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Cardiac Ablation after succesful Cardioversion?
About 1.5 months ago I was hospitalized for heart rythm problems (diagnosed as atrial flutter). They did a cardioversion which they said was succesful in bringing my pulse down to the 70bpm range. For about two weeks, I had random pulse spikes (highest was 187bpm) which seemed to subside 20-70 minutes after taking an extra 25-50mg dose of metoprolol.
After those episodes pulse seemed to normalize, though I sometimes feel a little flutter as if it was going to spike back up but it stabilizes quickly enough that I can't get a reading on how high it may be (within seconds). I am currently on tropol and digoxin which keeps my pulse at around 55-65bpm at rest.
When I went to see my doctor, I told him about the spikes. He said that I should have cardiac ablation done to cure the atrial flutter. He has not seen me since then (about a month ago); the ablation is scheduled for next week but I'm having second thoughts. I'm starting to wonder if the spikes were just the heart adjusting to the new rhythm and meds, since it seems to be under control now.
I have been reading up on it and it seems that ablation isn't really a cure, and recommended if meds cannot control the flutter. Is that so? Anyone go in for an ablation after being cardioverted and being controlled with meds? The EP said I would still need to take medicine anyway, anticoagulant and antiarrythmic medication. And I would need to stop my current antiarrythmic and anticoagulant 5 days before the procedure.
I'm scared to stop taking my medicine 5 days before and ending up in the hospital again. Any insights would be greatly appreciated :(
After those episodes pulse seemed to normalize, though I sometimes feel a little flutter as if it was going to spike back up but it stabilizes quickly enough that I can't get a reading on how high it may be (within seconds). I am currently on tropol and digoxin which keeps my pulse at around 55-65bpm at rest.
When I went to see my doctor, I told him about the spikes. He said that I should have cardiac ablation done to cure the atrial flutter. He has not seen me since then (about a month ago); the ablation is scheduled for next week but I'm having second thoughts. I'm starting to wonder if the spikes were just the heart adjusting to the new rhythm and meds, since it seems to be under control now.
I have been reading up on it and it seems that ablation isn't really a cure, and recommended if meds cannot control the flutter. Is that so? Anyone go in for an ablation after being cardioverted and being controlled with meds? The EP said I would still need to take medicine anyway, anticoagulant and antiarrythmic medication. And I would need to stop my current antiarrythmic and anticoagulant 5 days before the procedure.
I'm scared to stop taking my medicine 5 days before and ending up in the hospital again. Any insights would be greatly appreciated :(
Jessy, I am sorry that you are experiencing such a hard time. I hope you recover soon and your atrial flutter and the treatment for it is nothing but a bad dream for you soon.
Take care and kind regards,
Ger
Take care and kind regards,
Ger
And if anyone reading this is wondering, no, if I had known what I know now I would have put off this procedure as long as I could have. I still have to take heart rhythm medicine and I have no idea how I'm gonna do that when I can't even swallow. The whole procedure was horrible. They schedules me for 10am, I ended up having it at 3pm. Spent 9 hours in recovery as there were no rooms available, and when I was finally going to be taken up they had a more urgent case to handle and short-staffed, so I finally made it to my room at 12:30am. It is currently 8:09am, doctor has not been in, I'm still in the paper gown, with the urine catheter, and no one knows when the doctor will be here. One of the worst experiences I've ever had, I was doing very well when I was taken off the medicine in preparation for this, now I feel I've taken several steps back. My heart rate is higher than it's been these past few days as well.
So I would not wish this upon anyone and hope I don't ever have to get this done again.:(
So I would not wish this upon anyone and hope I don't ever have to get this done again.:(
And if anyone reading this is wondering, no, if I had known what I know now I would have put off this procedure as long as I could have. I still have to take heart rhythm medicine and I have no idea how I'm gonna do that when I can't even swallow. The whole procedure was horrible. They schedules me for 10am, I ended up having it at 3pm. Spent 9 hours in recovery as there were no rooms available, and when I was finally going to be taken up they had a more urgent case to handle and short-staffed, so I finally made it to my room at 12:30am. It is currently 8:09am, doctor has not been in, I'm still in the paper gown, with the urine catheter, and no one knows when the doctor will be here. One of the worst experiences I've ever had, I was doing very well when I was taken off the medicine in preparation for this, now I feel I've taken several steps back. My heart rate is higher than it's been these past few days as well.
So I would not wish this upon anyone and hope I don't ever have to get this done again.:(
So I would not wish this upon anyone and hope I don't ever have to get this done again.:(
They said the procedure was ok, but the TEE they did to detect blood clots messed up my throat badly. I can't eat, talk, drink or swallow, the pain is excruciating. I can't even focus on my heart rate right now...
I don't know if this will help you much. But here is my situation. 43 yrs male, 5' 10", 190 lbs.
Mitral valve repair 6 months ago due to mitral valve regrug. 2 days after discharge from hospital i was readmit due to chest pain at which time i was diagnosis with afib and aflutter. My heart was switching between the two, unable to get into normal rhythm.
Meds was given to "fix" this. It didn't work. Readmitted to hospital for a number of other issues including chest pain, blurry vision and palpitations. A number of other meds was prescribe and remove. An initial ablation was schedule 3 months ago, but TEE found a blood clot in the left atrial so ablation was aborted.
A month ago, ablation was finally done, what was suppose to be a 3-4 hrs procedure turn into an 8 hours procedure that did not fix the afib. On the bright side, the EP said that I will never have a flutter. But it did not fix the afib.
Now both cardio and EP are suggestion a PVI ablation which they hope will fix the afib. I am on a regimen of meds right now including coumadin, lisinopril, hydrazine, labetalol, protronix, cudarex and furosemide. BP on average 180s/135s - uncontrollable at this time.
Difficultly in breathing at time. Heart rate is all over the place. Get tired very easily.
I guess my concern is the same as you Jessy. Is another ablation worth considering at this point in time?
Mitral valve repair 6 months ago due to mitral valve regrug. 2 days after discharge from hospital i was readmit due to chest pain at which time i was diagnosis with afib and aflutter. My heart was switching between the two, unable to get into normal rhythm.
Meds was given to "fix" this. It didn't work. Readmitted to hospital for a number of other issues including chest pain, blurry vision and palpitations. A number of other meds was prescribe and remove. An initial ablation was schedule 3 months ago, but TEE found a blood clot in the left atrial so ablation was aborted.
A month ago, ablation was finally done, what was suppose to be a 3-4 hrs procedure turn into an 8 hours procedure that did not fix the afib. On the bright side, the EP said that I will never have a flutter. But it did not fix the afib.
Now both cardio and EP are suggestion a PVI ablation which they hope will fix the afib. I am on a regimen of meds right now including coumadin, lisinopril, hydrazine, labetalol, protronix, cudarex and furosemide. BP on average 180s/135s - uncontrollable at this time.
Difficultly in breathing at time. Heart rate is all over the place. Get tired very easily.
I guess my concern is the same as you Jessy. Is another ablation worth considering at this point in time?
With the aflutter your main concern would be a clot forming and causing problems else where. I've seen patient's with leaky valves and it caused them afib, so I'm not sure if having an ablation would help since you probably would need a new valve before hand. Both of these factors, bad valves and aflutter, can cause CHF or worsening atrial enlargement i believe. I would get a second opinion on the whole ablation aspect. If you're able to control it with medication then I would hold off, but would definitely get another opinion.
It that case you only have to consider the arrythmia. Then it is back to my first answer (which is of course a non professional one) and you must decide whether you want to pay the money to discuss in stead of treatment and perhaps still end up with treatment later on.
I would be reluctant to undergo treatment when I was not experiencing AF. DeltaDawn23 also describes that medication worked for 10 years. When you are in doubt, a thorough discussion with your EP about the necessity and the pros and cons of treatment as well as pros and cons of medication seems the logic thing to do.
I wish you good luck.
Let me know how things work out.
I would be reluctant to undergo treatment when I was not experiencing AF. DeltaDawn23 also describes that medication worked for 10 years. When you are in doubt, a thorough discussion with your EP about the necessity and the pros and cons of treatment as well as pros and cons of medication seems the logic thing to do.
I wish you good luck.
Let me know how things work out.
Already spoke to the surgeon; he said replacement surgery wouldn't get rid of the arrythmia and it was only recommended if I had other symts such as SOB.
Now that you mention your other heart problems, I suggest that you post your question also in the heart disease community for extra responses.
Severe regurgitation can cause atrial fibrillation.
I don't know what your plans are with regard to the regurgitation of 2 valves, but severe leakage will probably need treatment in the future.
IF your regurgitation is causing the atrial flutter and CHF, it seems to me that you would perhaps be better helped with valve repair/replacement.
Severe regurgitation can cause atrial fibrillation.
I don't know what your plans are with regard to the regurgitation of 2 valves, but severe leakage will probably need treatment in the future.
IF your regurgitation is causing the atrial flutter and CHF, it seems to me that you would perhaps be better helped with valve repair/replacement.
Thanks for your responses! The problem with rescheduling is the doctor will charge me $200 if I don't do the procedure. And it's not that easy to get an appointment here so I would have to wait and talk to him the day of :(
I'm 34, female, history of restrictive cardiomyopathy and severe valve regurgitation (mitral and tricuspid valves). I was also diagnosed with CHF back in October.
Now I'm really confused because I was given the tropol and digoxin to lower heart rythm and as anti-arrythmics; also have metoprolol handy in case I had any episodes of tachycardia. They caught the episodes at the hospital after the cardioversion while I was still admitted and said that sinus rythm was normal but fast (no flutter).
So what are the toprol and digoxin used for?
I'm 34, female, history of restrictive cardiomyopathy and severe valve regurgitation (mitral and tricuspid valves). I was also diagnosed with CHF back in October.
Now I'm really confused because I was given the tropol and digoxin to lower heart rythm and as anti-arrythmics; also have metoprolol handy in case I had any episodes of tachycardia. They caught the episodes at the hospital after the cardioversion while I was still admitted and said that sinus rythm was normal but fast (no flutter).
So what are the toprol and digoxin used for?
Not sure what your age or history is, i.e., if you've had more than the one aflutter and cardioversion. It is my understanding that you must fail 2 medications before insurance will pay for an ablation. I would not go ahead until you are sure it's what you want -- you can always reschedule. If you've only had one episode, I would think medications might be tried before you go that route. Toprol and digoxin are not anti-arrythmics, altho they can both lower your heart rate and blood pressure, considered "rate control." I took beta blockers for 7 years and controlled my afib. Then when my afib got worse, I went on Norpace, which controlled it pretty well for about 3 years. Last summer I had chest surgery, which changed the whole picture and I've been in and out of the hospital with afib ever since. So I had an ablation February 3rd this year and am scheduled for a second one the end of April. Maybe another opinion (or two) would give you an idea which route you want to take. I had numerous opinions over the last couple of years and most said ablation was reasonable, and after my chest surgery they all said I should have one sooner rather than later. I have had afib since 2003. Wishing you well on this and keeping you in my thoughts and prayers.
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