Disappointment after Ablation Number 4

[frankiec5]

I had my 4th ablation just two weeks ago and since then, have enjoyed two weeks of blissful NSR and a wonderfully steady heart rate of between 50 and 60 bpm.

I was feeling a bit lightheaded, breathless and dizzy so my EP advised me to reduce my Bisoprolol dosage from 5mg twice a day to 3.75mg in the morning and 5mg in the evening. This I’ve been doing for the past 6 days.

And then this morning, for no apparent reason, my heart rate shot up to 115 and my Kardia showed tachycardia.

A couple of hours later, my heart rate had gone up again to 145 bpm with the dreaded ‘Possible Atrial Fibrillation’ reading. And I can now feel my heart jumping in my chest.

To say that I’m disappointed is an understatement. I know that it’s very early days since Ablation Number 4 but I’ve never reverted without surgical intervention before so I’m very much afraid that I’m facing the prospect of yet another procedure. Devastating.

Does anyone have any words of encouragement for me? Is a pacemaker the inevitable next step?

I’d be so grateful for any words of wisdom from fellow sufferers.

[frankiec5]

Just thought I should add to my post above -

I’ve been following the forum’s advice and taking things very easy indeed for the past two weeks. I haven’t done anything more energetic than walk from room to room indoors so I know this situation has not been brought about by over-exertion. It makes it all the more baffling and frustrating

[mjames1 in reply to frankiec5]

It's still too early to draw any conclusions. Often a fib behaves differently after an ablation, so hopefully you will convert on your own. But if you don't within three days, or feel in distress, then definitely contact your ep for a cardioversion if that is the custom where you live. Those were the instructions I was given by my EP in the US..

Jim

[mjames1 in reply to frankiec5]

Don't put the blame on yourself. Afib often does what a fib wants to do. As to next steps, should the ablation fail, I would look into a surgical ablation like mini maze. They have often been successful where numerous catheter ablations have failed. But again too early to be thinking about that.

Jim

[Ppiman]

A PM would only be required, as I understand it, if you needed a dose of BB that would cause symptomatic bradycardia (i.e. to speed up the heart to a comfortable 60+ bpm).

However, again as I have been told and read, recurrence within the first 4-6 weeks “blanking” period is usually not a sign of other than the heart reacting to the burning of the ablating catheter. I hope this is the case.

Steve

[CDreamer]

Pacemaker is not the inevitable next step, always a choice, but one I was VERY glad to have made as it took my AF burden from about 90% down to 2%.

Pace and Ablate is the final option - pacemaker followed by ablation of the AV node but I had the pacemaker which stopped my AF from the moment of insertion.

Pacemakers are not only for Bradycardia and RST therapy worked for me. Modern pacemakers algorithms can be set to reduce or even stop AF. Trouble comes in getting the funding, unless you are in heart failure.

There are other posts on the forum where stand alone pacemaker has worked to stop AF.

Other options:- hybrid mini-maze - difficult to obtain in UK, Amiodarone - drug of last resort, living in permament Af - OK for many if you are not symptomatic.

But as has been said, don’t be too quick to despair as if you self convert or even have cardioversion back to NSR, it is still very early days.

[Snowgirl65]

I know the feeling of wanting words of encouragement! I've had three ablations. The first two weeks after my first two ablations, I was in blissful NSR, but then a-fib episodes began. I attributed it to the healing process. Same as with, say, a wound on your knee -- you put a bandage on it, it has an inflammation period, then comes the itching period when it heals. Imagine what your heart's going through after an ablation. I hope you understand my analogy! Just give it time -- it's very soon in the healing process. Best of luck to you.

[frankiec5 in reply to Snowgirl65]

I really appreciate the empathy Snowgirl. Thank you.

It’s now been 5 days since I started registering ‘Possible Atrial Fibrillation’ and I’m pretty sure things aren’t going to change. The high heart rate and Afib readings are constant.

I’ve been here three times before and I’ve never just flipped back into NSR sadly. It’s always involved another ablation - hence my despondency. I’ve now had 4 ablations in the space of 21 months. Can’t help feeling that enough is enough. But I’m desperate to get some quality of life back. I’m just praying that my EP will have some words of encouragement

[ozziebob]

I would have hoped that the England priority list of patients recommended for the limited number of minimaze procedures available would definitely include patients with multiple failed ablations, if that becomes a next viable option for you.

I recommend you research this Dr Wolf procedure on his website, as well as the Posts documenting his similar experience in Japan by saulger ...

healthunlocked.com/user/sau...

Hope your luck changes soon.

[frankiec5 in reply to ozziebob]

Thank you

[4chickens]

Give it time but know how you feel, I never self converted either. I’d had 4 ablations longest lasted 12 months others up to 6 months, I was scheduled for a 5th when I stumbled accross minimaze. My EP wouldn’t refer me as felt it wouldn’t help. I paid privately to see Mr Hunter at Sheffield, he then listed me nhs but for a hybrid minimaze due to atypical flutter I did wait 10months but I’m coming up for 11 months post surgery now. I’ve had 3 runs of af since all self converted and all infection driven, 1st one lasted 4 days, next 7hrs and the last less than 2hrs. I’m so pleased that I had the procedure but a little disappointed that the af is still lurking admittedly much improved. I’m on no heart medication except for blood pressure. Good luck with any decisions you make.

[frankiec5 in reply to 4chickens]

Thank you for your message. It really helps to hear from someone with similar experiences.

I’m glad your procedure was a success and that your symptoms have improved. I will be seeing my EP in two weeks time so he will hopefully suggest a way forward. I’m desperate to get some quality of life back.