In November last year, I had my third, very extensive and arduous ablation which also involved 3 cardioversions. I felt pretty rough for quite a while afterwards, much worse than the previous two, but I have enjoyed 10 weeks of blissful NSR.
My heart rate has been 50 - 60 bpm and my EP has reduced my Bisoprolol dosage from 10mg to 5mg a day. My energy levels improved dramatically and I was sleeping better. All was going swimmingly and I was finally feeling like myself again when …..
BAM! Out of nowhere as I was getting up this morning, my heart started to jump and race (138bpm) and my Kardia announced the dreaded ‘Possible AF’. It has remained like that for 3 hours now.
I’m absolutely devastated. I know I’m still in the blanking period but the longer this goes on, the more concerned I am that I am back in persistent afib. And the prospect of a fourth ablation fills me with dread.
Does anyone have any words of advice or encouragement? I really am so upset that I may be right back where I started.
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frankiec5
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Far too early to worry but please contact your arrhythmia nurse and discuss. IF you really are in AF then a cardioversion (DCCV) might be appropriate but it could also be atrial tachycardia as that is a typical rate for AT. Happened to me after two of my three ablations at around two months but one zap and better.
Of course not. On one occasion I was visiting my sister in France so e mailed my arrhythmia nurse and and by the time I got back to UK she had arranged a day for it to happen. I was and still am on anticoagulation so no reason to delay.
Thanks Bob. I’m on anticoagulation too so maybe my EP will suggest a cardioversion. (I’d certainly prefer that to a fourth ablation).
I’ve sent an email to his secretary together with a download of the latest Kardia reading and I’m hoping to speak to her on Monday for some advice.
I do feel rather despondent that this has happened (any spirit-lifting words of wisdom?) but this forum shows that I’m certainly not alone in the experience.
After my third ablation and before I could leave the hospital the next morning, I went into tachycardia and was kept in an extra day. Was discharged when my heart suddenly went back to normal. About 5-6 weeks later I went into AF and was cardioverted back by my EP. I haven't had an extremely high heart rate since then.
When my heart kicked off several times again around 130-150bpm I was given cardioversions. My EP said I wasn't suitable to have any more ablations, he said some people weren't helped by them and I was one of them. Then after having two cardioversions in one year and then still going back into AF I was told that I wouldn't be offered any more of those either. I was really disappointed I can tell you.
I'm now in constant AF, have been for about 3 years with a heart rate between 60-90bpm and can lead a good life doing anything I want. I think there comes a time when the heart sorts it self out to a point, without any medical intervention. I take Metoprolol and Warfarin.
My heart rate is still up way too high despite taking additional Bisoprolol and Digoxin as suggested by my EP last time this happened. And I’m starting to feel a little light-headed and nauseous as a result.
I have to admit that I’m feeling quite despondent but your experiences give me hope that, whatever happens with this latest setback, I still have the possibility of leading a good life even with AF.
I would suggest you ring 111 or go to AandE for advice , it may be better to be treated sooner rather than later if you are having symptoms like lightheadedness and nausea rather than waiting until Monday.At the very least whomever you speak to can give more suggestions about taking extra medication doses or appropriate Self Care to try to reduce your heart rate.
Also try to keep hydrated with cool water taken in sips. The aFib event can get worse if you become dehydrated . Plain water is often the best option if you are feeling dizzy or breathless.
Increased Sodium isn't always appropriate for everyone.
Many people with aFib require Potassium or Magnesium instead but it's best not to try and experiment with which one your often imbalanced in while you are suffering with an aFib event , just in case you choose the wrong combo for you.
Sit up on the bed ,or, if you prefer a chair keep your legs raised in line with your hips on a chair or high stool. Make sure you are comfortable and supported.
Try deep deliberate breathing.
Try to keep yourself and the room at a steady temperature, not too cool or too warm.
Do you have any other health conditions that might be effecting it?
My symptoms of nausea and lightheadedness have subsided thank goodness. I think they were a result of the increased medication which my EP advised last time this happened.
My heart rate has come down to between 115 and 95 - much higher than it was before but better than it was.
I don’t have any other health conditions apart from being 73 with dodgy knees due to osteoarthritis.
I’ll see how today goes and will be contacting my EP’s secretary first thing tomorrow for advice. I know he’s going to be disappointed at this latest turn of events as he worked so hard with the latest ablation to cover all eventualities.
Thank you for your advice and good wishes. I just wish I could feel less upset and disappointed 😞 I keep wondering if and hoping that I might suddenly revert to NSR as so many in this forum seem to have done.
I have never read or been told that many people with AF need extra potassium or magnesium. Do you have any references? I know that potassium depletion is rare and usually linked to kidney failure or use of loop diuretics but that is a specific thing that applies to just those unusual cases. I have also read that it can be dangerous for some people to use extra potassium without its being prescribed owing to its effect on the kidneys. I do know that magnesium is given intravenously in emergency departments to try to stop arrhythmias but that it has no provable effect when given orally.
I have a banana every day, for potassium and lots of food I eat, contains potassium. I also take magnesium tablets, as advised on here. I try to avoid salt, as it’s not good for you and most food products have some in, so don’t need to add any. Every year, my GP practise takes blood tests for my bodies electrolytes, also liver and kidney functions and a few other things, I can’t remember and my body electrolytes are usually ok, so I must be getting the right amount of potassium, magnesium and sodium..
Salt is essential for life and low sodium can cause dizziness , lightheadedness and muscle weakness. Although present in manufactured food products ,if you follow a diet which excludes as much as possible such products there is no guarantee that you are getting enough sodium unless you use salt in cooking or add it at table. When in afib the heart puts out a hormone that tells the body to dump sodium which it does by increased urination. Not only can this cause dehydration it can also cause the above mentioned symptoms of low sodium. Jean's advice about taking salt when in afib is sensible . This "salt is not good for you" is a simplistic myth just as "you shouldn't eat foods like eggs that are high in cholesterol " always was and is now recognised to be .
So are mine but I suspect during an afib episode I get low sodium temporarily due to weeing every 15 mins during the first 2/3 hours so next time I am going to try Jean's salty drink tip.
I'm sure you are doing the right thing. Food brings all we need if chosen wisely. Magnesium is easily available from all vegetable matter - loads of it as plants can't grow without it! So taking magnesium as an artificial chemical supplement is unnecessary. But, as you say, a few here find it useful, so why not try?
I hope you're going on all right! My ectopics are all over the place but AF is unusual thankfully.
Hi Steve,Apart from this awful cough, which is doing the rounds in Hinckley. Is it going round your part of Leicestershire? I’m not doing bad, just keeping my fingers crossed, the ablation has worked ok. My palpitations don’t seem to be as bad at the moment.Sorry you’re having problems with ectopics. I was still waiting for the 3 monthly check, so rang Glenfield last week and they sent me an appointment out for a telephone appointment. I rang them and said I was suffering these palpitations and thought I needed an ECG, so Dr Sandilands secretary said they’d got no appointments for a year. Anyway, she got back to me and told me to come to Glenfield at the same time as my telephone appointment was and they’d see me face to face instead. What good are telephone consultations. So going on 16 th Feb.
They aren't. Covid has provided the NHS with a system that is appalling. Mind you, during the main part of the pandemic, I had a private appointment by Skype. £120.00 down the drain. A joke.
I joined Benendon Health a few years ago. £12.80p monthly. You get free 24 hour GP helpline, plus several other things. Obviously not the same as health insurance, but you could google it and see what it’s about.
You don’t get a lot of things, with Benendon, like you do with health insurance, such as BUPA, which my husbands firm paid for, when he worked. I do miss having that. . Benendon cost is so little compared to BUPA, so you can’t expect to get as much from it.
It still seems quite good as our friend is having her varicose veins done even though she did have to wait till she’d been in the society for six months (if I recall).
She’s lucky then, as my latest Benendon health magazine, says “from this month, they will no longer provide access to treatment services for varicose vein procedures. All services are on a discretionary basis and are subject to resources available, so they may change the list of approved procedures.” So she must have got in, just in time.
She's a hairdresser, so I bet those veins give her gyp! Mind you, having them "stripped out" sounds too horrible for me to contemplate, even worse than an ablation! I am glad I don't suffer with them.
Yes Potassium depletion to the level for hypokalemia is rare but low serum potassium can have an adverse effect, just as high levels of potassium can, and like high sodium levels cause an increase risk of aFib onset among other health issues. In the general diet of someone with cardiac issues both sodium and potassium need to be consumed with care and according to individual requirements.
That's why it is really important to know what's happening with your electrolyte levels generally as part of your Self Care , as well as taking into consideration the requirements your other health conditions if you have any , before taking supplements or cure suggestions for certain oral supplements like high dose Electrolytes , either as a preventative or during an active event.
It's also why it is suggested to take steps to hydrate yourself with water during an aFib event because of the amount of water that is lost during the elimination of sodium to prevent dehydration which will prolong the issue.
Electrolyte imbalance is often in part a cause in new aFib events, but knowing which electrolytes are most beneficial for a positive treatment outcome is important and in an Emergency setting it's judged with care using testing.
Pharmacology management suggests that even if a person admitted to AandE requires IV saline , this is administered carefully taking into consideration blood results because a rapid change in sodium intake can cause further problems depending on whether it is part of the patients overall need. Chugging back saltwater orally can exasperate the dehydration , especially if someone is nauseous and it makes them sick or aFib occurred after an infection or illness. It may actually be the water itself , and the effect of swallowing and breathing change on autonomic signalling that was more beneficial if it had an instant affect .
The main reason for IV saline , preferably alongside oral water intake , is to gradually ensure sodium balance is restored whilst treating the dehydration caused by excess urination during AF making the electrolyte balance worse, unless hyponatremia is known to have occurred.
There are two studies that I have seen that suggest that improving low Magnesium and low Potassium levels in the daily diet ( rather than via supplements) can help reduce the repetitive risk of various cardiac events.
Analysis of Emergency Room data suggests IV admin of them is beneficial in improving spontaneous return of NSR, and improving serum magnesium and potassium levels could reduce repeat events and post treatment recovery in various cardiac events .
Kardia recommendations about reducing electrolytes imbalance because it is a risk factor for AF seem to have taken note of these findings and also suggest improving intake of these electrolytes in the diet (after checking your baseline levels).
I know we can't leave links anymore so I'll send you a private message with the information. One was cited on the JAMA network , among others , the other was in an International Arrhythmia Journal both during 2022 ( but I will have to double check the links ) Give me 24 hrs and I'll pop them to you.
Thanks , it's taken some time.Unfortunately, with an uncommon cardiac issue that is orthostatic, autonomic and neurological rather than structural and is affected considerably by electrolyte imbalance hunting out research has become like a full time job!
Well done for such enthusiasm. I spent half my professional life in health care industries (what some mockingly call "Big Pharma") but might otherwise have fulfilled my late mum's dream and become a doctor had my maths not let me down. I am still fascinated by the human body and its workings.
These are all the tips I’ve saved over the years, given by forum members, for stopping AF. None have been written by me, all from other members here (names have been removed for privacy):
I am a therapist in private practice for over 20yrs.One of my therapies is yoga based. Having quite an accurate knowledge of anatomy, neurology and physiology also having PAF I have found this technique helps me immensely when my heart is fluttering like crazy. Make yourself comfortable either on a bed or lying on the floor, position a pillow under you head, Raise your left arm in an extension position as if you are doing the backward crawl. Stretch as much as you can and imagine that it is stretching your heart muscle...I bend my arm and position my hand under my head palm upwards.. Stay in that position for as long as you can or until the fluttering subsides...At the same time I think of something pleasant. It does not matter what you think about as long as it is a pleasant thought for you. This stops my heart jumping about almost instantly....I also place my right hand over my heart area...Don't panic and just keep calm thinking pleasant thoughts....I do hope this helps you. Kind Regards. C
As someone else who finds yoga breathing and some positions helpful, I would love to try (xxxx) suggestion, but lying down flat tends to make things worse for me. My most helpful position, taught me by a lovely yoga teacher, is based on a yoga forward bend. I sit up with my legs outstretched in front of me and a pillow under my knees, and then bend forward from the hips not the waist with my arms relaxed but outstretched towards my ankles and breath deeply and slowly. It's not so good on a full stomach and is more comfortable with your knees slightly apart, and I guess you have to be a bit flexible to find it comfortable, but it has proved to be a great help.
I agree with (xxxx) that staying calm and focusing on something pleasant is a must, and I've even fallen asleep like this as most of my episodes occur at night.
Finally, like AV nodal re-entry, some people have recurrent rapid rhythms that are infrequent and easy to self-control by using various methods to increase neural slowing to the AV node (so-called, "vagal manoeuvres"). Using these manoeuvres, one can sometimes stop the arrhythmia. These manoeuvres include:
Bearing down forcefully like you're having a bowel movement for 5-10 seconds, then
Coughing forcefully
Rubbing the carotid artery (only one side at a time, never both)
Placing very cold (soaked in ICE water) cloth on the face abruptly.---------------------------------------------------------------------------------------------------------------
There's a yoga breathing exercise that has worked for me before. Lie on your back, bend your knees up so they are above your hips and your lower legs are at 90 degrees. Take a breath in for a count of 4 then breathe out for a count of at least 8. As you breathe out, bring your knees into your chest so you curl into a ball. When you think you've got all the air out of your lungs, try and breathe out more! Breathe in again for 4 and release your legs out to the starting position. Repeat several times. It helps to reset the diaphragm and focus should be on a good long out-breath.
So, after discovering that making myself sneeze stops Afib. I have discovered another novel way to stop an attack. It involves drinking a litre bottle of water while holding my nose. It's especially effective if I experience almost panic as I can't get a breath. I don't always finish the bottle but find that's not always necessary to gain the desired effect. Works especially well if I catch an attack early.
A quarter teaspoon of sea salt mixed with 10 ounces of warm water. drink that and then put a smaller amount on your hand and lick it off. Within a minute my afib stops.
This may sound like a "wind up" but believe me it works, for me anyway.
Hi - honestly no idea if this will help but I’m sure this resulted in breaking me out of a 5-day consistent 160, 2 weeks after ablation. Was talking to Arrhythmia nurse who suspected the problems I was having were related to inflammation caused by the procedure. I’d never had an episode before the ablation which didn’t self-revert …I had a glass of warm water with bicarbonate of soda and then chewed 3 cloves of raw garlic - this burned the roof of my mouth, tongue and when I swallowed it I could feel the warmth going down- couple of minutes and I’d broken out of the rhythm, an hour of AFib (up and down) which actually felt worse, then it just settled and it’s been 3 weeks now and has just settled more over that period - appreciate this sounds a bit mad but I was a bit desperate at the time and we’ll look I know this worked for me so just wanted to pass on in case (it kind of makes some sense - garlic anti-inflammatory, oesophagus right by the heart…). Hope you get this sorted one way or another
As it’s 10 weeks since my third ablation, I’m not sure the reason for the sudden return of afib is due to inflammation but I guess your arrythmia nurse could be right.
I hate garlic ( or at least it’s lingering after effects!) but it might be worth a try
I don't know which medications you take but various cardiac and blood thinning medications interact with garlic , so it's worth checking this with a drug checker against the medications you are prescribed before taking garlic capsules or consuming large amount of garlic.Combining both can affect the efficacy and half life of the drugs and the elimination of the drug from the system.
A small amount of garlic in meals timed well after medications can be fine for many people though.
The water and CO2 from the bicarb would swell the stomach which would, via the diaphragm, irritate mildly the base of the heart. This can both cause and stop ectopic beats, I gather. As to the garlic, pure coincidence, I would guess. Garlic contains active ingredients that I suspect alter the blood chemistry slightly, I think thinning it somewhat, so a longer term effect might be possible, but the physical effect is the one I'd put my money on. That and a modicum of luck that a range of other things were in place at the time, so repeating this is, probably, unlikely.
I’m pretty sure it was the garlic as I could feel the burning sensation going down and pretty much as soon as it had the consistent 160 bpm changed - no idea as to why - but a shock to the system maybe but I’ve no doubt what it was - whether it would do it again who knows
Here's another thought. The food pipe presses tightly against the atrium in some people and is far thinner than might be realised (as is the atrial wall, hence the risks to it from the heat of the ablation). The pressure and localised heat caused by the raw garlic would likely create a muscular spasm or peristaltic effect a bit like gulping, thus pressing physically against and mildly irritating the atrium and potentially causing or stopping PAC ectopics.
While I was in hospital with atrial flutter the nurse noticed a sudden run of PACs when I gulped my tea while on the monitor. It caused her to comment but I gather it's common. I've had the same many times since.
Who knows Steve - reason for doing it in the first place is because garlic is meant to be anti-inflammatory hence the thought process and though well what have I got to lose - thoughts about it after are around the fact that the chemicals in the garlic which burnt my tongue, roof of my mouth, throat may have been enough going down to kind of disrupt the arrhythmia I’d been in consistently for days - don’t believe in coincidence so thought worth sharing in case it works/helps anyone else
What you've actually done, based on your description, is caused a massive stress reaction in your body which caused an extreme " Fight or Flight" response from your Autonomic Nervous System , which luckily , in your case , forced you back into natural sinus rhythm.It's a Kill or Cure approach.
Very similar , to that occasionally felt by those whom choose to use extreme Cardio exercise whilst in active AF causing a similar extreme Stress reaction .
It might have worked for you once, it may even work for you again , but there's no guarantee that it would always work for you , or anyone else , and could in fact cause a worse reaction , hence the term, Kill or Cure.
These approaches are inconsistent , inefficient ways to try to covert your heart rhythm during an event which can actually cause more harm than good.
It's very unlikely that the garlic had anything to do with it, even with it's antiinflammatory properties; apart from the fact that eating raw garlic brought on a severe gastric reaction.
Depending on how quickly your heart jumped back into NSR the garlic , and possibly the Bicarb, would not have been digested and metabolised by your body and the active chemicals would not have reached your bloodstream to have a positive effect.
Please take care and think carefully before trying this approach in the future. I know I sound very Mumsy but I wouldn't want you, or someone else, to do themselves any harm or need a trip to AandE by using this type of DIY"cure", hugs , Bee
Exactly which is why this wasn’t a gastric reaction but was however one that for want of a better word ”shocked” me out of a 4-day 160bpm episode - we’ll all have opinions on this I’m sure - like I said I was somewhat desperate at the time and I’m pretty certain it was a result of the garlic - I didn’t consider and believe doing this would result in any worse an experience to what I was already having but equally am not saying this is a fool-proof way to resolve a similar problem - merely a share of an experience that I’m grateful for having since it stopped a route (for me) to Digoxin and Cardioversion and since I’ve been free of that Arrhythmia and any AFib post ablation and long may it continue as I’d almost forgotten what Life felt like 👍
I understand we can feel desperate in these situations and may not want to have to use the medical options available to help it safely ,if or when, we do experience a period of aFib or arrhythmia after having an Ablation as it appears you had done.The trouble with taking more extreme routes at home forcing your body into Shock is that a negative , and far worse, medical reaction can also occur, worse than what you were already experiencing , and with the potential of causing a cardiac event that is a lot harder to recover from or treat.
And that equally likely possibility would have a longer and farther reaching effect on your Quality of Life .
Yes appreciate your personal opinion on this - we all have to make decisions and I might not as risk averse as some although I weigh up what I do and like I’ve said I don’t consider eating garlic to be an especially risky approach and considering just waiting another 3 days with a 160-170 HR, before taking the route to starting digoxin followed by Cardioversion I’m still happy with that decision- won’t be for everyone but it worked for me (in my opinion)
Hi, try to remain calm & not feed the AF (easy to say). Yes blanking period time - all is not yet lost. I’m 14months post 3rd horrendous ablation but have had excellent NSR followed by some very doubtful blips. Recently a 5 hrs of 163bpm a few weeks ago then it’d gone. I’ve been able to possibly pin down it was extreme fatigue & stress so managing that has helped (hopefully). It’s all still so fresh in your mind right now so you will be anxious - try to breathe very slowly & try to give yourself the impression of “who cares” “it’s fine” “so what” attitude - I saw my consultant after the 163 episode, he’ll go in again if necessary but all is calm again . Obviously this is just my way of doing it but hope you find a way & everything settles for you soon x
Been there with five ablations and the entire pharmacopoeia it seems. My latest is Sotalol. Waiting to see when the shoe drops on that one. It’s a mongrel of a disease. Sorry. Keep hopes up.
I've had similar to you, but now have a pacemaker & on the 13th February they do the final abaltion which is not so invasive & disables my natural pacemaker & then it overrides the symptoms will still need blood thinners for rest of life but will be not needing Bisoprolol & will not notice the horrible symptoms, hope this may help you xx
The actual fitting of the pacemaker was ok, some bruising & uncomfortable for a few days but less than the abaltion pain, at the moment the pacemaker is in & settled & in 2 weeks I go in & then it will take over the heart beats my cardiologist as said in 15 years no one as not been helped by having this done so I'm very optimistic I will let you know after what happens
I'll only be in as a day case as I was for the pacemaker x
I know exactly how you feel -- it's happened to me and may others here! You're right in that you're still in the blanking period, and there's a reason for that -- your heart's still healing and possibly still inflamed and is likely to protest. Seeing that I'm in the US and reading your post later than others, you're probably -- hopefully! -- back in NSR by now. Try to take the disappointment in stride and get on with your life. I know -- hard to do, as you're probably sensitized to the fear of another episode. Again, it's happened to me. Best of luck.
Unfortunately, I’m still in atrial fibrillation with no sign of a return to NSR so it’s increasingly difficult to be optimistic. I feel powerless to do anything to improve my situation. But your understanding is very much appreciated. Thank you
In the US at least, it's very common to be put on anti-arrhythmic meds during the blanking period to help hold things together while the heart heals. If you're not on one, something to talk to your ep about and if they agree, then they also might give you a PIP (as needed) dose to get you out of afib, should it break through.
I do understand you're discouraged, but while much too early to predict outcomes, always good to look forward. Should you need another ablation, you might consider a surgical ablation like mini maze or hybrid. Several of our members have had success there where multiple catheter ablations failed, but let's hope you don't have to cross that road.
I went back into persistent AF within 48 hours of all 3 of my ablations. EP said if I go back into AF in the "blanking period" then it will prob stay that way as I've been in persistent AF so long...20 years of AF, 10 in persistent...So when that happened after the 3rd I certainly felt despondent. And It did stay that way until 5 months after when I suddenly went into NSR and been that way since.
I saw my EP today and after looking at the ECG printout, he decided that I now have atrial tachycardia rather than AF. He wants to carry out a fourth ablation to target the area in the left chamber which seems to be causing the problem.
I’ve agreed to go ahead but I’m finding it hard not to be despondent about having to go through it all again.
Has anyone had a completely (as far as you can tell) successful fourth ablation in similar circumstances? I could really do with some positive vibes at the moment!
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