Post Pulmonary Vein Ablation neurocognitive complication[s]
Otherwise healthy 67 year old male [non hypertensive]:
I had  PVI ablation procedures performed at a leading cardiology institution within the past 8 months for paroxsysmal Afib.
Following the 1st all was well for about 7/8 weeks when I went into persistent Afib and A.tach which required a second procedure. The 1st took ~ 7 hours, the second was thought-I was told would be quick, 'a touch up' but took ~7 as well.
I was non-responsive for between 30-60 seconds recovering from anesthesia. It was reported the 2nd took as long because all PV's had reconnected requiring a full 2nd ablation procedure.
Complications-symptoms followed: pericarditis-treated with multiple courses of steroids, symptoms persisted for about 12 weeks, - sleep disruption, my circadian rhythm was off to the extent I could not sleep for more than an hour or so for 4-5 weeks and I was taking pain meds [percoset] briefly which was difficult to tolerate but allowed a form of sleep. As I improved over those 3 or so months I had occasional severe head aches, was aware- knew my memory function was affected as I couldn't concentrate-read much of anything and although those symptoms improved to the extent I can actually read and write [like this] I'm not the same as before the 2nd procedure particularly memory function.
Recently my consulting EP [not the PVI MD] advised to have a neuro exam workup. The imaging results indicated "multiple foci of increased signal intensity within the subcortical white matter of both cerebral hemispheres most likely representing microangiopathy..." During the work up the neurologist [local community hospital] was unaware of what PVI ablation are and ordered the imaging ref'ed above. She's now on holiday until late summer.
After reading the recent cardio-neuro literature one would suspect the micro-emboli produced/formed from RF energy delivery plus long full ansesthesia are causal-suspect?
My questions - what if anything shall/should I do and is there a plausible explanation for these sysmptoms beyond that described?
I failed to include diagnosed [western blot] and treated for Lyme about 9 years ago. Typical symptoms and Herxheimer' response during the 1st course of AB none on 2nd AB course three week later.
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