my cardiologist had recommended an ablation a year ago but I choose to wait. I’ve had very few episodes on Flecinide and Eliquis. Now he’s saying my heart rate is getting too low and we need to revisit having the ablation. I’m looking for feedback from those who have had the procedure.
cardiac ablation : my cardiologist had... - Atrial Fibrillati...
cardiac ablation
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Rals52
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I've not had CA (catheter ablation) but had a surgical mini-maze about 4vweeks ago.Lots and lots of folks on the AFA site had CA, and I hope that you will receive a reply very soon. Good luck.
i had a catheter ablation nearly a year and a half ago which was a great help although I'm still on flecainide for breakthrough af.
Would be interested to know what 'too low' a HR is, presumably in the daytime. Also how many episodes is 'very few' in the last year. Another issue regarding the ablation decision is do you have any relevant health weaknesses or are you fighting fit!
Hi 😄, my resting HR is 51-52 and has dipped into the high 40s. The side effects from either the Flecinide or the low HR is constant shortness of breath and getting near to passing out. I haven’t had but 2 or 3 episodes of AFib this past year. I also have rheumatoid arthritis an autoimmune disease which seems to be controlled with a medication I take as part of a clinical research project and prednisone. I also take 2 BP medications. I recently just recovered from COVID. The medications I take to control my RA lowers my immune system so that is another concern with getting the ablation.
Hi Rals - to be honest I would question that reasoning because usually the first treatment option would be pace maker for low HR. How symptomatic are you? How low does your HR go - these are all things that will be considered before a decision is made as to best course of action. The thinking could be that would make an ablation more complicated. HOWEVER, I understand that ablation is sometimes used if you have TBS - TachyBradicardia - where the heart goes slow or pauses and then very fast?
Ask a lot more questions and ensure you understand the answers and the consequences before you decide would be my suggestion. You will find a lot of information on the AFA website.
heartrhythmalliance.org/aa/...
Hi, my resting HR is 51-52 and it has dipped into the high 40s. The Flecinide has controlled the AFib. I haven’t had an episode in well over 6 months. The low HR is causing me to be short of breath and have had a few episodes of nearly passing out. The pacemaker would control the low HR but it seems to me that it would make more sense to have the ablation with the goal of getting off the Flecinide. Having the ablation and then going through the recovery are a bit scary to me.
☹️
please don’t be afraid of the ablation it will be over before you know it. I was freaking out the first time but what I discovered was from the time I entered the hospital the staff took over and suddenly I felt pampered and safe. Depending on your doctor they may give you a cocktail before it. I had a tough Doctor No cocktail. That being said I actually had a big delay waiting for my ablation but they made me comfortable and even put me in a room rather than where I had been waiting. Once I knew I was in capable hands everything seemed smooth and the next thing you know I was waking up and was home after dinner time. I walked up the walkway and I remember waking the next morning amazed at how good I felt. We all have different reactions but I had two ablations and the second one was even better. I practically skipped up my walkway lol it was probably the drugs I admit but again I woke up feeling so much better. I think the hardest part is waiting to get to the hospital and having them take over. As long as you trust and have faith in your doctor you’ve got this.
Thank you so much for the positive reinforcement. I really need to hear that it makes a difference and it’s not as scary as it sounds.
We all need that that’s what’s great about this site. Sometimes we need a little bit of shaking also to snap us out of things. I can be direct and some may not like it but I’m not doing it to be a meanie. I like the truth I may not like what it is but I want straight answers so that’s what I give others. Otherwise we tend to imagine things. Like I said I was terrified of a cardioversion and really had a hard time of it even more than any ablations. The people here got me calm enough to go and get it. Lol my new doctor also got me good because I went in for an echo and did not know until that morning in the hospital that he decided if the echo was good he would just continue on with the cardioversion. I had a TEE so I was halfway there to begin with and it made sense. The good thing about it also was I knew it made sense to agree to have it done. This site is terrific
I had excessive PVCs (>34% burden) for a number of years with the last years being extremely symptomatic. I held off on getting an ablation because I was scared. I got pregnant and had scary episodes of PVCs and symptoms; I lost that pregnancy. My cardiologist ordered a cardiac MRI because my EF was lower than 50%. Those results came back normal but my doctor was afraid my heart would get weaker. I decided to have catheter ablation done 8 months later. The EP thought it would be slightly complicated because he expected he would need to work in left ventricle in addition to right ventricle. However, during the procedure he found all of the PVCS originated in the right.
The recovery part wasn't bad besides the first few hours. I had to lie flat and still to make sure I didn't bleeding out in the incision site (femoral artery) and I was sore for a few days. I don't regret having it done because I don't have PVCs anymore! No more symptoms either. I feel normal. I tried medication first...metoprolol but my BP is already on the low end (90/60 before ablation). So the meds would make me dizzy and have more PVCs.
Thanks for sharing your story. I’m scared and I guess I’m looking for confirmation that others have had success with an ablation.
I am so sorry for your loss. One thing I might mention if you have not heard of it and if you need another going forward. They now have a new product that they use instead of putting weight or pressure on your artery. I’m sorry I forget the name of it but it is great. I did not have the soreness and bleeding as previously. I had three entries my groin, my neck and my wrist. I had it done in Florida and again since I have moved to Texas so it must be getting used more. I know I have the pamphlet around somewhere if I find it I’ll let you all know about it. When they have things to help us with coughing, nausea or to stop bleeding easier without pain why don’t they just use that stuff instead of putting it on us to know about it and ask for it? I did not have to ask for them to use this for bleeding.
Okay thank you . I ended up having another pregnancy, which went well. My heart did fine since I had had the ablation . I wish I had done it sooner because my heart functioning decreased some (EF went from > 55% to 50%), most likely from having the PVCS for so long. I'm just happy that my quality of life improved so much. I had gotten to the point where I was having chest pains and palpitations frequently.
I am so happy to know you have had happiness. My new EP just told me that he cannot continue to let me go with the high heart rate because yes damage is being done. Nothing substantial yet and he doesn’t wanna wait until it is. They were horrified to know I had a heart rate in the 150s for almost 6 months straight. My loop recorder confirms it. To see me and if you could feel what I felt you would think I was having a full heart attack with the chest pain, nausea etc. I was just like a walking heart attack list. As you know know I have had a couple of procedures. I will be having my second cardioversion Tuesday and new meds and I’m hoping I can become very boring and nothing else new for a long time. Unfortunately a fib has no cure and sometimes our bodies get used to our medication etc. so something needs to be done again. One day at a time be happy with yourself when you’re feeling good. It sounds like you know that😊 Life does not come with any guarantees
It's entirely possible that the falling HR was caused by the Flecainide. If not the cause then it may have been a significant contributing factor. Flecainide can cause bradycardia.
TY, yes cardiologist believes it’s caused by the Flecinide. The other option he presented was to add a pacemaker. I know it makes more sense to have the ablation and hope I could stop the Flecinide. The idea of messing with my heart is just really scary.
I would always prefer ablation to a lifetime of medication. You will be messing with your heart further if you opt for a pacemaker as the wires go through arteries into your heart and remain there forever. Were you properly warned of the dangers of Flecainide and regularly monitored? Talk of pacemakers leads me to think that the Flecainide has already done a lot of damage to your heart. I really hope that this is not the case.
need to find outwhat too low is and what causes it. I thought mine was fitness and exercise but turned out it was a leaky heart valve and after that was dealt with a pacemaker ws inserted to stop my heart going below 60.
Thanks for your quick response. My resting HR is 51-52 bpm and I’ve had a few episodes of almost passing out. My cardiologist is sure it’s from the Flecinide. He said could do a pacemaker but if it’s caused by the Flecinide it would make more sense to do the ablation. The goal would be after the ablation I could stop the Flecinide. I’m just a bit terrified of having the ablation or the pacemaker.
I’ve had both and now have almost no AF, my heart is strong, I haven’t taken any heart drugs for 9 years now - the drugs did me a lot more harm than either ablation or pacemaker.
Flecainide is a very toxic drug - better without if possible. The recovery is variable for different people but typical for most people is 2 weeks to recover for wounds to heal & its a tiny, tiny incision & then a gradual return to normal life feeling a lot better.
In order to get through this you need to put on your big girl pants, get loads of support in place & positive mindset & you will fly.
We will be here to support & answer questions.
thanks for your response. I e had full hip replacement, cataract surgery, esophageal hernia repair and made it through covid in the last 3 years, I guess I can handle this but it’s the heart so much scarier.
I don’t know if I’m the only one that noticed but it seems that anything to keep us in rhythm seems to have horrible side effects etc I am about to be put on Dofetilide. It requires staying in the ICU as well as being monitored EKG every two hours for at least five doses or three days plus. This makes me more nervous than anything I’ve had done so far but if it keeps me in rhythm this time I’m willing to try. I have tachycardia at this point. I just had six months of heart rate constantly in the 150s without a break and I have a loop monitor to prove it. My cardioversion worked so this medicine will keep me feeling as good as I did for 3 1/2 weeks I’ll take it as long as I need to
I had my ablation in June of this year, something I was a bit reluctant to have but medical intervention options had run out. My AF was not as bad as many on this forum, but it was affecting my quality of life (indeed I took early retirement) so I decided on having the procedure. Since then I have not had any AF, just a couple of sessions of ectopics, the day after the ablation I had an optical migraine (see previous posts on this), which disappeared after a day.
It’s only when you no longer have AF episodes that you realise just how much they can affect you (but some people do not suffer while having AF), but I am so grateful that for now I am without them!
I thought I was asymptomatic and had been for years. The bisoprolol took my hr down too low at times so I wanted an ablation rather than upping the dose.
I had an ablation in July 2020 and haven't had an episode of AF since. Although I thought that, in spite of my hr averaging about 140 for a third of the week, it wasn't having an bad effect on my health I can now see that it was. I am able to do things that I would have avoided before.
All in all, I am only taking the Eliquis and feel fine.
so good to hear you have quality of life again. I absolutely know how it affects me. Trying to walk across the room and breathe and not have pain in my chest or in my arms and legs because of lack of circulation are just a few of the things never mind trying to stand and do a load of laundry or dishes. To those of you who do not suffer that way I am very happy for you. Those of us that go for the ablation at Cetera want to feel the same way that’s why we do it.
I had a catheter ablation in august, and felt horrible for 1-2 weeks. Very inflamed chest, some difficulty breathing, pretty exhausted. It was much worse than I anticipated. I went on Bisoprolol and Flec post op but I really suffered with low HR (mid 40s) and light headedness. My normal resting HR is low 50s. My consultant quickly took me off the Bisoprolol and that improved things and at 6 weeks moved me to Flec as a PiP. Again, my HR improved.
Unfortunately I was still getting AF prompted by exercise so had a repeat ablation a week ago. (When I took Bis+Flec as a PiP I always had 24-48hrs of feeling urrggh due to depressed HR). Second time round my recovery couldn’t be more different! Within a day I felt completely normal, and had to keep reminding myself to go- steady because of the groin wound! Time will tell on its success, but based on general feedback and my second experience it’s most normal to have few post op problems.
If your incidence of AF is low I’d speak to your consultant about moving to Flec as a PiP. Whichever way you go, good luck 👍
thanks I appreciate the response and the details on your ablation. Everyone sounds very brave in getting the ablation so hopefully I’ll hang onto everyone’s positive experience. I want to stop these meds and feel somewhat normal.
I don’t know why you mention stopping meds because you probably will need some thing to keep you in sinus rhythm. At least for a while. Just be aware of that if no one told you. I have been on Multaq and Metropolol. This time I will be on a stronger med hopefully that will keep me in rhythm. They will never get my blood thinner away from me lol my EP said I will probably always be on it. Previously I’ve had a doctor mention coming off of it and that is what scared me. I will not take a chance of having a stroke if I can help it.
just remember one day at a time even with meds. I was taken off Multaq because I was not NSR and it makes no sense to take it. That was my Doctor Who decided not me. I will do whatever it takes to feel normal again.
I’m guessing your Cardiologist will know best. Too low is just as bad is too high. It’s good that he waited because what I’m finding out now is that too many ablations can cause scarring. I had an extensive one back in April I’m thinking that’s where the problem for me is it was not just one spot. If he wants to do one for you he probably feels sure it’s going to help. My new EP is hesitant because of the scarring and the fact that mine is atypical flutter which is very hard to map. I think our doctors want to feel sure that what they do to us is worthwhile. If you like your doctor and you trust him please listen to him. It is normal to be nervous and hesitant no one wants any type of surgery. Some people say it’s not surgery but I asked my EP what the difference was between surgery and procedure and he said there is no difference. I think they say procedure because it sounds less scary. When you are in the hospital the staff will take over and just whirl you through everything. It will be over before you know it. The only problem I had the first time was a cough when I woke up and the next time around they made sure they gave me a medication with my anesthesia so that has not happened again.
My one common theme you’ll hear from me on here is what do you have to lose? If you’re feeling lousy odds are pretty good you’re gonna feel much better when you wake up and have some quality of life again.
That’s what I’m hoping for, some quality of life back. Thanks for answering my question. I’m going on a very long trip for vacation and I’m hating that I’m having to worry about AFib or Flecinide side effects.
don’t worry it will only make you feel worse. You already have a fib what’s to worry about? If you’re not having side effects you probably won’t have them while you are away. Usually it’s just in the beginning. I honestly have only had side effects with Amiodarone. If I were on that I would not be going anywhere. As much as we don’t like it we must embrace the fact a fib is now part of our lives whether it behaves or not. Don’t stop living your life because of it just do what you need to do. Enjoy the trip. As long as you don’t push yourself and try to do things you shouldn’t you will be fine. I might hold off on the bungee jumping is someone mentioned earlier lol just pace yourself and enjoy
lol, I’ll heed your advice and forgo the bungee jumping. My travels will be to Egypt & the Middle East . I usually don’t let my medical issues stop me from enjoying life but haven’t ventured this far from home. I’ll schedule the ablation when I get back home.
please try to avoid repelling down any pyramid soul self lol. What a wonderful trip that sounds like. Enjoy and please let me know when you’re getting your ablation 😊
Visiting the pyramids has been on my bucket list, so I’m excited to go. From what I’ve been reading here, it seems the recovery time from cardiac ablation isn’t very long so I’m going to check with my cardiologist and see if I can have it done in March so I’ll be ready for spring & summer !
The ablation might be a good thing for various reasons. I was told by my EP that many permanently have a slightly higher HR after the procedure, and that was my case. I had low HR, but it didn't cause symptoms and he wasn't concerned with it. At night, it would commonly drop to high 30's/low 40's. I had my ablation last June and after things calmed down, my HR is about 10bpm higher than it was pretty much at any given time. I will be around 50 - 55 at night when sleeping. So the ablation might alleviate your Afib and raise your HR to normal levels.
That’s what my cardiologist is expecting…to alleviate the AFib and stop the Flecinide which should bring my HR back to normal. My first episode of AFib lasted 7 days before it went back to normal rhythm. I was having 3 - 4 episodes a week until the Flecinide kicked in and started to work. The AFib has been fairly controlled on the medication but the side effects are limiting my quality of life.
My hr in afib was always very fast so different symptoms. But the abalations were fine, I had one for Afib then another for AFlutter a month later. Both whilst concious under sedation The first was a PVI cryoablation, left atria. No issues. Slight pain on the cryo part but it is only like the brain freeze biting into a very cold ice cream on a hot day, but lasts a few minutes for each of the four pulmonary veins. I also got a feeling that was exactly like swallowing something and it "getting stuck" at heart level, which was quite painful and it was the last vein I think, however I had a drink of water immediately I went to the recovery room, and it very much decreased. An hour later I was eating a chicken and stuffing sandwich pain free! Went home the same night.
The second RF ablation for reentrant Atrial flutter, a little more painful, the pain was in the right shoulder. Far from agony. A few small burns were required. Nothing lasted beyond the ablation. Again home the same day.
I have not had afib nor flutter since. Coming up to 5 years. I also have not taken any drugs except Paracetamol since May 15 2018! (Just over 3 months post the second ablation).
I was fit and had no other comorbidities.
I was taking flecainide and diltiazem pre ablation.
Not medically trained just what I experienced.
Best wishes.
Oh my goodness you are awake. I have been put out even for my cardioversion. Do what you want to me but knock me out please. You are quite the warrior. The only pain I had after the first was is my throat from the tubes etc. and coughing. The next day I felt great except for those and aches. It felt as though I had been either in the same position too long or are used as a football lol yes I notice shoulder pain after the second but again I think it might be the position we are in for so long. My third was a VOM plus other areas. I have not felt well since that and now with new doctors. I had a great cardioversion in October unfortunately it did not last so Tuesday I am having another and being put on new meds that are supposed to be very good. Fingers crossed that I feel as good as last time and I get to keep it longer. Five years of feeling good that would be heaven. after the cardioversion in October just walking to the car feeling like a new person compared to the one that entered the hospital that morning made me want to cry I was so happy as well as a heart rate gone from 158 that morning to 82.
My first was a cryo- only lasted six months they said it was a one shot deal the RF lasted a year and a half. My new doctor is unsure about another one due to scarring because atypical flutter is so hard to map. One step at a time Tuesday I’m hoping for the best. I will be in I see you a couple of days due to the monitoring of the new med including EKG every two hours for at least five doses.
every time I see someone feeling good for as long as you have it gives me hope thank you
That is the medications I’m taking, flecainide and diltiazem plus Eliquis. I do have rheumatoid arthritis, an autoimmune disease, which is controlled with medication from a clinical research project I’m in and prednisone. I’m not sure how that will affect my ablation. The RA medication does suppress the immune system. In the past surgeries I’ve had to stop the RA medications prior to surgery and fight after surgery.
just out of interest, why do you think its the flecainide thats slowing your HR down, if you are also taking the diltiazem? The flecaindide is a rhythm control drug, whilst the dilatiazem is used for AFib as a rate control drug, and lowering your HR is what it is supposed to do!. it defintely lowered mine, unfortunately a bit too much at the 200Mg modified release I was prescribed, I tried 120mg and it was a quite a bit better, but owing to a lot of things the medics put me back on 200mg, which I put up with until after my ablation.
I had quite a few side effects on Diltiazem
Not medically trained just what it did to me
That’s a very good question! They did lower my Diltiazem dosage to 120 mg a few months ago. I also take Losartan for a HBP. The cardiologist seemed to imply my symptoms were from the Flecinide. I’m might see if he can try another blood pressure medication instead of the Diltiazem after the ablation. I think the AFib started after taking the losartan because they had to add potassium pills. Which I believe caused the AFib, but I’m not medically trained either. I might try for a second opinion before having the ablation.
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