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AFib much worse since ablation on July 6th

MoyB profile image
MoyB
31 Replies

The first two weeks after the procedure I felt better than I have done for years! My feet and legs were not so swollen and I had no AF at all.

Unfortunately, this week the AF is back with a vengeance and seems to be getting worse each day.

I was expecting it to a certain degree, but it's worse now than before the procedure.

Should I be concerned?

xx Moy

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MoyB profile image
MoyB
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31 Replies

Good morning MoyB, hopefully NSR has returned by now. If not, prior to the ablation, were you taking a daily maintenance dose of a rhythm drug such as Flecainide. If so, it might be worth contacting your hospital to see if they think you should continue taking it to help support the heart to maintain rhythm during the recovery period. They may even suggest taking it as a PiP to help jolt you back into rhythm. As you rightly say, bouts of AF can often occur during the recovery period but bearing this is the start of the weekend, if you are still in AF, I would be tempted to visit A&E as they might carry out a cardioversion.

Hope this won’t be necessary and that all is OK now…….

in reply to

Thanks for acknowledging my reply, it would be helpful to know if you are back in rhythm….

MoyB profile image
MoyB in reply to

Hi, thank you for your concern I'm sorry not to have replied properly sooner. Just had a few other things to get on with and so wasn't able to spend the time needed to be on the computer.

I used to take Flecainide and was on it for years. When they started me on Diltiazem they said it would be better than the Flecainide and so that was stopped.

The irregular heartbeat is coming and going all the time at the moment but my pulse rate is not in the Tachycardia range, except for an occasional shoot up to 120 which has then returned to 90 or lower within a minute.

I have the sensation that my heart is shaking all the time, if that makes sense.

I'm not sure I need to bother A&E yet, but will give 111 a ring if things don't settle down soon.

Before the procedure, I had paroxysmal AF and some quite high heart rates with it. I went to A&E a few times then as my GP had said if my heart rate stayed above 120 for more than 15 mins I should go there. Of course, I would arrive and when I was seen and given an ECG, my heart rate would be back in the 80s, so no cause for concern. They would keep me in the waiting area for hours before letting me go home. The last doctor I saw there was wonderful. He talked to me a lot about the AF and had clearly read my notes thoroughly. He told me that I should go to A&E at any time if I was worried but that I needn't rush there every time my heart rate went over the 120 for 15 mins or more as long as it started to drop eventually.

Since then, I have been far less anxious about it all and have not been to A&E since.

I have a Kardia and have been checking that fairly regularly. It is going between 'Possible Atrial Fibrilation', 'Unclassified' and 'Normal Sinus Rhythm' and if I take the readings fairly close together I might get all three within a space of 5 minutes!

I know I can't rely on it, but my body is telling me that something is working in overdrive, if you know what I mean, even when it says NSR.

One thing that has changed recently, I've just thought about, is that I've been told to take Gaviscon Advance 4 times a day. I'm wondering if that could be causing it. I am leaving 2hrs either side of taking my meds as advised in the patient info. I can't think of anything else 'external' that might be affecting it.

Thanks again for your concern.

xx Moy

in reply toMoyB

Thanks for the info. It actually sounds as though it may settle. If the rate had been consistently very high for over 10 hours then a trip to A&E might have been necessary especially as it’s almost impossible to get any other form of help over the weekend. I’m sure you know that Diltiazem will help to slow your heart rate, it’s the Flecainide that should bring it back into rhythm but you have to follow your medics advice. Hopefully it will continue to stabilise, deep breathing exercises might help…….

MoyB profile image
MoyB in reply to

Thank you. When I was prescribed Diltiazem, I got the impression that Flecanaide was no longer being advised for people with AF and have been surprised to read that some people even use it as a PIP. We just have to trust the medics and hope they get it right, I suppose.

I do think things have settled down a bit now so will try and stay away from A&E if I can but be assured, I'll be there like a shot if things escalate!

I appreciate your concern and helpful posts.

xx Moy

healingharpist profile image
healingharpist in reply toMoyB

Hi Moy, Definitely, flecainide is still in constant use here in the US, and (like me) usually as a PIP. It has always resolved every one of my afib episodes within 1 - 4 hrs, usually within 2 hrs. & hoping that effect continues indefinitely. I take 25 mg metoprolol daily, which seems to keep my heart calm, & it got rid of ectopics also. I am so sorry it's rocky going for you right now, but from what I read here, it takes some people 3-6 months before really getting stable good results from their ablations. In the meantime, maybe inquiring about using flec PIP would offer you some relief... will pray for that result for you! Peace & healing... Diane S.

Singwell profile image
Singwell

It's not unusual for AF to kick off but I agree it's worrying that it's getting worse, not settling. Are the rates increasing? I agree wuth what Flapjack has said. If its still getting worse over the weekend consider getting checked out at A and E. Then call your cardiology department 1st thing Monday for advice re maintenance dose etc. I'm assuming here cardiologist won't be around at weekends- ours never is!

MoyB profile image
MoyB in reply toSingwell

Hi! My heart rate was about 90bpm for a week or two after the ablation then started to settle at about 70 - 80 bpm which I felt quite pleased about. Now its in the 80s and 90s again. Having said that, I just checked again and now it's in the high 70s and Kardia says I'm back in NSR.

I am wondering whether consistent jolting whilst using my mobility scooter due to the awful pavements could do any damage during the healing process. I did a 20 minute recce to the Pulmonary Rehab venue last Sunday as I was due to have an assessment there on Tuesday. I found the pavements to be absolutely dreadful and it was a VERY bumpy ride. That's when the AF first started to become more frequent. I had another bumpy ride there and back on Tuesday and another, shorter, bumpy ride to another place yesterday.

I'm also wondering if Gaviscon Advance can be the cause. I've recently been told to take it 4 times a day. I'm leaving 2hrs either side of my meds as advised, but still wondering.

I'm trying to think of anything that can be causing it, TBH, as it's really getting on my nerves now and I'm also feeling a bit anxious about it, although I know it's not life threatening.

Singwell profile image
Singwell in reply toMoyB

Thanks for the info. So, two things to look into from what I know If you suffer from acid reflux then Diltiazem can make it worse because it's a vasodilator and ENTs have noted it also tends to widen the oesophagal sphincters. I had terrible heartburn when I started it.

The other thing is that although Gaviscon is an alginate there us an interaction between it and other meds. I'll try to tag the forum member who mentioned this. Doesn't meant you can't take it, just adjusting when. So by experimenting with your med or Gavison timing I'd say that's a good idea.

I suppose another thing to ask is why the Gavison we prescribed in the first place? Did you notice that acide reflux came on or got worse AFTER starting the Diltiazem?

All things to look into. Doesn't mean you cannot take both. I do as it happens but I only take my Gavison these says just before bed.

Might also be worth asking if you could.have the same dose of Diltiazem in two units each day e.g. 60mg am and 60mg evening. Others here do this and it might lessen the impact. mjames1 ?

MoyB profile image
MoyB in reply toSingwell

You've given me a few things to think about there, Singwell. I didn't realise there was a connection between Diltiazem and reflux.

In answer to your question about why I'm on the Gaviscon;

I was diagnosed with a Hiatus Hernia approx 27 years ago and have been on various meds for it ever since as I suffer with reflux. Recently, I have had trouble with losing my voice and was seen at ENT a few weeks ago. The consultant looked at my larynx with the camera and said that there was 'nothing sinister going on' but he could see evidence of reflux damage. His advice was to take the Gaviscon Advance for 4 weeks to see if that improves things. In addition, I've followed his advice to raise the head of my bed and avoid all sorts of food and drink. However, I have found it impossible to follow the advice to have 5 small meals a day instead of 3 normal size ones. It's bad enough trying to fit the meds around 3! He also arranged an ultrasound for me which showed that everything was normal in my neck. I have a follow up appointment on September 22nd.

Regarding taking Gaviscon and other meds, I have paid attention to the advice given on the label and also the NICE website and I make sure, when taking the Gaviscon, to leave at least 2hrs before and after taking the meds. This does mean I have had to adjust my medication routine in order to fit everything in and am sometimes having a very long day in order to manage it all. I will look into all my meds a bit more carefully, though, and see if taking some together that I usually spread over the day could be having an effect.

The trouble is once a week I take Risedronate which has to be taken 30 mins before any other meds, food or drinks. So I take that at 6.30am. The rest of the week, my meds start at 7.00 am and through the day, I normally follow with breakfast at 9.00 am, another med at 11.00 am, then lunch at 1.00 pm, more meds at 3.00 pm, next meds at 5.00 pm, dinner between 6.00 pm and 7.00 pm, more meds at 7.00 pm, last food and drink at 9.00 pm and final meds at bedtime. In order to fit the Gaviscon in, I've stopped taking the 11.00 am tablet for a few weeks (this is calcium and vit D so a short break won't do me any harm) and I've been taking my 3.00pm and 5.00 pm meds together at 5.00 pm.

My Diltiazem dose was reduced shortly after starting it due to ending up in A&E with a head injury after a faint due to low blood pressure. I take one tablet in two halves ie half in the morning and half 12 hours later - usually 7.00 am and 7.00 pm.

I'm sure I'll get on top of all this soon, but it really is a nightmare at the moment.

xx Moy

Singwell profile image
Singwell in reply toMoyB

Sympathise over the HH. Have long suspected I have one too. OK I'll.share what I know. If reflux is causing you to lose tour voice etc you need to know about the difference between LPR and GERD. sounds like you have the former, which is whT I have as it attacks the soft tissue of the larynx. Its not the acid that causes the damage its the digestive enzyme pepsin. Pepsin needs acid to operate and digest protein and we don't want it 'digesting' the soft tissues of either the oesophagas or the larynx. Because that causes inflammation. Go to the British Voice Association Website and look for 'Free Leaflets" where you can download an excellent PDF on this topic. As for eating 5 small meals, yes and no. I eat three with an occasional snack. Since you have an HH you'll already be eating well before bedtime anyway so no problem there.

In addition to raising the head of your bed we're advised to sleep on our left side to avoid the stomach being squeezed by the liver. No food or liquid after the gaviscon for 2-4 hours depending on whether during the daytime or at night. I sometimes drink a bit of water at night around 4.00am or whenever I go for a pee!

My absolute best advice is to read this book - The Complete Acid Reflux Diet Plan and follow it through the 8 week programme. It will really help you to.get the issue under control.

The 4 X a day thing with the Gaviscon Advance (do take the Advance as its the most effective) is a standard procedure just to help reduce the inflammation, which will hopefully resolve. Will post link to book.

MoyB profile image
MoyB in reply toSingwell

Thank you so much for all this info. I have been onto the website and downloaded appropriate leaflets, which I found very useful, and have also ordered the book which is arriving on Wednesday.xx Moy

Singwell profile image
Singwell in reply toMoyB

See my post just before this. The Comlete Acid Reflux Diet Plan by Nour Zibdeh, MS, RDN, CLT

MoyB profile image
MoyB in reply toSingwell

Wow! Thank you for all this info. I will read it and 'digest' it. 😀 xx Moy

Singwell profile image
Singwell in reply toMoyB

LOL 😆 you're welcome! This is a topic that as a professional voice user I've had to get my head round. I often give this info out here. Must save my 'Acid reflux lecture' somewhere for easy copying and pasting. BTW did you know there are links between HH and AF? Your cardiologist on YouTube has a video on it. Am convinced my own digestive issues dating back to early adulthood and a severed vagus at digestive end have brought me here...

Cookie24 profile image
Cookie24 in reply toMoyB

Yes things with meals and other meds is a pain

stoneyrosed profile image
stoneyrosed

Are you able to contact your cardiac nurse? If so ask if you can take a pill in the pocket ( flecanaide). Hopefully that should put you back in nsr within a couple of hrs. Also he/she maybe will be able to alleviate some fears you have about Af getting worse. I too having been having AF attacks just 5-6 weeks after my ablation but perhaps it is the blanking period and it will settle itself when it is ready to do so. Thank you for helping me when I needed it I do hope I have helped a little in some way. Relax and take care x

MoyB profile image
MoyB in reply tostoneyrosed

Good to hear from you! Unfortunately, I don't have a cardiac nurse to call, so I'm looking at GP, 111 or A&E really. Like you, I'm hoping it may be the blanking period, but I don't like the fact that it's got worse this week. My heart rate isn't going high, but it feels as though it's all over the place for much of the time now. It's a very uncomfortable feeling!

Had a party for my husband's 80th on Wednesday and that was all a bit hectic, but good at the same time. He had a heart valve replacement last November and we are thankful that he was able to reach his 80th as time was running out before the op. They can do amazing things these days, can't they?

How are you feeling now? You sound much more relaxed.

xx Moy

PS You HAVE helped me - thank you!

stoneyrosed profile image
stoneyrosed in reply toMoyB

Hi Moy, I feel so tired all of the time and my heart rate is constantly below 50 bpm. No AF for ten days but everyday I get the feeling it is about to breakthrough. I am trying to be a patient patient 😊. I hope your GP can give you some answers. Hang in there. X

MoyB profile image
MoyB in reply tostoneyrosed

You too! I hope you feel better soon. xx Moy

Lilypocket profile image
Lilypocket in reply tostoneyrosed

HiAre you taking any meds? As you have read after my ablation nearly 5 weeks ago they took me off meds. Heart went into Afib twice so they put me back on . Six calm days then loads of weird arrythmias. Taken off meds again then Pandora's Box opened - the whole gammut of rhythms available presented themselves.

Put on Amiodarone 100 x2 a day for 7 days then 100 x 1 a day. This I must take for 3 months. Will have tests and see cardiologist mid September. But I feel so much better even though I have had 2 episodes of Afib but not too fast. Maybe just maybe as my heart is resting and mending now the ablation may have time to start working . We will just have to wait a few months to know. Each person is different and healing time varies hugely. I just hope you ,Moy , Jane and I have good outcomes 🤞( and anyone else in the same boat of course)

Take care xx

stoneyrosed profile image
stoneyrosed in reply toLilypocket

Hi Lily, I was told to stop taking flecanaide straight after my ablation but to carry on 2.5 bisoprolol and apixiban . I felt ok the first two weeks and then the bpm started to drop down to 43-50 bpm. Then an afib attack followed by two more within a two week period. I asked the cardio nurse if I should go back on flec but he says only if afib becomes troublesome. I have relented going back on flec and have rode the episodes out but I still don’t feel great. No AF for 11 days now, but still get that feeling it is about to kick off. Basically just hoping it will eventually settle but it is really affecting me in a mental sense. I am wary about going back to work because of how I feel but also feel pressure about going back to work which doesn’t help. Fingers crossed for all of us Lilly. X

Lilypocket profile image
Lilypocket in reply tostoneyrosed

I really think it's connected to those of us who are taken off our meds from one day to the next. On reading other post ablation posts the people who stay on meds for at 3-6 months don't seem to have epidodes and have quite good outcomes. I feel that damage may have been done in letting my heart run amok creating a set back in recovery and possibly creating other arrythmias. Thank goodness I found a cardiologist to help me. The EP just said " it's normal to have arrythmia in the blanking period" but surely not as much as I had! I had multiple episodes of Bradycardie, A Flutter ( which EP said he had dealt with during ablation) and my old friend Afib. Take care xx

CDreamer profile image
CDreamer

Oh dear Moy, I would be concerned if the episodes were frequent, very symptomatic and with a high heart rate for more than a few hours ie: 150+. You describe the return of AF as ‘with a vengeance’ but don’t describe your symptoms so it’s a bit difficult to judge without specific information as to how long the episodes last, heart rate, how you feel - I would imagine anxious which is very understandable - as to whether or not it is a matter of urgency. I would get in touch with your arrythmia clinic as soon as possible and discuss.

I can draw parallels with my own experience, felt great for a few weeks and things quickly accelerated to a point when I eventually ended up being admitted and had a second ablation within a few weeks after my first because I was very symptomatic.

Unfortunately A&E is probably the last place you want to be but if you have chest pain, feel very unwell and have a high heart rate for more than a few hours, maybe you should get checked out and call 999. If you do go to A&E under your own steam ask them to ring the EP who performed your ablation as a matter of urgency.

Best wishes and hopefully things will settle on their own for you.

MoyB profile image
MoyB in reply toCDreamer

Thanks for your helpful reply. Fortunately, my heart rate is not going too high at the moment (hope it stays that way!) but my heart rhythm is all over the place most of the time. I have checked it with the Kardia and am registering more 'Possible AF' than before the procedure and also a lot of 'Unclassified'.

I'm going to try and wait it out until Monday, then call the cardio ward where I had it done to see if they can advise me, but if necessary, I will go to A&E. No chest pain so far, just this awful feeling as though my heart is shaking all the time.

xx Moy

Snowgirl65 profile image
Snowgirl65

I hope by now you're back in NSR. I had the same experience as you two weeks after my first (cryo) ablation. My heart was all over the place, much worse than before the procedure. I thought it strange that the first two weeks were fine. Eventually it calmed down, but it was definitely a stressful time. I hope you contacted your EP for advice and things are better now.

MoyB profile image
MoyB in reply toSnowgirl65

Thank you for your reply. It's very comforting to hear that I'm not the only person it's happened to and even more comforting to hear that at least in your case, it calmed down eventually. As it's Sunday, I doubt I can even get through to our hospital, let alone contact the EP, so I'll see if I can wait it out until Monday and reassess the situation then. If things become more extreme, I'll go to A&E.

xx Moy

Snowgirl65 profile image
Snowgirl65 in reply toMoyB

Best of luck to you, MoyB.

MoyB profile image
MoyB in reply toSnowgirl65

👍❤️xx Moy

BlueINR profile image
BlueINR

I would certainly let your doctor know if you have not already. The dang thing about ablation is that it's not a guaranty you'll not have it again. Do talk to your doc ASAP.

MoyB profile image
MoyB in reply toBlueINR

It seems to be settling at last so I'll see how I go over the weekend and speak to my GP on Monday, if I can. Otherwise, I may phone the Cardiac ward where I had it done and ask for their advice.

I feel a bit annoyed that our hospital has given me virtually NO advice beyond what to expect in the first few days. Thank goodness for this forum and the information I've found out from the people on here or I wouldn't have had a clue what to expect when I had the procedure either.

Just before I went in to the Cath Lab, the consultant came to see me and then, for the first time, said, 'Some people need to have it done more than once.' Thankfully, I knew this already.

The information sheets available on here are wonderful, thank goodness, or I wouldn't have had a clue about any of it.

xx Moy

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