my husband had his ablation on 12th June and has had problems every since. He didn’t have any episodes in the year leading up to it but was advised to have it as he can’t tolerate the medication. He has been getting episodes every day then 6 weeks post ablation developed a chronic cough and breathing difficulties which GP said was reflux and was given PPI’s and a blue inhaler.Ended up going to A&E who said it was nothing to do with his ablation gave him a course of steroids and upped his Bisoprolol to 1.25 twice a day. 2 weeks later back in A&E transferred to acute assessment unit diagnosed asthma caused by bisoprosol given more steroids a red inhaler and bisoprosol changed to diltiazam. 36 hours later back in A&E and is now on a cardiology ward since Friday. His AF is now mostly happening after eating . Saw the consultant yesterday (not a EP) who said he may need another ablation or last resort a pacemaker and is referring him to his EP. Does anyone have any views please.
Edit the acute assessment consultant said it was atrial flutter.
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Oak321
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Whilst it’s good that he has been referred to an EP, things may have changed since Covid but since it’s probably less than 3 months since his ablation, I’m surprised he is not still under the care of the EP who did it. There are a number of issues which you both need to bear in mind and they are covered in the factsheet “Recovering from an ablation” link below.
As you will see, he is still within what is called the blanking period which can extend to 6 months or even longer. Another consideration is that if he had a Cryoablation, it’s possibly that if the tissue around one or more of the pulmonary veins was irregular, they might not have been completely treated. Therefore there are number of things to consider and that there is still a fair chance that things will improve without invasive treatment. Good luck…..
I’ve just looked at your earlier posts. You need to try and give things more time to settle, not easy especially for the chief carer! Generally, atrial flutter is easier to treat AF and has good outcomes…..
this sounds like a textbook case for an “AV node full ablation” and at the same time insert a bi ventricular pacemaker to pace the ventricals and restore his quality of life. This is what has worked for me so far anyway ❤️. My best !
When I developed reentrant Atrial Flutter ( right atria) 10 days after my succesful PVI Cryoablation I merely had a flutter RF Ablation to stop it!It is a simpler procedure being in the right Atria, is 90% succesful ( according to my EP), and if succesful the flutter rarely returns.
I have not had AFib or
AFlutter since! (5.5 years ago)
Oak321
AFlutter CAN also occur in the left atria. This is more rare , and I believe is more complicated.
I have no experience of this so comment further.
However I would ask the medics for more information on this.
Furthermore I agree with others who have said it is too early to think this is failed.
I was very concerned when I developed flutter as it was MUCH more symptomatic that AFib for me, but it was sorted out.
It seems to be quite common for an ablation for AF to be followed by flutter. Another ablation would be an RF (radio frequency) one to fix the flutter and touch up bits the Cryo missed. You are both having a very hard time but hopefully things will improve soon. It sounds as though the ablation has caused a lot of irritation which happens to some unlucky people but time, as others said, should help ❤️🩹
When I developed reentrant Atrial Flutter ( right atria) 10 days after my succesful PVI Cryoablation I merely had a flutter RF Ablation to stop it!It is a simpler procedure being in the right Atria, is 90% succesful ( according to my EP), and if succesful the flutter rarely returns.
I have not had AFib or
AFlutter since! (5.5 years ago).
AFlutter CAN also occur in the left atria. This is more rare , and I believe is more complicated.
I have no experience of this so comment further.
However if I was you I would ask the medics for more information on this.
Furthermore I agree with others who have said it is too early to think this is failed.
I was very concerned when I developed flutter as it was MUCH more symptomatic that AFib for me, but it was sorted out!
A cardiologist and an EP are much the same kind of doctor excepting that the latter can carry out catheter ablations having done a year-long training course or similar. Their ability to understand heart issues will be the same.
Bisoprolol can trigger asthma attacks in some very sensitive people who already have it, but it sounds to me much more as if he hasn't been properly diagnosed up to this point. Let's hope things now change. An ablation can occasionally produce unusual side effects, including affecting the oesophagus (hence the PPI drugs) but I would wait and see what the cardiologists now find and do. It sounds like your hubby is now in good hands.
An EP is a cardiologist who specialises in electrical problems in the heart and other cardiologists deal with structural problems with the heart so they are not the same!!!
Many cardiologists specialise in electrical problems especially in hospitals like mine which don’t have an EP on site. I was recently referred to a cardiologist who was obviously not up to speed on AF because I had ‘non-typical chest pain’ but he referred me to an AF nurse who clearly knew her stuff and she referred me to a cardiologist specialising in electrical problems who would refer me to an EP in London if an ablation was considered useful but that has already been ruled out - unless pace and ablate.
So far as I know, having worked with doctors, albeit years ago, all cardiologists follow the same specialist course after their initial medical degree to eventually become a consultant. Their training covers all aspects of the heart, including, since they are central to the organ’s health, arrhythmias. A few cardiologists later decided to take a one year (variable) training course in using a catheter to carry out atrial ablations. That makes them experts in using a cardiac catheter rather than experts in the heart’s rhythmic activity.
If I’m wrong, things have changed and my apologies but, so far as I know, all cardiology teams in major UK hospitals will include one or more cardiologists who have trained as an EP.
I wonder whether a cardiologist might not see any essential differences between the heart’s “physical” and its “electrical” activities, since they could be said to be two sides of the same coin?
The heart’s “electrical” activity is a physical action, being the movement of different ions across the cell membranes of the heart’s muscle. These “myocyte” cells make up the main structural aspect of the heart so far as I know.
This may now be true in most areas but I have to say that when I was first diagnosed 6 years ago there wasn't an EP anywhere near me - there is now one who is "on"loan" from the next area - so I would have had to travel a long way to see him from where i lived when I was first diagnosed. The local hospital had not been able to recruit a cardiologist for 14 months so I eventually went private as didn't want to wait.
I think you’re probably right for many more areas of the UK. I read that Covid has led to an increase in heart problems and stretched our already overstretched health service.
Well, you've had bad luck, I suspect, there. And that can only be a personal viewpoint from that particular doctor I would guess since all of the heart specialists will have had very similar training in the workings and malfunctioning of the heart. Ask your EP the next time you see him or her, maybe?
It's possible that that EP you see is an exceptional doctor, of course, and the others are not. EPs are cardiologists with some extra practical training in the use of a cardiac catheter and are always colleagues in a cardiac care team, so far as I am aware (in major centres).
The distinction isn't really "electrician vs plumber" is my point, I suppose, since all are trained in both aspects and, in an important sense, it is the "plumbing" that goes awry - in ways often yet to be worked out or never found - to cause the arrhythmias. A cardio-thoracic surgeon is more "the plumber" I would say, but even he or she will be acutely aware of the arrhythmic aspects of the "plumbing" he is dealing with.
I had my first ablation last November and was worse than before having it done as I too got atrial flutter after which can happen so I had to have a second ablation on the 11th June the day before your husband and I haven’t had any episodes since I was told it can happen. I also developed a cough with this one that lasted four weeks so I had a chest X-ray and they said I was fine and the cough has now gone.
Ask your cardiologist about dronedarone. It is effective at limiting AF and AFl episodes, and controls heart rate to some degree (he may not need a rate control drug). It is far less toxic than amiodarone, and might be the solution to your husband's issues.
I had an ablation 10 weeks ago and about 4 weeks post, I was very short of breath and had a really bad cough, my AFib came back, back to ER , my EP was on call that weekend. They stabilized my AF, and sent me for a chest CT to rule out any stenosis, This is so so rare, but he needed to rule it out, I was put back on Colchindine a medication used to treat Gout but a very effective anti inflammatory. When the heart is burnt, a lot of inflammation can occur, so it takes time to settle. His EP needs to schedule that, as others have mentioned it could probably be as a result of Meds I had a Cryo / RF ablation for Atrial flutter and AFib, and it took me until week 9!to see improvement,I can now walk up a stairs without stopping four times.My cough abated 10 days after being on Colchicine .I know his team is trying to rule out everything, but the course of Colchicine definitely helped, everyone is different and reacts differently. I wish you both well and I hope they get to the bottom of this very soon
Oh dear, it seems one thing after another. Two things caught my attention, i.e. Bisoprolol and steroids. I don't have asthma, but when I was on Bisoprolol many years ago I developed asthma-like symptoms -- however, many don't. Secondly, steroids cause me to go into a-fib. Again, not everybody has the same reaction! Your husband is still in his blanking period and so could expect a few issues as his heart heals, but it seems a few problems are now added to it. I'm glad to hear he's off Bisoprolol as it may relieve his asthma. I hope he can get something other than steroids too.
Thanks everyone for your replies after 4 days on the cardiac ward he has just been discharged. On 240mg of diltiazam has to wear a monitor for 24 hours in the next few weeks and have a heart scan. Follow up with cardiologist and appointment with his EP.
Really hoping things now settle as it has been a horrible 10 weeks.
Have they checked him for pericarditis? I have gotten it every time I had an ablation. The only time I have not gotten it was when I had my pace and ablate but they had me on a strong course of antibiotics in the hospital to prevent. An echo should be able to tell if he has it. I was put on Colchine I think it’s the spelling. One pill a day for 30 days. It’s an off label use the pill is usually used for gout within days. I was feeling better.
of course, we blame everything on our a fib and as my EP recently reminded me, we have other parts of our body. Also, they can have a problem. That being said, and oblation has no guarantee from day one. Some people are very lucky. They work well and never need another. That was not the case for me, nor was medication, so I did pace and ablate. There’s always a chance of some kind of issue, but I have no regrets. Best thing I could’ve done was get this because I have quality of life again. L O L today I got to vacuum and steam my floor. I never knew I liked doing it until I could not because of my atypical, flutter and a fib when I could not breathe or walk. Be aware it takes a while to heal. This is my fourth month. I’m finally feeling good. I was told it could take up to a year. Your body hast to rest and it has to heal.
Hi Dawn thanks for reply, he did have a scan on his heart when he was in the acute assessment unit so I don’t think it was pericarditis. He is on his 11 th day of diltiazam and the coughing is slowly getting better.
Ablation was 11 weeks yesterday still extremely fatigued wearing a 24 hour heart monitor on Thursday to see how the diltiazam is working.
Hi. that is good if he does not have it I hope they get to the bottom of what’s going on. Fatigue is some thing that can be coming from anywhere. That’s the problem. New medication can easily cause it sometimes for as long as you take it. Heart failure gives you fatigue, so even with my pacemaker, I can have it. Nothing is going to fix us completely as we get older things change. I’m having a hard time dealing with that lol but it’s true
He obviously had something more going on to be so ill please let us know how he’s doing and just remember how long it takes to heal from an ablation or any type of procedure. It can be months up to a year, depending on what else is going on. Unfortunately the aggressive one I had I never really healed from until I got my pacemaker I believe I had damage in there. I know my current EP is not happy at all with what he saw for scarring, and by the way, the doctor that did that is world renowned, and in a top hospital in the world, so it just shows how things can happen thinking of you people forget how hard it is on thecaregiver
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