Flutter and Eblation possible Cardioversion

[fairyfeathers]

hi to you all

I had a telephone call from an EP who after a quick chat about my symptoms told me I would be having an eblation under sedative and if this was not successful i would have a cardioversion under GA. There is a year waiting list to have eblation but he hoped mine would be done in around 8 weeks. Im a little shocked really and a little scared. I have lung disease and worry about laying still for hours without coughing! Also sedation doesn't seem to work for me. I had a colonoscopy with sedation which didnt work so nurse upped dose which made me feel extremely sick.

I was diagnosed end of June this year with Flutter, etopics and narrow complex reg tachy. I have low BP so Bisoprolol a difficult drug for me. In fact I have issues with meds as react to fillers in tablets. EP said stop Bisoprolol 1.25 as not helping me. I am on Edoxaban 30mg daily. I mentioned my etopics he just said of no concern as normal. Doesn't feel very normal to me. I am not having a device like a Kardia provided by NHS for a few days until after the eblation as it will be helpful apparently to see if eblation a success.

This is all a bit of a shock to me as my telephone chat was very matter of fact and I felt I could not take up his time by asking lots of questions. So thank goodness for this site. He did say he would write to me so im hoping things will become clearer??

[Hidden]

Good Afternoon Fairyfeathers,

It is perfectly normal to have lots of questions regarding treatments and procedures, you may find it helpful to take a look at our information sheets 'Preparing for an Ablation' and 'Recovering from Ablation' which can be found here: heartrhythmalliance.org/afa...

Please do feel free to get in touch with our Patient Services Team 01789 867 502 or [e-mail] who will be more than happy to talk things through with you, as well as offer advice and support.

[fairyfeathers in reply to Hidden]

thank you so much Katrina for your helpful support and advice. I will have a read of the information sheets.

[BobD Volunteer]

I think you may have things reversed as it is common to have a cardioversion (DCCV) to see if you are able to attain normal sinus rhythm (NSR) long before ablation is considered . DCCV is done under deep sedation but only takes around five minutes so is relatively easy to do.

Ablation takes anything from an hour to six hours under GA usually although some EPs who use cryo ablation methods may use sedation as this can be done in around an hour and half in some hospitals. There are limitations of course and not everybody is suitable for Cryo ablation. There is a wealth of information on our main Atrial Fibrillation Association website you can download which will explain everything.

[fairyfeathers]

hi and thank you for your helpful response to my post BobD. Yes, I thought I heard incorrectly but the EP definitely said Eblation under sedation, i suppose Eblation under GA would cost more with longer wait time? Then cardioversion under GA. He had read my notes and looked at an ECG my GP surgery had done. He said you have "typical Flutter" and what he intended to do. He seemed short of time and I was really out of my depth. I hope his letter explains a little more?? Do I need to be concerned about Eblation then he would do Cardioversion if this fails? I suppose I thought the chat with the EP was just to reassure me, perhaps id have a stress echo or a scan of some description some time in the future? He did ask if I was on oxygen for my bronchiectasis I said no.

[Ppiman]

I had atrial fluter in 2019 and was told it wasmuch harder to control than fibrillation except by ablation, which was quicker, safer and near 100% effective. My flutter caused tachycardia (155bpm naturally, 105 bpm with bisoprolol, around 55bpm with digoxin and bisoprolol combined - this latter was the best),. Overall, the AFl left me feeling ill and anxious, with chest discomfort that was hard for me to deal with as, after a few hundred yards, I would feel as if I was about to peg out. Luckily I had an ablation in June that year, under GA, which worked well. AFl ablations are safe and sure, I gather.

If I were you, I'd ask for GA if you are sure sedation won't work well. It will be a different form of sedation compared to colonoscopy, I imagine, one where you will be larger unaware of what is happening. There seems to be a shortage of anaesthetists which means that GA ops are far more delayed than sedation ops.

Steve

[fairyfeathers in reply to Ppiman]

thanks so much for your support and helpful info. My tachycardia makes me feel quite unwell and the flutter causes me to feel light headed and exhausted. The Bisosporol even at a low 1.25 made me feel awful with my tinnitus becoming distracting. I have started using a walking pole as feel light headed and wobbly. Im hoping the EP's letter will contain more information. I think you are correct when you say there is a shortage of anaesthetists. This is all new to me as I had no idea there was any issues with my heart. Im finding it a challenge to keep my anxiety under control as have noticed when I get upset or stressed my heart becomes erratic so have been trying to control my breathing which does help. I will see what EP's letter says and will contact his secretary re my anaesthetic worry. Hope you are feeling ok.

[Ppiman in reply to fairyfeathers]

Hi - thanks for your lovely reply, too. Like many here, I cope well enough as age brings its ailments. Anxiety is a tough one for us that have to deal with it, for sure. Sometimes it seems to bring a kind of depression with it, too, making it even more unwelcome. I'd definitely await the letter and then visit your GP to discuss its contents and what to do next for the best. My EP cardiologist, for example, has prescribed a blood pressure tablet called losartan for prophylaxis and long term heart protection as he said it has been shown to be very useful in that regard, even though mt BP is normal. You might ask about this, perhaps, too?

Steve

[fairyfeathers in reply to Ppiman]

I have made a note of Losartan. There is a 6 week wait to see my GP but I have found the receptionists will put a note thro to him if I have a query and they will get back to me with his response. I just hate feeling anxious all the time even after all these years I just wish for some peace and quiet from my silly overthinking brain.

[Ppiman in reply to fairyfeathers]

You and me are in the same club. The only solace is that such a brain has its positive side without which, perhaps, the world would be a poorer place!

One thing that helped reduce my anxiety a great deal was to have an MRI scan of my heart, which showed that mechanically it was fine and wouldn’t be stopping anytime soon!

Steve

[fairyfeathers in reply to Ppiman]

hi again, presume the MRI of your heart was done privately? I definitely see your reasoning for having one as reassurance re health definitely helps dull the annoying anxiety! Pleased you got the reassurance in this respect.

[Ppiman in reply to fairyfeathers]

Yes - I paid for it. If you search the internet you’ll be surprised how the price for these things has dropped this last few years. It was difficult awaiting the results but, yes, quite a relief that there were no blockages and enlargement or whatever. Not that the anxiety ever goes away by any means.

Steve

[fairyfeathers in reply to Ppiman]

An excellent result. Lovely to get that reassurance but a nuisance that the brain then goes on to the next to get anxious about. Got to accept its part of the way we are made!

[Ppiman in reply to fairyfeathers]

Actually I don’t hear from too many who describe anxiety much as I experience it, so thanks for posting!

Steve

[Buffafly in reply to fairyfeathers]

I have found taking a bp med (Candesartan) very helpful as I am going through a terribly stressful time and had reached the limit of the other medication I take for HR and BP (diltiazem). I used to feel little warning bumps whenever I experienced even a little anxiety. I have to admit it has made me a tiny bit too laid back but worth it to be able to keep going.

[fairyfeathers in reply to Buffafly]

thank you Buffafly. So sorry you are going thro a very stresstressful time, I do hope things settle down for you very soon and you experience the calm you must need. Ive made a note of the medication you mentioned. Sending you a gentle healing hug.

[Buffafly in reply to fairyfeathers]

💞

[jeanjeannie50]

I keep saying this on the forum and regulars will think, here she goes again! I've had lots of cardioversions and I actually love having them. At my hospital, you sit waiting for your turn to be zapped. Then when it comes, you're led into a small ward with beds, you undress and put on one of their gowns. A small group of people including doctors and nurses come along with the machine. They are usually all happy and laughing and you can't help but join in with them (anyone would think it was a party). A cannula is put in the back of your hand and then you're anaesthetised, you're out for about 5 minutes and then when you awake from a very deep sleep your heart is beating perfectly again. A cardioversion has never failed to put me back into normal sinus rhythm. It's the most wonderful feeling to have a normal heart rate again and at times, full of gratitude to the team I've become a bit tearful. I'm offered a cup of tea and piece of toast. Once they see you can eat and drink, well you can go home. You'll need someone to pick you up and stay with you for the rest of the day.

Re ablations, I've had three of these and once again can tell you that you will know little about the actual procedure as your either sedated or given a general anaesthetic. It's the recuperation that can sometimes take a bit of time as you need to rest and let your heart heal.

Trust me, (a devout coward) there is nothing to fear.

Jean

[mrgwair567 in reply to jeanjeannie50]

A very reassuring reply!

[fairyfeathers]

Jean, you made me chuckle😀 with your description of cardioversion experiences. The cup of tea and toast sounds nice! I feel im overthinking everything and this is making me anxious, well even more than normal so your reply has made me smile, so a big thankyou.