Had pulse field ablation April 15.

[Karenjaninaz]

I'm 82. retired US nurse-anesthetist. I had the ablation for paroxysmal Afib April 15 ,It wasn't a difficult experience considering I am a high-risk anesthesia patient due to scoliotic restrictive lung disease and asthma. It only took about 1,1/2 hrs. (I have all the records on my patient portal.) They can do it under sedation, but I needed general anesthesia because of the asthma and woke up fine. This was Mount Sinai Hospital in New York City by Dr. Vivek Reddy who is actually a top name researcher.

I am still recovering because I have these other issues: polymyalgia rheumatica on long term steroids, secondary adrenal insufficiency and asthma. This is my 3rd month and I am resuming exercises and feeling better. The Practice tells me it take 3 months after an ablation for the heart to totally heal.

I have at times felt some ectopy but it never shows up as afib on my Apple watch. Always sinus rhythm by the time I activate my watch. The practice told me that is normal during healing.

I don't think we can compare our hearts: we are all wired a little differently. Think of the assorted arrythmias people have.

I would not want to be on the meds. F[ecainide, though effective, bothered my gut within several hours after taking the 50 mg 2x a day. The problem was excessive wind; I have IBS. I even had extensive bowel Xrays to look for an organic cause nothing found. It was a great relief stopping the drug 4 weeks post ablation- wind free.

Diltiazem made my ankles swell and it enhances the action of any steroids one takes be it Inhaler, nasal spray or systemic like me. After some months I developed moon face so I discontinued the asthma inhaler for awhile and it went down.

[mjames1]

First, congratulations, sounds like you're doing great and you were in good hands at Mount Sinai!

Were you part of a trial or was this done post trial?

It's also nice to know that they are able to offer the "sedation" option, because when I called several centers both in the US and UK, they only offered PFA with general anesthesia (GA).

Do you happen to know what the sedation drugs the use? Sometimes they use the term "sedation" broadly to include MAC (monitored anesthesia) which is similar to GA both in level of sedation and the sedating drug used which is Propofol. Just no tube down throat.

This in contrast to medium or light sedation where other drug agents are used and sometimes you are conscious or semi conscious. One of the drugs used here is fentanyl, which I'm guessing is why they couldn't go that route because of your asthma?

Jim

[Karenjaninaz in reply to mjames1]

Jim, The anesthesia records report says I breathed Sevoflurane gas by mask to start; this opens asthmatic airways then given fentanyl, lidocaine, Propofol, succinylcholine then intubated. Then placed on anesthesia ventilator using anesthetic Sevoflurane and given a longer lasting muscle relaxant -forgot which one.

For sedation usually Propofol drip, fentanyl, versed and oxygen. The doses of fentanyl are small and reversable. It is given as part of the anesthetic technique. If given too fast the chest gets rigid and a muscle relaxant is needed.

Sedation means the patient is breathing on their own; with GA breathing is assisted or controlled. MAC means monitoring usually or maybe a little something while the surgeon injects local anesthesia in the operative site.

The anesthetist must always be ready for any eventuality meaning more or less sedation or converting to general anesthesia.

[Karenjaninaz in reply to mjames1]

Not part of a trial but I gave permission to use my records for research.

[Ppiman]

Balancing this and that as we age is such fun, health wise! Oh my. Anyway, you sound as if you did the right thing and with luck and a following wind, should be set fair to sail off for new AF-free climes soon enough! Let's hope so.

Steve

[Hidden]

Hi! I’m 82, too, and had an ablation last February. I also am on longterm steroids for PMR. I, too, have intolerable side effects from the drugs I’ve been prescribed. I also have PAC’s that come and go, but stay in sinus rhythm.

I had one brief, minor episode of atrial tachycardia, which can be a side effect of an ablation, especially during the blanking period—but could also not augur well for maintaining NSR longterm. Who knows. I believe it was a minor blip caused by a typical trigger (large meal followed by physical exertion on a cold day) and is nothing to worry about. My cardiologist agrees.

My healing seems to have been a little bumpy and slow, but my cardiologist, judging from monitor results last month, believes the ablation can be considered a success and gave me enthusiastic permission to put my Watch in a drawer and get on with enjoying life. Exactly what I wanted to hear!

My Watch is in a drawer. Hooray! I do not need a Watch to tell me that I’m in Afib. I know. My Watch was exacerbating my hypervigilance, to no good purpose.

I have no idea what tomorrow will bring, so I’ve stopped worrying about it. So far so good is good enough for me. I’m delighted to be in sinus rhythm today and that’s enough. Here’s wishing both of us an uneventful recovery and good heart health going forward!

[37Polly]

encouraging. I an 83 yr old female, scheduled for combination PFAblation and traditional at Mass General Hospital in August. Fingers crossed and hopeful.

[Hidden in reply to 37Polly]

I’m hopeful for you, too! We are fortunate to have such good medical recourse when our hearts are injured. I’m grateful for my two ablations, the first for AF, the second for AFL. Today I’m happily in sinus rhythm. Good wishes.

[37Polly in reply to Hidden]

Thank you. You lift my hope.