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3 months after ablation, still have chest pain
Hi everyone, I am Scott. I am 57 and moved back to my native Massachusetts last fall after living in Florida for 8 years.
I was diagnosed with afib as soon as I arrived in Boston last fall. My PCP found it by taking my pulse during an initial physical. He referred me to a cardiologist, who referred me to the EP. My mom and my youngest brother have both had multiple afib ablations and my middle brother had open-heart surgery last summer. I had an ablation on Feb. 28 and except for some palpitations the first month, which freaked me out a little, I have been out of afib since. My problem is ongoing chest pain.
I have taken myself to the hospital 4 times since the ablation for chest pain, convinced each time I was having a heart attack. I have passed multiple EKGs, blood tests, a stress echo, a nuclar stress test, and finally a cardiac catheterization, which showed no blockages at all. Every time they test my blood my troponin is 0.
I was developing some reflux before the surgery and the surgery apparently put it into overdrive. But I had an endoscopy and passed with completely normal results. The doctors seem stumped, except to say my heart is in better shape now than it was before the ablation (70 percent ejection function vs. 40 percent when I was in afib). My BP averages about 120 over 80 now, down from 160 over 110. My HR is about 60, down from 120 when I was afib. And I have dropped a bunch of weight - almost 40 pounds.
I wasn't taking any meds when I moved here last fall, except ambien to sleep. Now, in addition to the ambien, I take sotalol, eliquis, lipitor, imdur and lisinopril for my heart, celexa for anxiety (mostly about my heart) and dexilant for the reflux.
So why all the ongoing chest pain? Reflux? Recovery from ablation (and cardiac cath all within 3 months)? All the meds? A still-undiagnosed heart problem? I have read that ambien can have some weird side effects, including horrible heartburn and chest pain. I also still pretty much eat what I want, when I want and drink wine with dinner a few times a week.
I live alone (divorced four years) and essentially work alone (in IT for a big law firm) and I tend toward anxiety and have had some depression as an adult. So I get that anxiety could also have a lot to do with it. I have never been sick before this and it takes some getting used to.
After the cardiac cath two weeks ago showed NO blockages, I am finally coming around to the point that my heart might be OK. But then why the ongoing chest pain? Anyone have any ideas?
Spencer, June 4, 2018 4:04pm EST
Bshersey - I am with you on the chest pains. I have had three ablations and still have some chest pain pretty often. It feels like a constriction on the heart or just plain chest pressure. I think it is due to the healing process of my heart as my EP ablated the @#$@# out of the heart this last time. Tip... don't chew out the guy who is about to work on your heart just before he puts you under. I did, and he came back with a retort of, "well we will just see about that." He took it as a personal challenge to fix me. Kinda of cool... but I was on the table for like 8 hours. So I attribute the pain to the chest to work done. One of the docs said that it will take about a year to fully recover from the ablation (3 in 6 months) and during that time your heart will hurt. So if you are good on the heart health, I'd say it is probably your heart healing.
Take respite in the fact that you have been checked out three ways to sunday and you are good. Take that as a win, get a glass of wine and relax.
Waiting for my Sunrise.
bshersey, June 4, 2018 4:07pm EST
Thanks for the reply Spencer. Three ablations in 6 months... wow. No wonder your heart hurts. Sounds like you've kept your sense of humor about it all. My ablation was about 5 hours, from what I've been told. But I was out cold long before the EP walked in the room.
rjrsm, June 4, 2018 4:12pm EST
Hi Scott: I read your post and found similarities in your post-ablation issues with acid reflux. I had my first and, hopefully last, ablation a month ago. All seems to be going well. However, the acid reflux is also a problem for me. I'm not sure what medications you're on, but I was taking sucralfate for 14 days and multaq for one month. While on the multaq, I did some reading and found that for some people, multaq can cause digestive issues. When I spoke with my EP, he confirmed multaq can affect digestion. I just came off the mulltaq and hope that resolves the part of my problem. BTW, are you taking protonix to help reduce some of the acid reflux? I take 40MG of esomeprazole.
bshersey, June 6, 2018 9:00am EST
To update: I had an MRI and abdominal CT scan to see if they could figure out cause of chest pain. I passed the MRI with nothing but a stiff neck, according to doctor. But his secretary was cryptic about the CT scan. Just said there were "irregularities" and I need to have a colonoscopy next week and stop taking Eliquis. The secretary wouldn't be any more specific than that.... Now something more to get anxious about. But still no afib :)
UPDATE: My colonoscopy came out OK. 4 polyps removed. Come back in five years. Back on Elquis today.
ShawnMarie, August 9, 2018 9:50pm EST
Hi bshersey. I'm sorry you're experiencing this. I just turned 57 recently and I just had a long-awaited ablation last Friday. The electrophysiologist said my heart lit up like a Christmas tree. I have been dealing with afib and ectopic atrial tachycardia for years and it's gotten worse than ever. This was my second ablation--the first was in 2004 and they couldn't fix anything then, but they only stayed on the right side of the heart. This time they did cryoablation on the left side for almost four hours. That was way more traumatic than the first time. I feel terrible. I was back in the ER on Saturday with awful pain. Then I had an ocular migraine on Monday morning and had to go back to the ER. I wondered if it was the Eliquis because I never had a headache that caused temporary blindness in one eye before. They sent me home and about an hour later I was calling 911 with the most uncomfortable case of afib I can remember. My heart was 210 beats per minute and the rhythm was completely erratic. I passed out in my neighbor's driveway and was rushed to the hospital by ambulance. I was admitted for two nights and I'm home now, but this pain in my chest, side, and back is awful. I'm also very clammy and have run a low-grade temp of 99.2-99.8. They think I may have some mild pericarditis and say I have to wait it out. What I don't like is that the pain goes down my arm. I've talked to the nurse and she says I just need to heal. My heart rate is normal but I'm terrified of having another afib episode like I did just after the ablation. It was awful.
I hope you can get it sorted. Three months is a long time.
12245, August 11, 2018 5:44pm EST
I had a ablation 5-29 and am going on the 90 day period where they tell you if it was a success. I have chest pain, acid reflux (had my esophagus scoped and that is fine, reflux is most likely from the meds). My heart rate is high 70’s to 125, most of the time high 80’s and 90’’s... It used to be around 68 when not in A fib. Climbing stairs can bring it up to 140. Ep doctor is basically unreachable. My primary can’t reach him either. I have seen him once since the procedure although I was back in the hospital 5 days after the procedure (in a ambulance) with A fib and tachycardia. I was there two days on flecanide. I did not see him then. I did see him two months out of the procedure and he took me off flecanide, still on pradaxa. My heart rate on flecanide was 78. I am wearing a holter monitor for 48 hours they want to see if I have any A fib episodes. Today vacuuming brought my heart rate up to 125 and it took 5 mins to go below 100. I took a flecanide (which when he took me off, told me not to throw it away). I am 72, was active walking two miles or more a day, gardening etc. He told me not to walk on the treadmill because of my heart rate. Heck I can’t even walk up stairs without the heart rate going high. It is depressing to feel as though I cannot do anything. It is depressing to not know what plan he may have (or maybe not) about this heart rate issue. Stress has my blood pressure higher than normal, my blood sugar also. I was much healthier before this procedure even with the occasional A fib. I had it done at a well known heart hospital in St. Paul, Mn by a EP that has done over a thousand procedures in 22 years. I thought I had done my homework, hmmmmm.