Post ablation

[pms_barbie]

Hello and thanks for taking my question.  I had an ablation 4 weeks ago last wednesday.  I was having constant bigeminy.  The day after  my ablation I went into junctional rythym tachycardia.  As capytured on an ekg there at your clinic..  Well the dr told me I would have some funky things happen for a while after the ablation.  They saw 9 spots all located around my mitral valve and burned the 3 causing me what they thought the ost trouble.  Sometimes I still have what isnt bigeminy but a trogeminy rhythym.  Somedays I wont have but a couple of pvc's   and others, like yesterday the bug me all day long.  Is this normal after the ablation.  I would think the futher I got from the ablation the better it would get not worse.  I was also curious as to why they said they found nine and only ablated 3.  The whole procedure lasted 9 and half hours.  I called the dr and talked to a nurse about getting a monitor and she said it would be best if I got one locally.  I called my local cardio and he said if I got one this soon it would be a false reading because my heart still isnt healed and to wait a month or two.  Twice I have gotten this real fast heart beat where I dont feel the skips in my pulse but I can feel it in my chest.  Just like the junctional thing I had there before I came home.  Is all this normal?  Or has the heart healed about all its going to heal and this is all new stuff I have to deal with?..............Thanks for any help you can give me.

[CCF-M.D.-MJM]

Hi,

The science of PVCs, bigeminy, trigeminy, etc. is still expanding and we are often learning right along with you.  PVCs often wax and wane, being quite in intense for several weeks and then decreasing or disappearing for a time. We don’t understand why this happens and don’t have a great way to control them.  It is try that the after an ablation, PVC frequency can actually increase while the heart takes some time to heal.  Hopefully over a period of weeks to months, the frequency will gradually or abruptly decrease.

I wasn’t involved with your procedure so I can’t say for certainty why they didn’t ablate all your foci, but it is possible they didn’t want to do too much at one time.  They may have been near another important point in your conduction circuits—but I am speculating.

One problem with determining how successful an ablation is that we don’t know how many you would be having had the ablation not been done.  It is possible that your symptoms would be worse if you hadn’t had the ablation.

I think it is reasonable to wait a month or two more before doing more tests.  

I know PVCs make you feel poorly and to some extent affect your quality of life, but do your best not to focus on them and try to ignore them (I know, easy for me to say).  One problem we see that people let the PVCs control there life instead of vice versa.

Hang in there and I hope you feel better soon.

[dquenzer]

As someone who had an ablation the answer is a qualified "yes."  It is normal to have irregular beats after an ablation.  It actually takes between 3 to 6 months for complete healing.  The fact that you were "on the table" 9 hours means that's quite a time to have your heart messed with.

I had an ablation for paroxymal AFIB. I was on "the table" for about 7 hours.  It actually increased my resting heart rate significantly.  I had about 3 or 4 episodes of AFIB after the ablation, with periods of wierd beats for about 4 to 6 weeks.   I was concered "it didn't work."  It seemed that once it got to about 2 months things started really settling down.  I had no further AFIB, much fewer PAC's, and PVC beats occasionally.

I am now AFIB free, very few PAC's and PVC's.

It's too early to tell about success.  It takes about 3 months.

Are you taking any beta-blockers?  My EP at Mayo thought it would be good to be on beta-blockers just to keep irritation down.

Good Luck

[pms_barbie]

I am taking verapamil.  The same thing I was taking before the ablation.....thanks for your response.

[LynnSB]

I was SOOOOOOOOOOOOOOO upset after my ablation when I kept on having all sorts of skipped beats and fast beats. No one told me that was normal for a while... six months later ( last feb), at a check up, my routine EKG revealed I was in atrial tachycardia and my cardiologist wanted to put me right back in the hospital for another ablation. Coincidentally, i had met a new EP doc that morning and I asked if i could get his opinion -- the new EP doc put a monitor on me and said he really thought the problem would calm down and suggested we wait. I can honestly say it took just about a YEAR but my heart arrhythmias are between 80 and 90 percent better.. we now think there's one spot they didn't get but they did get the one producing the most trouble. I still have rough days and even rough weeks but all together it is MUCH better. For me, however, it took waaaaay longer than expected.

[pms_barbie]

Thanks to everyone for their responses.  They were greatly appreciated,....Stephanie

[slam]

I too have recently had an ablation and am still having numerous irregular beats.  I also have pulse rates from 48 to 160, has anyone else had this experience?  Thanks for any help.  This is very frustrating.

[pms_barbie]

what was your ablation for?  How long ago was it?

[sailthenet]

I had an ablation in Birmingham AL 7 weeks ago for A-fib. I am taking 750 MG of Norpace every day (an extraordinarly high dose according to my medical provider, Kaiser), along with Verapamil for heart rate control, and Coumadin.  I have been on anti-arrhythmics and blood thinners for 3 years, since my A-fib went wild after losing 35 pounds in 2 and a half months on the Adkins diet. Prior to that, I had three or four events a year, but suddenly they became every day occurances. I blew through the anti-arrhythmics in under a year, and settled into Norpace.

My EP specialist advised me 9 months ago that I can not increase my  dose of Norpace, and have run out of drugs, so I started looking into alternatives. Contrary to another posting I have found on this site, I am advised from other websites and a doctor friend that Norpace and similar drugs of the same class will kill you within 5 to 10 years (I am 53), so once you reach the level I have, you must either stop the A-fib (RF Ablation/Maze surgery), or get an ablation of the AV node and a pacemaker, and stay on blood thinners the rest of your life.

I was having episodes of A-fib on a daily basis prior to the ablation.  Most were under 6 hours, and the longest ever was 19 hours. I have not been cardio verted via electric shock to this point (except during the ablation, and thankfully, I was too doped up to remember that).

It has been a wild ride since the ablation. I am still taking all my pre-ablation drugs. I had PAC's for a couple of weeks, and those hurt more and are more physically discouraging than A-fib. My heart rate dropped to 45 BPM at times, then A-fib would kick in and the rate went to 120 to 140. As another person has observed in another posting, my resting heart rate is 10 to 15 BPM higher than before the ablation. I stopped Verapamil for rate control as the Ablation doctor said it might be causing the bradicardia.

The third week things settled down, and got much better, but then on the 5 th and 6th weeks, things got much worse. In the 5th week, I had a fib that ran at 190 or higher and had to go back on the Verapamil to control the rate. At 6 weeks, the original healing period the Ablation doctor predicted (prior to the ablation), I "celebrated" the 6 week anniversary by having 30 to 40 events in a single day.  It is difficult to tell whether an event is PAC's or A-Fib, but I am having both. These events were short, not over 10 minutes each, but never a dull moment at the 6 week anniversary.

Immediately after the ablation, I was told the healing and success/fail evaluation took 6 to 12 weeks, twice what I was told before the ablation. I had a 16 hour A-fib last night, after PAC's and A-fibs off and on all day yesterday. I don't count the  number of events any more. Again, I am at 7 and a half weeks now. My local EP specialist says the ablation did not work, the ablation doctor say let's wait and see.

I am very disappointed by what the ablation doctor did NOT tell me before the ablation. PAC's are not a good trade for A-fib in my book. You don't have to take blood thinners for PAC's but physically, they are more painful and have a stronger impact (physically and emotionally) on you than A-fib.

From reading other postings in this string, I see that the  recovery period is potentially much longer than I am advised even now, and I can see that the PAC's do not necessarily go away. I advised the doctors that I would not have traded A-fib for PAC's had I known going in.

I am also considering the Maze, which is open heart, and allegedly it has a 95% sucess rate. I WILL ask well informed questions about quality of life, PAC's and other side effects, before I submit to the Maze. I prefer to avoid the pacemaker and taking blood thinners (rat poison, to be specific) for the rest of my life.

My EP specialist recommends the Maze, not the Ablation. The ablation seemed a reasonable interim step short of open heart surgery.

I would be interested in hearing from anyone who has had a similar experience to mine post ablation, but still had a "good result" from an ablation. Has anyone had a second "touch up" ablation, and if so, was it sucessful? Going in, the ablation doctor gave me a 70% probablity of success, and says he gets an 80% sucess rate the second time (only a 10% increase). Is it worth the aggravation?

PS: I think it is great for A-fib sufferers to be able to share experiences, such as on this site. I do not know anyone who has A-fib, and it you have never had it, you have no idea what it does to you. People without it simply can't relate. I do have a friend with SVT, and that comes close.

[pms_barbie]

Sorry to  hear of your troubles.  Actually this was my second ablation.  The first one didnt do anything for me at all.  The second one still so far has kept the bigeminy at bay.  I still get the pvcs or maybe they are pacs because I have documented both on holter monitors.  I hope you can find some help.

[sailthenet]

Thanks for your reply to mine. I have never posted on a website before (does it show?) and I really should have posted mine as a question. Looking back at your reply to me and your original question, I might have some useful input. You said your first ablation accomplished little or nothing. Did you get any relief or improvement in your A-fib?  Did you have bigemony after your first ablation, PAC's or any new and "fascinating rhythms"?  If not, I would guess the doctor's missed the boat completely on the first one. It seems that bigemony, PAC's and other irregular rhythms, or tacycardias, are fairly normal side effects. I saw my EP specialist last Friday for an 8 week follow up, and he started off by asking me: "Well, if you had it all to do over again, would you get an ablation?". I didn't know whether to punch him or not. I'm still not sure what he meant (he recommended the Maze instead of the Ablation, and his question smacked of "you should have taken my advice"). Anyway, he told me that my present condition is better than 80% of his other patients who have had ablations, and I still have A-fib, PAC's and bigemony.  I don't know if this helps answer your question or not, but I hope it is of some help.

[lefty64]

I had ablation 6 weeks ago. Was only one focus and told 95% cure. OK until week 5 when I started having PVC's again. Before ablation was in bigeminy / trigeminy nearly all the time with runs of PVC's up to 20 in a row. My question is how long is healing and will the pvc's go away eventually. They come and go, sometimes I'm aware of them and sometimes not. Told heart normal after CT scan and EKG. Not on any heart meds only ones for COPD which I was on before. Couldn't take antiarrhythmics before ablation so decided on that instead. Meds made me feel terrible and I couldn't function after trying 3 different ones. Can't take beta blockers due to lungs. I feel better than before ablation but want pvc's to go away. Is the heart still irritable? Not told how long healing after ablation takes and thought only a few weeks.

[lefty64]

[416340]

I'm a 24 year old female who has been diagnosed with Right Ventricular Outflow Track Ventricular Tachycardia with about 25,000 PVC's a day. Over the past year, I tried living with this, but my episodes started becoming more frequent and more intolerable (dizzyness, extreme fatigue, palpitations, chest pain).  For the past few weeks, i have been taking a beta blocker (Sotolol) and it's been very effective.  However, i am very concerned about the long term side effects of beta blockers and am debating if i should get ablation done.  Has anyone here choosen ablation surgery even though the medication was working?

[PETER007]

A related discussion, HEART was started.