who has been through the same thing but discovered that the heart eventually settled down and have been ok since? Searching for Hope really. I am going to try and ride them out for as long as I can because I really want to keep of the flecanaide.

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stoneyrosed profile image
stoneyrosed
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76 Replies

What you have experienced is very common because an ablation is a procedure, not an an operation so it takes time, often a long time for the scar tissue to heal which prevents the rogue impulses to fire off. This blanking period can take up to six months, sometimes longer and is why many EP’s now wait six months before scheduling their first review. Don’t be down hearted, try a be a patient patient and if you haven’t already, read the second pinned page at the top right of this page………

stoneyrosed profile image
stoneyrosed in reply to

Thanks for that flapjack, gives me hope and some reassurance which my cardio nurse doesn’t give me but I understand why he doesn’t. I emailed him a couple of weeks ago and told him my bpm is low at 45 bpm and he mailed back “Cool”. He obviously doesn’t want to give much away but your right I am an impatient patient and will try to ride these out.

CyclistMark profile image
CyclistMark

Sounds perfectly normal based on what I was told.

Had my first ablation just over 2 weeks ago, came off hr and rhythm medication immediately after and within 3 days I was back in persistent fast AF. I therefore had an urgent cardioversion back to NSR and I’m now on fleccainide while I navigate the blanking period. I’ve been in NSR ever since.

Just try and take it easy and follow any EP guidance and flapjack / Bob on here as they seem to know their stuff

stoneyrosed profile image
stoneyrosed in reply toCyclistMark

Thanks Mark yes early days I suppose it was the hope that got me, after been af free for 5 weeks and for it to suddenly appear again is disheartening . I really hope yours settles too, good luck 👍

CyclistMark profile image
CyclistMark in reply tostoneyrosed

Hi, how are things now? Hope you’re ok. We must compare notes from time to time

stoneyrosed profile image
stoneyrosed in reply toCyclistMark

Hi Mark, No AF since Thursday, though it feels like sometimes it is trying to break through. I think it is down to everyone’s individuality as to how we react and recover from these ablations, of course it is not a cure as such, but we all hope for a big improvement in to how we were before the procedures. These ablations take a bit of recovering from, and I feel sometimes we are left to our own devices by the medical teams. Once you leave the hospital that’s it for 3 months or in some cases even longer. I wish there was more professional help for us all immediately, and the weeks after the procedures, but its like everything it all comes down to money I suppose. This is my second procedure by the way Mark, my first was cryo and second RF. Sure we can swap notes 👍

VeeWat profile image
VeeWat in reply tostoneyrosed

Afibbers dot org has a good forum too

Lilypocket profile image
Lilypocket in reply toCyclistMark

You sound similar to me. My Rf ablation was 12 days ago. I wasn't cardioverted when Afib returned for a few hours but resumed medication which did the trick. Just have to go through the blanking period now (like waiting for Christmas and hoping you get what you would like 😄).

dedeottie profile image
dedeottie in reply toLilypocket

Same here. After an initially good 6 or 7 days my AF / tachy/flutter has come back and is persistent for the last 4 days. I have left my arrhythmia nurse a phone message and will post on here whatever her advice is. I think in my case that there are other areas in the heart that will need ablating but I am still holding out hope that things will get better with time. One way or another I guess we have all just got to be patient. X

Lilypocket profile image
Lilypocket in reply todedeottie

Well I went into Afib again this morning at 7 am (6 am uk time) and am still in it. I just hope it pops back into NSR. I don't mind bouts of Afib in the blanking period but just wondering what happens if I don't revert back and all the drs are on their summer holidays - rather not have a student dr. 😄Xx

dedeottie profile image
dedeottie in reply toLilypocket

It’s a bummer isn’t it? I am waiting to hear from my nurse with a time to go for an ecg which she will then show to my EP.. x

Lilypocket profile image
Lilypocket in reply todedeottie

You'll get to your appointement then revert. The ECG will show nothing you will get a pat on the head " Nothing but ectopics dear " then you will go home. 😄 ( my experience last week . Went back into arrythmia after.Typical) x

dedeottie profile image
dedeottie in reply toLilypocket

Yes, that would be absolutely typical 😝

smwdorset profile image
smwdorset

Don’t panic - yet - it can take a while for the heart to recover from the shock of the treatment. Five weeks is not a long time for this . It may yet settle down! Personally I wouldn’t intervene so long as it keeps reverting or not yet . But of course if it gets v fast etc you have to do something and take advice anyway .

stoneyrosed profile image
stoneyrosed in reply tosmwdorset

Thanks for reply Dorset hopefully it will settle

rosyG profile image
rosyG

It seems very common fir the first few months from what people have written here in the past so don’t worry at all

stoneyrosed profile image
stoneyrosed in reply torosyG

Thank you Rosy, I have a degree in worry when it comes to AF 😊. I get your point thanks for the message I really appreciate it.

Globe-J profile image
Globe-J

Hi,

I am afraid, 'have been there' too. Opting for the 'Maze Procedure' finally got rid of my AF.

It is difficult to find an evidence based study, offering a documented success rate of ablation. From my research, you and I are more of a norm, rather than exceptions.

Please, do not give up

J (-:

Lilypocket profile image
Lilypocket in reply toGlobe-J

I had an RF PVI + Box Isolation which goes behind the left atria to deal with rogue signals. I believe it is the same idea as the Cox but from inside the heart. However I have read that scarring is thicker in the Cox procedure and more effective at blocking un wanted signals.

Jalia profile image
Jalia

Goodness, far too early to start worrying! I had my 4th ablation almost 12 months ago and have had blips like that which I just disregard and return to NSR spontaneously. Prior to ablation my rates were really fast and prolonged, sometimes 200+, and then I would seek help.

stoneyrosed profile image
stoneyrosed in reply toJalia

Thanks Jalia, Did they tell you why the other 3 ablations have not worked for you? I don’t think I would have a third unless they were able to convince me it would definitely be successful . Thanks for reply

Afib_girl profile image
Afib_girl

I had mine done almost 3 weeks now and I have been in constant afib ever since the ablation it’s miserable I’ll take blips any day. I am just riding them out… hoping they settle down… I don’t go back to my ep until October.

stoneyrosed profile image
stoneyrosed in reply toAfib_girl

I’m so sorry, yes it is hard isn’t it? Especially when all your faith goes into the ablation procedure and you try to think positive. Here’s hoping ours will settle eventually. I find it difficult to communicate with the medical team during this period, my cardio nurse just gives one word replies and GPS hardly know anything about the condition, feeling alone is the difficult part. This site is all we seem to have, thank goodness for it.

Lilypocket profile image
Lilypocket in reply toAfib_girl

Did you contact anyone about that? I think I read some members have had the same experience and had to have a cardioversion. In most cases that sorted it and they are still in NSR. X

Afib_girl profile image
Afib_girl in reply toLilypocket

I’ve had 2 cardioversion they don’t work for me I go right back into afib unfortunately

Lilypocket profile image
Lilypocket in reply toAfib_girl

May I ask what sort of ablation did you have?

Afib_girl profile image
Afib_girl in reply toLilypocket

Cryo ablation for paraxsomal afib…

Lilypocket profile image
Lilypocket in reply toAfib_girl

It is early days to know if it has worked or not as others have said.But it may be the signals are also coming from elsewhere. I believe Cryroablation is very effective for pulmonary vein Isolation arrythmia. But some people need an RF ablation to deal with rogue signals from elsewhere or touch up the work already done.

We just have to wait and see with everything crossed 🤞🤞🤞if it works for us.

I hope you fall back into SR soon and it sticks. x

Afib_girl profile image
Afib_girl in reply toLilypocket

It’s hard bc I am basically in worse shape than before then procedure. So it’s a little disheartening.

Singwell profile image
Singwell in reply toAfib_girl

I went through this last year. It started to normalise after the 3 weeks. Fingers 🤞 for you.

belindalore profile image
belindalore in reply toAfib_girl

🙏. Hope you heal soon.

dedeottie profile image
dedeottie in reply toAfib_girl

You sound exactly the same as me except I had about 6 days in NSR which was bliss but now it is persistent again and exactly the same as it was before ablation. X

momist profile image
momist

Early days yet. My last skirmish with heart rhythm disturbance was in April this year, nothing since. However, my ablation was at the end of June _last year_! So yeah, give it a bit more time and wait and see. My first consultation with my EP will be next month, nearly 14 months after the procedure.

stoneyrosed profile image
stoneyrosed in reply tomomist

Thanks Momist very nice of you to reply, thank you

Gowers profile image
Gowers

I went into AF the morning after my 1st ablation under sedation & had to have conversion. Seems ablation works different for everyone I'm still on medication even though had 4 ablations in just over two & a half years.

stoneyrosed profile image
stoneyrosed in reply toGowers

You would think after 4 ablations you would have some improvement. Have they given you an explanation of why your still getting AF despite 4 attempts?

Gowers profile image
Gowers in reply tostoneyrosed

No more af so far - v glad I went for the 4th. I'm on reduced medication while heart heals after last ablation.

stoneyrosed profile image
stoneyrosed in reply toGowers

I really hope it works for you this time. Thanks for responding I really appreciate it. Good luck 🤞

Sounds like my experience- but those episodes were brief weren’t they? I haven’t had a repeat for a year, but had two brief episodes in first few months after cryo ablation, not the 8-12 hour monsters I had pre

stoneyrosed profile image
stoneyrosed in reply to

Thanks Faber, my first cryo basically failed hence needing a second touch up.

Lilypocket profile image
Lilypocket

Hello

I had an RF ablation 11 days ago. Was taken off all meds ( except anti coags) immediately. Had 2 hours of Afib 2 days later which self- terminated. On the 5th day after went into a mixture of Afib and very rapid regular HR with lots of ectopics. After 4 hours I took a reduced dose of my meds ( after contact with the EP by mail). Two hours later it resolved.

I am to stay on meds until at least September. The EP said this happens to 20% of his patients and is no indication of failure or success. It is very early days Stoneyrosed and a couple of episodes of 5 minutes is nothing at all.

I'm interested to understand why some EPs stop drugs immediately after ablation and some advocate the continuation for at least 1 month and up to 3 months + in some cases.

Anyway the best is to wait while the heart heals and adjusts and stay optimistic. 🙂

It is very early days and 2x5 minutes of Afib is normal and means nothing.

What sort of ablation did you have?

I am bloated with no appetite since the procedure - probably an annoyed Vagal nerve 😉

Take care and let's compare notes in à month or so.

X

stoneyrosed profile image
stoneyrosed in reply toLilypocket

Hi Lily, This was my second ablation, the first was cryo and the 2nd RF. I was kept on all meds beta blockers flecanaide and Edoxaban for 3 mths after the first ablation. This time I was told to stay on Edoxaban and beta blocker but to immediately come off the flecanaide. Review phone call will be on 3 month. Yes I am confused as to why some people stay on meds and some don’t, have to admit as to been slightly nervous coming off the flec as it kept AF at bay in the 6 months leading up to the 2 nd ablation. I know the AF was only for 5 and 15 mins but I am finding it hard to stay positive. Still getting the odd feeling it is going to start again but into day 3 of no AF. Yes Lily we can compare each other’s progress and give each other encouragement, good luck in your recovery and thanks so much for replying.

Lilypocket profile image
Lilypocket in reply tostoneyrosed

I got used to living with Afib and stopped thinking " when is the next epidode " and being worried about planning anything . After a couple years of stressing for the next episode I just thought "what the hell" and just lived with it hardly noticing it even when I latterly had episodes every 2 days. I think after an ablation we go back to our way of worrying the way we did at the beginning of our Afib journey - waiting for an episode. But it' ll settle and even if it doesn't cure our Afib it hopefully will reduce the episodes and their duration or even ,who knows ,give us a few years free of it.🤞 Stay in touch x

stoneyrosed profile image
stoneyrosed in reply toLilypocket

I wish I had your resilience 😊. When AF starts my thoughts turn so negative and I make it such an event. On the other side of that if I go a few days AF free, all is right with the world again lol. Hoping ours settle is the hope I need to keep going. Thanks Lily will def keep in touch x

Lilypocket profile image
Lilypocket in reply tostoneyrosed

I'm not so resilient and shed a few tears after the ablation - especially when the Afib lasted 6 hours. I think it's just an accumulation of emotions , the GA and tiredness. But I immediately contacted my EP and felt more positive after. I also PMd a member and just just waffled. That helped me a lot too - a big thank you to her. I feel so much better mentally now . The big test will be coming off the meds 😉Why don't you keep à little diary and then make comparisons as the weeks pass?

X

stoneyrosed profile image
stoneyrosed in reply toLilypocket

Yes I struggle with the mental side of coping and I even see a CBT therapist to try and gain help with the anxiety side of it. I will keep notes from now on, and share them with you Lily in the coming weeks and months, Thankyou x

Cookie24 profile image
Cookie24 in reply tostoneyrosed

Well said. A few day afib free and I start planning.....

Cookie24 profile image
Cookie24 in reply toLilypocket

Good thoughts. I was the same - not planning anything thinking what if I have an episode.....

stoneyrosed profile image
stoneyrosed

Hi Lilly, I forgot to say I too was feeling bloated just leading up to the first AF event, also my BPM was down to 43/45. The bisoprolol is 2.5, I mentioned this to my cardio nurse and he just said that’s fine.

Singwell profile image
Singwell

Definitely been through this even while staying on my meds. Don't be despondent - we have unusually hot weather and that alone is enough to stress your heart . You are self converting from short episodes. I don't think this means the ablation has failed. Remember that the blanking period is 3 months for the cellular healing but in fact the tendency for the heart to kick off can take longer than that. It's learning a new behaviour after all. One thing my arrhythmia nurse told me was that the goal is to stop the episode with PiP (I take extra if needed) so the heart can continue to relearn, which they call remodelling. So if you're self converting quite quickly I'd be giving yourself a pat on the back.

Hope that helps!

stoneyrosed profile image
stoneyrosed in reply toSingwell

Thanks Singwell, yes I hope your right that the heart is remodelling, my problem is I never know when or which med I should take, for eg is it an extra beta blocker or a flecanaide as a pip? Also cardio was saying if you can ride them out do so, in other words he would prefer I stay off the flecanaide but take if bothersome. I was fine for five weeks after the ablation so why now ☹️. So many questions it gets overwhelming. Thank you for your help I really appreciate it.

Singwell profile image
Singwell in reply tostoneyrosed

You're welcome and I totally relate to the anxiety at this time. Do you have an arrhythmia nurse? If so I'd be calling them and asking for more specific advice on how to take the meds if needed. Usually I think it would be the Flecainide to put you back in NSR and the Bisoprolol to counteract the Flecainide tendency make the heart race. That's what I've been told but you do need to check. If you don't have a clear strategy you'll be adding to your worries with that. I do with the medics would think a out this when breezy saying 'ride it out'.

stoneyrosed profile image
stoneyrosed in reply toSingwell

Yes I am in touch with cardio nurse but I am not sure he is all that helpful, maybe he has a good reason I’m not sure. He told me to do what I want, take flec or ride it out. I think I am looking for answers he is not able to give me at this present time. As I was told earlier I need to be a patient patient. Thanks Singwell

ShowDogStacker profile image
ShowDogStacker

I had ablation June 13 2022, 1 week to the day I started back into afib a couple times a day, contacted my cardiologist, he was disappointed to hear but said that it wasn't unheard of. Then I started have more afib and lasting anywhere from 30 to 90 minutes, The cardiologist then started me on flecainide, 50mg twice a day, Iam also taking eliquis & metoprolol. Still was going into afib, not a happy camper now, so I started looking over my notes because every time I have afib I take my blood pressure so I can see how fast my pulse is and what my blood pressure is, I write everything down so I have a record. After going into afib 1 night that lasted a couple of hours I contacted my cardiologist again, he turned me over to his nurse, Think he was getting tired of me asking him question on why this is happening. I told the nurse that 99% of the time I go into afib my systolic number is between 100 & 115, which to me is low and wanted to know if I could cut back on my metoprolol meds and see if this might help, she agreed, so I went from 50mg twice a day to 25mg a day. I cut the pill in half so I take 12.5 mg twice a day instead of 25mg once a day. Low and behold my afib has stopped. Iam now starting to cut back on flecainide to just 50mg once a day , and if no afib happens Iam going to stop flecainide all together. Sometimes we have to be our own Dr. and go by what our gut feeling is telling us. Keep records so you can review and see what you blood pressure is when you have afib, talk to you DR and see if adjusting your meds might help. Before all this happened to me , I wasn't on any meds , ate healthy, exercise, all around lived a healthy life style. Looking forward to getting off all meds. Hope this was helpful. Good luck.

stoneyrosed profile image
stoneyrosed in reply toShowDogStacker

The couple of times I slipped into afib I checked on my heart rate which was down to 43 bpm, I feel the beta blockers are slowing my heart down so much that if I try to do something slightly energetic it goes into afib. I mentioned the heart rate to cardio but he says that’s fine. I hear what you say about gut feeling but I loathe to go against cardio advice. Thanks very much for your post.

ShowDogStacker profile image
ShowDogStacker in reply tostoneyrosed

If your heart rate is down to 43 bpm, I don't think your in afib, sounds like you are having PVC's , which is different from afib , ask your DR. about PVC's , They occur in the lower part of the heart, where afib occurs in the upper part, I was having both when all this started happening to me a year ago, PVC's can be annoying , my cardiologist told me that they won't harm me unlike afib, which can form blood clots or cause strokes. What is your heart rate when your not having any issues, should be 60-70 bpm , if its in the 40's then I would say something needs to be adjusted, I know you want to trust your Dr. , maybe get a second opinion just to be sure.

stoneyrosed profile image
stoneyrosed in reply toShowDogStacker

No my BPM was 43 just before AF kicked in, when in AF it went up to 105 which is not as bad as I have had previously 160-170. My alivecor confirmed I was in AF on both occasions. For the last week or so I have been below 50 bmp (bradycardia) but my cardio says not to worry but take flecanaide if AF becomes bothersome. For the moment I am going to try and ride these out and hope the heart settles before I start taking flec again.

Lilypocket profile image
Lilypocket in reply tostoneyrosed

That's why the EP took me off meds again as I had a drop in HR (39/40 bpm) with a couple of huge pauses. EP did not like the sound of that and told to come off the Flec immediately. That stopped the slow beats but Im now in Afib everyday for long periods. Yep the EP and Cardiologist are away til September on top of that . So a bit stuck!

Lilypocket profile image
Lilypocket in reply toShowDogStacker

Apart from PVCs you have PACs( premature Atrial contractions) . I had terrible PVCs but when I started Flecainide they were reduced almost disappeared. I got more PACs but much more discreet.

Safc1983 profile image
Safc1983

I’ve needed cardioversions after both of my ablations and have never fully stopped medication but I feel for you. Hopefully it’s just the heart adjusting during the blanking period and it will settle down, AF-free, soon

stoneyrosed profile image
stoneyrosed in reply toSafc1983

Yeah thanks it’s disheartening when it appears out of nowhere and you just know your in for a rough time for however long. Sorry your back on meds have you got a further plan? Unless they can convince me a third would definitely stop af I don’t think I will be having another.

Safc1983 profile image
Safc1983 in reply tostoneyrosed

I never stopped this time around but they’re looking to take me off anti arrhythmia drugs in a month or so which I’m not looking forward to. Have you read much about the Wolf mini maze where they clamp the appendage instead of burning the veins?

stoneyrosed profile image
stoneyrosed in reply toSafc1983

From what I can gather it would be a bit pricey unless you can get it done on the NHS. Maybe something that will pop up further down the line if it becomes widely available. Yes coming off meds is the big test isn’t it, I wish you well 👍

Safc1983 profile image
Safc1983 in reply tostoneyrosed

Thank you, and you too. Hopefully this is just a blip for you

Magson profile image
Magson

I don't think you should worry at the moment. Early days as they say. After I had ablation in late 2018 I have had a couple of short episodes not like 24 or 36 hours which I experienced before ablation. Unfortunately AF episodes tend to give you a sense of dread and you feel depressed. One thing I was aware of is taking Bisopropolol lowered HR to around 40.Most of my episodes occurred at 2.00 am (HR lowest).

Good luck.

stoneyrosed profile image
stoneyrosed in reply toMagson

Yes it very depressing isn’t it. I am only on bisoprolol and yes it lowers my heart rate to 43-45 and that seem to be when I feel so tired and also the AF kicked in when it was in the low 4Os. So many variables to all this I’m tired with it all. Thanks for message Magson

Lilypocket profile image
Lilypocket

Just to reassure you 5" and 15" of Afib is really nothing and no indication of failure at all. I'm in the middle of a bout of Afib that so far has lasted 5 hours ( second episode). I'm in the blanking period and will sit tight. 🤞🤞X

stoneyrosed profile image
stoneyrosed in reply toLilypocket

I understand what your saying but 15 min or 5 hrs is still afib I was kind of hoping I was getting somewhere as I managed 5 weeks afib free since the ablation. I feel for you though of course been in afib for so long and I hope so much you revert back to NSR real soon Lily x

Lilypocket profile image
Lilypocket in reply tostoneyrosed

Hi,I understand - the period after the ablation is tough - waiting for the blanking period to end .

Take care x

Achant1 profile image
Achant1

After my first ablation I felt super for three months then the healing really started, headaches and feeling like Af was trying to breakthrough all day every day, me personally I’d take the flecainide until all your bumps and runs die down. Be gentle with yourself it’s very early doors and these things take time.

stoneyrosed profile image
stoneyrosed in reply toAchant1

Hi Achant, Thanks so much for reply. I am very tempted to go back on daily flecanaide but that would mean going against the wishes of the EP who did the procedure. I am sure they know more about my afib than I do so I am loathe to go against their advice. If I go into afib for more than a few hrs I will definitely take it as a pip though. Thanks so much long may you continue to be well.

Lilypocket profile image
Lilypocket in reply toAchant1

Not sure if it always makes much difference. After my ablation 12 days ago I was taken off all drugs (except anti-coags). I had respectively 2 hours and 5 hours of Afib the 2nd and 4th day after. I re started the meds after speaking to my EP. And here I am today in my 6th hour of arrythmia . I think the heart is upset and with or without drugs we have to get through the " blanking period" and even beyond while the heart " does its thing" and cross our fingers 🙂

stoneyrosed profile image
stoneyrosed in reply toLilypocket

Also bear in mind though Lily once you stop and restart the meds it will take your heart a week or so to get back used to the meds again. It is all very confusing though isn’t it when EPs tell one patient one thing and another patient something else 😵‍💫. Speak soon hope your in NSR real soon x

Lilypocket profile image
Lilypocket

You can say that again! My heart is very strange at the moment. Afib, then fast rhythm with many ectopics, bigimy, trigimy and then terribly slow with pauses that make my chest tight. Poor heart - I think it's traumatised. Hope your SR holds x

stoneyrosed profile image
stoneyrosed in reply toLilypocket

I will think about you and keep my fingers crossed for your heart to settle Lily x

Lilypocket profile image
Lilypocket in reply tostoneyrosed

Thanks 🙂

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