Ablation questions

[dquenzer]

Ablation on 2/20/2004.

1.  I've had faster heart beat than normal (10 to 15 beats per minute).  On 50 mg atenolol.  Mayo states this may last several weeks.  How long is "several"?  Do you find this to be normal?


2.  It's been 3 weeks since ablation.  I've held off exercise to let the heart heal some.  Is it OK to do moderate exercise?  Will this irritate the heart at all?


3.  I've had short bouts of AFIB after ablation (5 of them after ablation from seconds to a few hours), but they seem to be getting less frequent and lasting for shorter periods of time.  PAC'S SIGNIFICANTLY DOWN! Good sign?


4. Also they found mild enlargement of lower part of ventricles (20 to 23 cm.  They said I should watch this.  I had been a long distance runner.  Could this be the cause?  Can this getting worse?

[Cleveland Clinic]

dquenzer,

1) There really isnt enough information to answer your question.  If you have a persistent heart rate about 100 for several weeks, then that isn't exactly normal. There are alot of causes for this though, so defining normal isnt possible.

2) Yes. No pain no gain. I would hold on heavy lifting for about a month, but otherwise you can start gradually hitting the bricks again.

3) Thats normal. The inflammation after ablation causes some to have increased events. The fact they are occuring less is a good sign.

4) Watch it over time. Conditioned trained athletes can have variations of LV size and dimensions outside the normal range. I wouldn't worry too much for now.

good luck

[arthur]

After my ablation for PAF three years ago, I spent the first week rather sedate, and started up jogging again by the second week, and by a month I was playing soccer again.  I was and have been very active athletically all my life.  I did experience some breathlessness during those first few weeks/months (this could have been caused by some mild PV edema or the betablocker or both).  I discontinued all meds after about three months in order to get back the energy needed to play competitively....but here you need to pay attention to your cardio's advice re. meds.

The message is that ablation produces its own set of insults (both to muscle and to the nervous system)...and it will take a while for everything to settle down.  

Finally, even now, after three years, I will occassionally experience a brief episode of arrhythmia best characterized as "lots o' PACs' which last 5-15 minutes...apparently caused by one of the remaining PV foci (which were left unablated in my case).

It sounds to me that you're on your way to a good recovery.  Good Luck.  -Arthur

[flipflop]

   Doug,

        Been following your progress , great forum, sound like you are having marked improvement since the a-fib ablation.

   hope the improvement continues,

           flip.

[Squimsy]

Arthur

I wonder if I could pick your brains on the subject of PVC's.

Briefly, I've been through all the testing for extra beats, and been given the reassurance that they are benign.  Recently, my focus has gone from being on the skips to now noticing what I can only describe as being a brief quivering sensation that happens only occasionally between beats.  I've tried some searches in the archives to try to get some insight, but it would appear to be quite an unusual complaint as I can't find too many posts, however, I did find a question that you posed some time ago, and I was hoping that you could give me your 'take' on these shakes.

In light of recent posts, I think I'd better mention that I'm not asking you to diagnose my problem, I'm just trying to decide if I need to follow up, or whether my anxiety has found another way through:-0

Thanks in anticipation

[arthur]

I am not afraid to post an opinion...afterall, it's what this forum is about (besides sharing stories).

Every since the advent of my PAF (some three+ years ago), which was accompanied by a noticable increase in PACs (as well as some PVCs), I have felt an internal quivering sensation which is entirely distinct from the sensation you get when "skipping" a beat.  In other words, the quivering occurs while the heart beats normally.  

After my ablation (for a PV focus driven PAF), the quivering remained, but gradually became less noticable.  Currently, I can feel it mostly at night when all other stimuli are at a minimum.  It typically shows up after waking from a vivid dream, or after getting back in bed after going to the bathroom.  Under these circumstances it lasts for 5-15 minutes after lying down.

A number of cardios/EPs have suggested an origin to these quivering sensations, and basically the theory is that they originate from the tiny movement of the focus (or foci) located behind the heart at the pulmonary vein entrance (behind the atria).  Thus, the feeling appears to come from the "heart" and is a bit disconcerting as a result.

In my case, when the quivering is at a peak, there does indeed appear to be an increase in PACs associated, which means that the focus responsible has a tough time affecting the heart's normal rhythm, and it's only when it's firing off particularly strongly that some of its signals reach the pacemaker circuits.  Also, in my case, it's clear that the sensation is triggered by adrenaline (vivid dreams, sudden movement).

I found that anxiety makes it worse, which makes sense since it's adrenaline-linked.  Over the past year or two, I have calmed myself down quite a bit, and the result is fewer quiverings and fewer PACs.  Easy to say, real hard to do.

Perhaps these sensations are similar to yours, and if so, ask your cardio/ep what his/her opinion is.  It's not a thing easily checked, since the quiverings don't show up on a normal ECG.

Good luck.

-Arthur

[Squimsy]

It sounds very similar.  I can feel the sensation distinctly when I sit down after work, just after eating, or when I go to bed and it will usually last for 10 to 15 minutes before calming down. When I'm relaxed its something that I don't notice.

Also, I don't associate with any significant interuption in the heart rhythm.

Thanks Arthur, much appreciated.

[Momto3]

WOW! I know about the quivering feeling. It felt completely different from the skips, etc. It wasn't scary, just different. Most of the time, I would wake up with the feeling (like you said, after dreaming or just as I would wake in the morning). I also noticed it after an ablation. I had one ablation in August, and one in November, and I can't recall having any real episodes in the last 2 months. Interesting!  Thanks for sharing! connie

[rohey]

Hello I was wondering if I have a AV node ablation done with pacemaker insertion will I still feel terrible as before even though my pulse rate will now be normal.What is puzzling me is will the shortness of breath go and the tired feeling go despite knowing my pulse is now regular but my heart is still irregular even though I cant feel it.
thanks

[dquenzer]

My Mom had chronic AFIB.  When she had an AV node ablation and a pacemaker she felt considerably better.

[NHS]

Thank you for your informative reply to my question about any meds you may have been taking, after your ablation was performed.

How are you doing now?

NHS

[socki]

I am 45 years old, have been diagnosed with PAF and have been having episodes for the last year and a half. Within the last two months, I have been to the ER twice for a very stubborn A-fib. I converted on drugs the first time after 36 hours, the last episode , a week after my doc took me off the lopressor , took an elctro cardiovert. I am set to  see an elctrophysiologist in a couple of weeks. From what I have been reading, it's questionable...

Drugs are working, yet I do notice more bumps after the last episode. Very little fatigue, I work hard on the job, very physical. I am on lopressor, digi, and coumadin. Thoughts on the RAF would be appreciated.

socki

[arthur]

There's a very informative video describing a PAF rf ablation procedure conducted at St. Luke's that was broadcast earlier this month.  
You can access it at: http://www.or-live.com/stlukes/1164/
It runs for about an hour, and is well worth the viewing time.

-Arthur