Post ablation atrial fibrillation

[Swanee44]

Dear Dr.,

I just had an ablation one week ago.  The day I was released from the hospital, I had an episode of atrial fibrillation.
After speaking with the doctor's office, I went to the ER.  They recorded a-fib with V-tach (but my EP said the EKG he got from them only showed AF).  They gave me cardizem in my IV and a cardizem drip and more cardizem afterwards.  I never converted to NSR but they said I could go home after 6 hrs. with a pulse rate of about 130 (and still with very irregular beats).  I finally converted later that night during my sleep.

The meds I was put on post ablation were:
Norpace 150 mg X 2
Topral XL l00 mg daily
Warfarin (now 3 mg daily... more to begin with)
Aspirin 325 mg
And the dr. said I could take Magnesium too (I'm taking 400 mg)

Since that day, I have had 2 or 3 other long attacks of a-fib with very irregular beats lasting 2 or more hours.  My EP told me to take additional Norpace + Toprol and if I don't convert in a reasonable amount of time, call the dr. and/or go to ER.

My question is this:
Is it normal to have bouts of a-fib like this post ablation? Is a-fib also part of the healing process? Or might we say right now that the ablation was a failure?

I have been experiencing PAC's and PVC's occasionally, but the literature I have states that I wouldn't have any more a-fib.  I'm having it now just as often as I had it before.

BTW, I'm not sure what kind of ablation I had...my EP spoke of the PV ablation before the procedure, so I assume that's what he performed.

Thanks

[dquenzer]

I was actually running about 3 miles 3 to 4 times a week at about an 8 minute clip when I had afib.  My Afib was not constant, but sporadic. I was on anti-arrythmics and a beta blocker.  Actually I was in pretty decent shape for being in the late 40's.  But pretty soon if I would run outside in the cold weather I would have atrial flutter that would turn into AFIB.  When I stopped and walked awhile, I would be OK and start running again, but I never felt tired etc.  But that's when I decided to get the ablation.

Right now I am on atenolol 25mg twice a day.  

I didn't start running again until 3 months after ablation.  I had bought a really good treadmill, and then I started very slowly.  I never exercised too the point I was really tired.  I just tried to increase length and intensity at very small increments  

Right now I run about two miles at about a 9:30 to 10 minute pace.  I don't push too hard, and then I try to ride bike for another half hour, this is mostly to get calorie burn with some aerobics.  At this point I really don't have any exercise intolerance other than just being 50.  At 50 I don't get in shape as quickly, but in the past few weeks, I've noticed I'm starting to see some results.  But I have taken it very slowly.

My suggestion to you is the following:
1.  Warm up by walking a few minutes at a fast pace.
2.  Then start walking and running.  I found it very helpful to walk a minute, run a minute, walk a minute, run...etc the first half mile or so.  This really helped me to build up to where I could run farther.
Then run your next mile slowly.  Or if you can't go back to intermittent running and walking.
4.  If you feel a bit tired, but good at the end of it that should be good enough.
5.  Then after about 3 weeks of that start increasing the time you run from one minute to a minute 30 seconds.

This is how I got back into shape, and it really worked well for me.  I never felt as though I was pushing too hard.

Hope this might help.

[axg9504]

I've discussed my situation before here and you've been kind enough to describe yours. I've been pursuing the cause of exercise intolerance for 3 years now, meaning having difficulty running after doing a mile in 12 mins or so. I can get dizzy if I push myself after this point and have to revert to a fast walk. I've had a heart catheter and an EP with an ablation for an atrial flutter in my right atrium and nothing has changed. I've had two event monitor studies. The first one was judged by one EP as showing small runs of Afib and the second set, which consisted of many more events showed only an irregular heartbeat in sinus rhythm. The EP who did my ablation wasn't convinced of my first EP's diagnosis of Afib. During the EP study they couldn't get my heart to do much of anything except for that atrial flutter which they successfully ablated. I've tried beta blockers and they made things worse. I have no problems during normal activities and after my exercise routine, limited as it is, at least from my perspective, I feel great! You say you are able to run now, can you tell me what your level of tolerance for running was before and after? If there's anyone else here with a similar problem please chip in.