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

[axg9504]

I would think that your medication would include Coumadin to thin your blood if you have Afib. I was told to take the same when my first EP saw (I think subsequent evidence showed he may have been incorrect) "bursts of Afib" on my heart monitor during running. I have never had any heart palpitations or recorded high heart rates at any time, or even widely fluctuating heart rates. My reasoning in rejecting Coumadin was that I did not think that I was in Afib, if ever,  very long at all to justify it. Sounds like you might need another EP study to determine the source of your arrythmia.

[axg9504]

It just occurred to me: You have Afib when running, and you are able to continue after a while, no dizziness, no tiredness. However my EP's think that my dizziness etc. are due to an arrythmia of some sort!! I assume you had very irregular heart rates when you had your Afib. My heart rate, as per my Timex heart monitor shows it goes up smoothly during my initial run, levels off at 130, thereafter as I run and walk it goes down and does not seem to go up to 130 again. when I step off the treadmill it goes down, sometimes as low as 50. It stays fairly steady at this low rate for a while and then it ramps up to 90-104 which is what it should be, since I work out with weights after the treadmill.

[PikaPika88]

Hi, Dr did not give me blood thinner.  I've a history of ITP (low platelets). I'm taking some herbs (in tablets form) that my mum posted to me.  It dissolved the blood clots and it helps to stop the bleeding as well.  (It is very good for gun shot wound and after operation.) I didn't tell this to my cardiology.  Two weeks ago, morning at 1:00am I went to ER because my back chest pain and I can't sleep.  My oxygen intake is 100%!!!  I knew that because my TCM practitioners are very strict.  They want me to do 2 kind of exercises to increase the oxygen intake.  I think all these exercises (slow motion) are came from part of the Martial Arts.  Hey, you all haven't told me which country are you in?  I just wander their ablation for A Fib is so advance than Australia.  Thank for your post. Hope you all get well and healthy. Pika

[dquenzer]

Strangely enough I never felt dizzy when I got AFIB while running.  I felt a bit nervous and anxious, but never dizzy.

I have heard others say the same thing.  In fact some people in constant AFIB run and don't feel dizzy.  I find that hard to believe, but it's true.

At age 61 I don't think taking an anti-arrythmic is a bad thing.  If you were in your 40's maybe.  I had no side-effects when on anti-arrythmic.  It is better to stay in rythmn.  The risk of AFIB is worse than the risk of taking a drug that has found to be quite safe.

[dquenzer]

I missed something significant in your last post.  You said that your heart rate doesn't really get above 130, and also that it slows very quickly.  That's a bit strange.  My normal heart rate during exercise is 130 to 140.  And when I start walking it takes about 3 to 5 minutes to get back down to 100 or lower.  This could be why you are getting dizzy during exercise.  Your heart rate doesn't get high enough to compensate the exercise.  However I will have to say that your target heart rate at age 61 really shouldn't be higher than 130.  

220 minus 60 is 160 (your max rate.)  80% of 160 is 124.  That should be about what your rate should be.  Anything more than that may be too strenuous.  Therefore it might be a conditioning factor.

I'm not a cardiologist, but I think there is a condition where the heart actually goes too slow. People in this condition need a pacemaker to speed their heart rates up.  I'm not saying you have this.

Have you described this condition to a cardio.  And what did he/she say?

[axg9504]

Both my interventional cardio and the EP he recommended are aware of my research with my Timex monitor but they have not set much store by it. Now the confusing thing is I have become dizzy when my rate was in the 90's. Every exercise period is consistent: It ramps up smoothly as I start my initial run on the treadmill. I wish I could run at that pace for a longer time than 5 mts to see if it will go down at some point. But I have to stop and walk. It does come down to the 100's when I walk, and will go up subsequently as I pick up pace. Since I can't do many more fast runs after that I can't tell whether it does not pick up because I'm not on a higher load long enough or whether its because of something else, but I do know that when I get off the treadmill it goes down to 60 sometimes 40 even. I can be in this stage for 10-30 minutes sometimes till the rate suddenly ramps back to 100. As I said I'm working out with weights during this time. There is no firm correlation between how I feel and my low rate. I don't get dizzy, I need to run to do that. My BP gets low too sometimes (90/60) at the end of my exercise. BTW I notice that a day or so after aerobic exercise my BP is 105-110/60-70 whereas its normally around 120/80. Thanks for your input, your info on bpm was useful. If you are typical, your bpm should not go down as you exercise. I was wondering if there is some conditioning factor that kicks in and slows things down...