Afib post ablation

[Cassag]

I am 8 days post ablation for flutter. Have had one or two short bursts of arrhythmia but today have been in a afib all afternoon. Does this mean ablation has failed or is it too early ? I am still taking flecanide 50 mg bd.

[jeanjeannie50]

It doesn't mean your ablation has failed as it takes time for the heart to form scar tissue to block the rogue beats.

I had the same as you after my third ablation. I telephoned my EP's nurse and she arranged a cardioversion. Contact the hospital where you had your procedure and ask to speak to the EP's secretary or the AF nurse.

Jean

[Cassag in reply to jeanjeannie50]

Thank you

[Cassag in reply to jeanjeannie50]

Thank you . Why 3ablations

[jeanjeannie50 in reply to Cassag]

The first two didn't help much, in fact my attacks became worse and lasted longer. The third did, but I still have AF now at a low rate between 60-90. My EP said some people aren't helped by them and I'm one of them.

[champdoberman in reply to jeanjeannie50]

I have had 9 ablations- to no avail; Best results to you

[jeanjeannie50 in reply to champdoberman]

My goodness. I think the highest amount of ablations I've heard of before on this forum is 7, but you are now the leader with 9. Are you in the US or UK?

[champdoberman in reply to jeanjeannie50]

us; I left my electrophysiologist after he wanted to do another ablation or the new Maze procedure on the back of the heart ( with heart surgeon); or a single lead, double lead pace maker.

I went to a cardiologist {a plumber not an electrician}no more ablations, no pace maker, trying new meds and watching my loop recorder more closely

[Gumbie_Cat in reply to champdoberman]

I’m wondering now if I’m lucky in some ways that my EP has looked at my failed ablation and decided that any more will be in vain. Rate control only for me now. I was desperately disappointed, but perhaps it is better that he recognised that I’m one of those it isn’t going to work on.

[Cassag in reply to Gumbie_Cat]

Thank you. That will be a consideration as I have an enlarged atrium. I may give one more try since they only did flutter ablation .

[Gumbie_Cat in reply to Cassag]

I wouldn’t worry at all about those short bursts you have had. I think mine was just very resistant - went back into persistent AFib within 2 days. I’m not sure of the health system in Australia, but certainly in the UK they only advise procedures if they definitely think it will help. I would have gone for another ablation if it had been advised. Does the trick for lots of people!

[BobD Volunteer]

NO .please read this and stop worrying.

healthunlocked.com/redirect...

[Cassag in reply to BobD]

That is the hardest think to do and not sleeping doesn't help !

[mjames1]

It depends on what the bursts of arrhythmia are.

Unlike with afib, there is no blanking period with a typical aflutter ablation (right side of heart).

So, if the arrhythmia was typical flutter, then the ablation likely failed. That's what happened to me recently and two ep's confirmed as such.

On the other hand, there is a possibility that the flutter is atypical flutter (from the left side) in which case, the ablation was a likely success, but probably fixed the wrong thing! Atypical flutter is much less likely if you haven't had a previous afib ablation, but still a possibility.

Since flutter episodes are often short, you might want to try and take an ekg at home with a device like the Kardia 6L. It won't tell you if the flutter is typical or atypical, but it will give a good indication if flutter is back.

Sorry about the afib, but getting rid of flutter often will increase the frequency of afib. That's why the usual convention now (at least in the US) is to do both the aflutter ablation and a PVI for afib at the same time.

Sounds like you may need a PVI in the future. I'm getting one and at the same time they will re-do my aflutter ablation if needed.

Jim

[Cassag in reply to mjames1]

Thank you . The report says afib and atypical flutter probably SVT noted AV junctional pathway. I am not entirely sure what they ablated .The report says the isthmus was blocked.

[mjames1]

It's a little unclear to me what they actually did. Sounds like they did a typical flutter ablation. Not sure if they did an SVT ablation and/or an afib ablation And if they additionally ablated anything for atypical flutter. Get them to explain to you exactly what they did.

[Cassag in reply to mjames1]

Cavotricuspid isthmus with bi directional isthmus block. I think that is flutter ?

[mjames1 in reply to Cassag]

I believe that is typical aflutter on the right side. However, that report also mentions SVT, atypical flutter and afib. I would call the doctor or nurse and have them spell out exactly what kind of ablation you had. Did they ablate the flutter line? (right side). Did they do an SVT ablation? (also right side). DId they do an afib PVI? (left side). Did they ablate anything else for atypical flutter? Did they do anything else not listed? That would be for starters.

Jim

[ETHEL103 in reply to Cassag]

That's what I had last May even though for 2 years during the pandemic my kardia was showing possible a fib.

[DawnTX]

If you haven’t seen it on here yet, you will hear about the blanking period. It is far too early to even consider calling it a failure. You need to heal. I am in my first month with my new pacemaker, and I had a horrible event the other day. It takes time even if you cut your finger it takes time to heal so think about what you just had done and be kind to yourself and relax. A fib does what a fib wants to do.

As far as the ablation failing, it isn’t so much that it fails in the way it was done, but that it didn’t quite get the right spot. I recently had it explained to me by my EP that you can be a millimeter off and it will not be successful. I had three ablations also. My first two were great the last one a year ago. April has been a nightmare because it was very aggressive and was in more than one area but most of all it appears it did not get the right spot or spots. A fib is not curable if you don’t know that yet. they do what they can to help us with the symptoms of it. There are no guarantees. I have been through just about everything and nothing worked for me. From ablations and medication’s to cardioversions a month ago I got a pacemaker, and it looks like it was the best decision I could’ve made. That being said, it could take up to six months to heal and have my body adjust to everything. A pacemaker also does not help with flutter and I not only have flutter, but it is atypical. don’t be afraid to ask questions here and better yet. Read some of the people on here because they will be some of your best supporters and educators. We are all so different that someone here will probably have dealt with or are dealing with now what you are. hang in there you are not alone

[Cassag in reply to DawnTX]

Thank you. I have read people talking about the blanking period. Does it mean recovery period ? You are right about a fib doing what it wants. Stops and starts at random, that is why it is hard to plan a day ahead !

[DawnTX in reply to Cassag]

I am not sure what it means. I am not from the UK but I guess you could call it recovery. Last week I had my best week yet since my pacemaker was fitted and yet Saturday was a nightmare that knocked me right off my feet. I have a 24 hour hotline and I actually called it. I was so upset and felt so poorly. My biggest concern was that I had somehow moved my leads of my pacemaker. I was in pain and breathless, and almost felt like I did before I AV node ablation. Thankfully, I am now back to feeling good again.

Yes when it comes to a fib, one of the first things I learned was that it does what it wants to do. My first year and a half was pretty good I had to ablations. I almost forgot I had afib. When it returns again, though, it was obvious my party was over. Because I had just moved to another state it took time for me to get situated with insurance and a doctor. The next ablation was very aggressive and I went downhill from there. Just know many people are successful with just medication others with an ablation as I told you we are all different. Make sure you are happy with your doctor and feel safe with him. You will know what I mean when you feel it. do you want a Doctor Who cares about your quality of life. My new one is passionate about that. He wants to get us to quality of life the shortest way possible. He will try the other methods, but does not believe in repeating failure. I did not think I would ever feel normal again but if the way I am feeling now is an indicator. I am very happy. Just know there is light at the end of the tunnel. Plus they are working on new things every day. Best of luck. Don’t ever be afraid to ask questions here or pick up the phone and call your doctor. As they have always said, knowledge is power.

[mjames1 in reply to Cassag]

Again, no blanking period for a typical flutter ablation. Blanking period is for an afib ablation, and that's where the confusion lies. So if all you got was a typical aflutter ablation (right side) and you are having flutter episodes, then the ablation probably did not work. That's why it's important to find out exactly what they ablated.

Jim

[ETHEL103 in reply to mjames1]

Your heart is still scarred so why no blanking?

[mjames1 in reply to ETHEL103]

The blanking period is more authority/consensus  based than evidence based. 

The consensus among the authorites (ep's) is that there is a blanking period after afib ablation, but no blanking period after typical aflutter ablation. 

Jim

[ETHEL103 in reply to mjames1]

OK thanks .

[Singwell]

Just hang in there as it's very early days. But do call the cardiology department and tell them what's going on. They can advise.

[ETHEL103]

Hi you said ablation for flutter and now a fib is that correct?

[Cassag in reply to ETHEL103]

I had afib as well before procedure. A cardioversion was done before they went ahead.

[ETHEL103 in reply to Cassag]

Ah I see.As I said I thought I did to but during the ablation couldn't trigger it so didn't do anything except the flutter which I'm.extremely grateful for .

[Cassag in reply to ETHEL103]

I think It was the same for me, they said they could not trigger svt. But now I am in a fib with pulse around 100, not sure if I should worry or just wait for healing.

[ETHEL103 in reply to Cassag]

I don't know about you but I constantly worry about my heart.If I am busy that's fine but if you feel any arrhythmia of any sorts it brings it all to the fore and anxiety creeps in.

[Cassag]

I agree. I don't sleep when i worry and that makes it worse. I try meditation . I am depressed now because I thought the ablation would fix things first time found .

[Down10FTN]

I am 4 weeks post ablation. A week after my cryoablation I went back to work and the gym. Simply bending over at the waist would fire my heart from 60 to 140 bpm. This was about 1 second up and 1 second back down. Totally normal while the heart fig'rs out what its new role is. These spikes were under load, simply bending over, or just tying my shoes. Upside is I could feel it coming-tightness in chest- and they were very brief. If I had a weight or was sprinting on a bike, I found no difference in stopping or powering through. Called my EP and she said "Totally normal." Happens less as time goes on. BobD has a couple links that EVERYONE should read.

Glad you're doing well!

[Lonelytraveller]

Hi Cassag,

Probably many people mentioned this but 8 days is so early and the first 1-2 months post ablation are restless. The psychology may be hard to manage and the disturbances you currently have do not mean that the ablation failed. I suggest you keep calm and wait for your examination in the end of the blanking period. Good luck.