njm5876
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njm5876, August 5,  2019  9:56am EST

Abaltion recovery questions

HI everyone,  My husband had a RF PVI ablation in July 15, 3 weeks ago. He took the rest of the week off, had a rough day 2 days after the ablation but started having better days.  He is still have frequent runs of skipping/missing beats.  No Afib has shown on the Emay home monitor we have.  EP wants his vitals taken daily for now.  On day 14 post ablation, the monitor showed VPB R on T arrhyhmia with a HR of 66.  His  normal resting HR is considered bradycardia-- in the 55-65 range both before and after the ablation.  Have any of  you heard of this arrhythmia?  I sent a note along with his vitals asking the EP for an explanation. Haven't heard one word from the EP. We were supposed to have his followup this week but 'someone in the office messed up' and now no appt until the end of Aug.  Husband says the missed/skipped beats are about the same as prior to the ablation.  We were told by the EP that husband had just PAC's and that he had found them orginating inside the pulmonary veins. Since he ablated completely around the veins that the PAC's were contained.  Last week my husband had a call from EP and asked about still having the skipping/missed beats, EP told my husband that the ablation was just for the Afib, that the PAC's were starting from ALL over the heart!  Both my daughter and I remember him telling us the PAC's were contained and my husband probably wouldn't have any more issues with them.  Now he is telling my husband differently!  

Yesterday morning my husband woke up with a pounding feeling,  A check with the montior showed tachycardia with a 145 HR. This lasted about 2 hrs.  From the looks of the montior it was all still in rhythm just fast. He rested most of the day and after a nap said he was feeling some better. Later in the day we checked with the monitor again, showed HR 58 and HR 56 but no arrhythmia. He was extremely upset, he is sure the ablation didn't work, he doesn't want to go on drugs, he has lost his sense of taste, he's still tired most of the time.  I have tried to explain that the EP said it would take up to 3 months to know how well the ablation did, and that things could get worse before they get better becuase of the inflammation.  I wish I knew how to help him feel better about this and how to deal with an uncaring EP.  I think it is time to see another one but he wants to stick with this one until we know better if the ablation was a success. 

Thank you in advance for any experience with this. I know everyone is different so no one may have had a similar experience. We are new to this Afib...diagnosed in April with paroxysmal.  We beleive that his use of Naproxen led to slightly elevated BP which in turn has led to the Afib.  The only possible trigger seems to be stress. Afib blew up shortly after he had a shoulder surgery & really took off when he had an infection in 2 of the incision areas. 

Hope everyone is doing as well as possible!

Nancy

2 Replies
  • TR
    TR, August 5,  2019  5:29pm EST

    Nancy,

    Fourteen days is a little early decide whether the ablation worked or didn't, but I hope it did work. I would recommend to anyone who has had an ablation to get a copy of the operating room report(sometimes called electrophysiology procedure report, or possibly something similiar). This is a complete description, a blow by blow if you will, of everything that was done and everything that happpened during the ablation. This report is a permanent part of your husbands medical records and should be available to you for no charge from the medical records section of your hospital upon showing identification. You should not have to go through your doctors office to get it.When you get home, read it, read it three or four times and try to understand it. Some of it will be above your head, but a lot of it you can understand. Any questions as to what was done and what was not done and how it was done should be in the report. If in the future you ever consult anyone else, they will certainly want to see it, and for that alone, you should have a copy. My first ablation was unsuccessful and when I read the report it sounded like a very proffessional job had been done. My second ablation was successful and was done by Dr Natale, in Austin, TX. When I checked out he gave me a folder with a copy of the report, I didn't even have to ask for it. I am not suggesting your husband had anything but a proffessional ablation, but as an involved patient this is information you should know. This is a post I wrote about 1.5 years ago, and towards the botton of it is a copy of the conclusions section of the operating room report. It was exactly what we had discussed was going to be done. Next time you are at the hospital get a copy of yours, and see what you can make of it. You might learn something and you have nothing to lose.

    I had an unsuccessful ablation two years ago at a major hospital five miles from my home. I was worse off after the ablation than before, but it was eventually somewhat controlled by drugs. I made the decision to have another ablation and scheduled an appointment with my EP. I went in and asked the question, ”Since the last ablation didn’t work, what will be done differently this time?” The answer was that this would be quicker and easier than the last, a “touchup”. The pulmonary veins would be checked for gaps in the ablation lines, and a new line would be made to further isolate the pulmonary veins as this was the protocol for a second ablation. A quick and easy touchup was not what I was looking for. I wanted a tough, thorough, exhaustive search for any of those weird electrons causing my AFIB, by the best and most experienced EP I could find. My insurance somewhat limited the choices of where I could have it done and by whom for my first ablation. I am extremely fortunate that that is not the case with my current insurance. I chose a doctor 1500 miles from my home, because I felt he was everything I was looking for. Below are the conclusions section from my operating room report. My point here is that all ablations are not the same, and instead of a “touchup”, he went into all areas of the heart looking for problems and solving them. It’s been over a month since my ablation and knock on wood I’m still in NSR, which that alone is a record for me. Best of luck and I hope for continued improvement.

     

    Conclusions:

    1. Successful isolation of all pulmonary veins.

    2. Successful isolation of the posterior wall of the left atrium utilizing roof and infero-posterior lines.

    3. Successful ablation of electrograms along the left atrial septum, floor of the left atrium, and anterior roof of the left atrium.

    4. Successful ablation of the coronary sinus with mid to distal isolation.

    5. On high dose isoproterenol there was no evidence of reconnection between the left atrium and the pulmonary veins and no arrhythmias were induced.

    6. Successful ablation of the left atrial appendage with conduction delays.

    7. Successful isolation of the superior vena cava.

    TR

  • Izzy1
    Izzy1, August 6,  2019  4:46pm EST

    Great post@ TR!

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