Ablation done.

[Jonco]

hello all, I wanted to share my recent ablation experience in the event it helps/informs.

My headlines are.

Diagnosed with AF in April ‘22 after attending gp’ with high stuttering heart rate.

prescribed bisoprolol and apixaban.

Remained in AF until cardioversion in May, established NSR but sadly for 2 days only.

Subsequent echo and CT scan unearthed a bicuspid aortic valve with mild/moderate stenosis. No immediate concern from consultant around this, I am now on a monitoring plan.

I remained in persistent AF, though it was much less symptomatic.

I was offered catheter ablation which was performed on Monday 27 feb.

They restored NSR I was discharged later that day.

Later in the evening I began to develop stomach pain which quickly became unbearable.

Long story short I was re admitted to the coronary care unit where after 2 days of scans , monitoring etc the doctor believes i have inflammation of the heart lining, possibly triggered by the ablation.

Despite the worry, lack of sleep etc I have remained in NSR, the pain in my stomach/chest is all but gone and I am reassured that outside the known issues I have a healthy heart.

This has been quite a journey for me I questioned whether I should have the ablation but I think more out of fear of the unknown. Having had it now I know that if I need the same process again I wouldn’t be daunted by it, the anticipation is worse that the event.

I have been helped by the posts on this site a lot.

The hospital staff were without exception outstanding, and reinforced just how invaluable our NHS is.

my plan is to gradually build my fitness, up until AF I was a racing cyclist, I’ve adjusted my horizons somewhat but hope to get back on the bike in some form or other.

I suppose my main point is that there are many factors weighing on a decision for elective surgery, and they are personal. One of mine was fear of the unknown but having had the ablation my experience is that it is a relatively pain free job, I was sedated but can’t really remember a thing,

Thanks

Jon

[Gumbie_Cat]

You’ve had a rough ride, but great news about the NSR. Mine doesn’t seem to have worked out as well in that respect, but I am a lot less scared about another procedure - if it’s offered. Not quite at the 3 month stage yet.

All the best!

[Jonco in reply to Gumbie_Cat]

thank you, early days for me I know, I’m sorry yours doesn’t seem to have gone to plan. From the conversations I’ve had with my EP and my own research further procedures are often more successful. As we personally now know the procedure is relatively straightforward. Fingers crossed for you.

Thanks

Jon

[BobD Volunteer]

Good to have validation Jonco. We tell people this many times that the fear is their worst enemy and that once done they will laugh at their reluctance. Thank you and as you say do re-appraise your horizons. Racing cyclists are prime candidates for AF as I'm sure you have been told countless times.

[Jonco in reply to BobD]

Thanks Bob, I agree completely now, if the only negative tick in the decision making box is worry over the procedure then I would press on. My big concern was being sedated for a 2 -3 hour procedure, in the event it seemed like 2 minutes. Worst bits are waiting to go in, but again that was fear of the unknown. I’ve also now seen anecdotal evidence around endurance athletes being prone to AF, I certainly used to wind my ticker up to the max regularly, I believe that lifestyle coupled with a bad bout of covid triggered me into AF. On the plus they discovered a congenital issue that may have seen me off asymptomatically. In the round I’m ahead I reckon.

Cheers

Jon

[pusillanimous]

You'll be back on your bike in no time. My son belongs to the same group of extreme athletes as you, who are prone to AF (he also had the disadvantage of being a candidate for familial AF) he is a competition canoeist and white water rafter - one of the members of the canoe club is a cardiologist, who frequently diagnoses members. My son was relatively young, (35) and had his ablation 17 years ago, and has since recovery, canoed , cycled, hiked and he ran a marathon the other day. His frequent checks are all good, he thinks positively, works hard (is a director of 8 companies) - I'm sure you will be the same !

[Jonco in reply to pusillanimous]

thank you, that’s all good to hear, I hope I can follow the same path, we’ll see, it’s always good to hear positive results.

[KMRobbo]

Great post! Best wishes that this sorts it for you

[Jonco in reply to KMRobbo]

thank you and fingers crossed

[Jfbould1]

Hi John, very good to hear you’re feeling close to walking out of the woods on the procedure. I’m curious as to why your care team apparently didn’t try an antiarrythmic, if you’d care to share on that? I’m in my 8th year of using one, first flecainide then propafenone. I get several relatively short episodes a month, typically I can link them to alcohol or coffee consumption. My family keeps helpfully suggesting an ablation. I’m not worried about the procedure per se, but I’m not convinced on the rate of success.

[Jonco in reply to Jfbould1]

Hi thank you for your kind words. I think in my case I was already In persistent AF on first meeting my EP and that and my wants tailored his approach. His initial plan was rate control, anticoagulant, cardioversion and if that held he would prescribe a pill in pocket. (Unfortunately it didn’t) He also said that if that first cardioversion didn’t work he would consider an ablation. During our conversation I was clear that my objectives were to get out of AF and off meds. If my AF had been sporadic I may have considered a different route. As it was I was stuck with a stuttering beat, high rate and high BP, all controlled to a degree by meds. I was told that for me it was about a 60% chance of success on first go of ablation with a higher success if a second is required, plus the potential for improved symptoms if not entirely successful, I weighed this against the risks and that AF can be progressive and thought it was worth it. But my HR is now lower, my BP is a lot lower, though I am still on 2.5 bisaprolol daily pending my 3 month review, and I’m aware it’s early days. I hope this helps and sorry to go on but I’ve tried to add context.

[Jfbould1 in reply to Jonco]

Sincerely appreciate your sharing and wish you all the best.

[WJ85 in reply to Jonco]

Hi Jonco. You have an interesting story and it is 100% helping others with their journey. Can I ask whether you were put on amiodarone before or after your procedure for persistent AF?

[Jonco in reply to WJ85]

Hello, consultant just had me on apixaban and bisaprolol for rate control. There was a discussion about a pill in pocket if the cardioversion worked but that became a moot point. I’m still in nsr and still on bisaprolol and apixaban pending my 3 month review.

[WJ85 in reply to Jonco]

I'm currently in persistent AF and I've been asked whether I want to take amiodarone now and after the procedure which I'm not keen on. My procedure will be a PVI initially. You mention that yours was a 2 to 3 hr procedure, are you aware that they did anything other than PVI during yours?

[Jonco in reply to WJ85]

No, nothing other than PV, all 4 sequentially treated

[Cabinessence]

Just googled this today as I started Bisoprolol 5mg and Apixaban on Monday having spent the weekend in Barts with my chest looking like it had a ferret inside the skin running around like crazy. I've had episodic AF ( I realise now) for nearly 20 years and definitely booze related, but which has become much more sensitive over the past couple of years. I had Covid in 2020 and it seems to have gotten worse since then, despite me dramatically cutting down on booze. Last weekend's episode took just 2 pints of 3.5% proof beer to trigger. Up until the weekend I'd self-medicated for 20 yrs using Hawthorn which had worked really well. Also, up until Saturday the hoopla that my heart goes through although uncomfortable, had been painless, but this time it was accompanied by pain with each stutter and contraction, which is what finally prompted me to call 999. Since then I've been in semi permanent AF with the medication thus far seeming to have no effect.

A thousand questions but firstly, does anyone know how long the Bisoprolol takes to kick in and what's the chances of it making the AF symptoms lessen? I'm really tired at the moment but no other side effects yet. Can I expect that to receed as I get used to the medication?

I too am an ex-high intensity trainer with a resting beat of 56, even though I'm 68. 20 odd years of doing over a thousand sit-ups, several hundred press ups and squat thrusts/burpees per session, followed by an hour of weights three times per week. Is the link that well established?

I've read the beta-blockers can cause impotence which is a major fear. Can anyone confirm that? At the moment any physical movement e.g. climbing the stairs seems to be triggering a new episode and I'm gagging to get back down the gym (I gave up that high intensity stuff about 5 years ago) just to do some light work, but am worried what might happen. How much capacity does having the ablation have on the heart? I realise it's probably early days to be talking ablation but after 5 days on meds having had no effect, I'm already looking past medication as an alternative. Silly I know.

Many thanks in anticipation. So glad I found this place.

[Jonco in reply to Cabinessence]

hi, sorry for delay. Bisaprolol kicked in almost immediately for me, it left me feeling tired and groggy, I think it still does but after 12 months of it I think I’ve adjusted to it, other than tiredness I didn’t suffer any other side effects. Since the ablation I’m still in nsr, my improvements though have been gradual rather than a kick start, that maybe psychological on my part too though. I’m back on the bike, swimming and gym though I don’t go anywhere near my pre AF numbers, that’s not to say I don’t train hard I just don’t spend any time at max heart rate. I’m off alcohol now and caffeine intake has been slashed. I’m waiting on my 3 month review and I’ll see what my EP thinks, I feel a lot better and my pulse seems regular. I hope you are doing well.

[Hidden]

Hi Jonco Thank you for your encouraging post.

I am a bit older than you (69) and enjoy cycling and walking.

Like you when I was first diagnosed with persistent AF I was very focused on getting it fixed and having my oomph back.

However after two failed cardioversions I have (reluctantly !) decided to stick with medication and just take life a little slower to see how that goes.

Both Cardioversions failed after a few days but the days following the second one (on 13th Jan 2023) slowed me down very significantly and gave me a thumping headache that prevented me from sleeping for 4 nights until it failed.

I attended A&E for two full days for observation, chest x-ray and CT scan but nothing was found. While in A&E on the second day my heart went back into AF and I felt well again immediately.

The Cardiologist could not give me a reason/explanation for what had happened or why I had a very different experience the second time round.

I was taking Amiodarone before the second Cardioversion and my resting HR afterwards was 52bpm but the Cardiologist did not believe either to be significant.

I don't have a fear of having the Ablation procudure but, from this recent experience, I am concerned that I could end up in a worse condition than on medication.

I have not been on this forum much since then but have been inspired by your positive experience... thank you.

I guess I do have a fear of the unknown, but more importantly a fear of making matters worse and being stuck with the consequences.

I wonder if the forum is more about the difficulties encountered rather than successful experiences/outcomes.

I will think about that and keep an open mind.

Thank you again.