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Help Afib after second ablation & cardioversion... now what do I do?
I’m a fit, athletic 62 year old male with no health issues other than recently developing heart arrhythmias. Zio patch and holster monitors have confirmed I have occasional Afib, flutter and SVT episodes... the trifecta. My Afib episodes were rare. I had a first ablation in April and episodes of SVT returned. After a second ablation in July I have now developed a persistent Afib and just this week had to undergo a harrowing cardioversion. I’m in NSR... for now. My next visit to the cardiologist is a few weeks from now. After two ablations and one cardioversion and checking all the good health habits boxes I am a bit perplexed. I would welcome help in asking the right questions such that I can figure out the next move... third ablation? I can’t deal with another cardioversion.
AHAASAKatie, August 19, 2019 8:58am EST
Good morning, I am truly sorry you are having to manage this and I look forward to reading what our members share with you. Have you read through the information we have on managing Afib? If not, that might be a great place to start. Best Katie
Spencer, August 19, 2019 10:27am EST
I have walked a long couple of miles in your shoes. Three ablations, two cardioversion and 21 days hospitalization all in six months. I was nicely awake when they zapped me in the last series of cardioversions so that really showed that cardioversions are fun. My ablations involved being fully awake and held down when they yanked the vein and artery catheters out of me. It was more like she hiked up her leg to get some leverage and said "this is going to hurt" She looked rather annoyed that I got blood all over her, the bed and new trainee. Another example was after the second ablation, and one of the caps for my catheters they came off, and I was asleep and leaking blood all over the place. It probably wasn't that much, but it looked like I got shot in my hip.
You have had two ablations and cardioversion. Getting the third ablation may be the way that you want to go. For my third, the doc did a four PVI (pulmonary vein isolation) and a full roof burn ablation. That did the trick but left me with a lot of scars inside the heart that have made me exercise intolerant. No AFIB but the cure came with consequences. Not saying that is what will happen, but with the third ablation, you are talking about a 98% chance of AFib free. But also remember that everyone is different and this is an electrical problem in your heart. You can not eat right nor exercise your way back to health. If you can convert and stay in NSR, do the cardioversion. The cardioversion leaves no scarring in your heart - the ablation will. Take the less invasive procedure if you can.
Have you thought about a second opinion?
If I were you, I was center my questions on why another ablation or cardioversion will work where others have failed. Find out the type of previous ablations you have before and info on the cardioversion (amount of the charge, and placement of the pads) - then compare that info to what the Doc is recommending now. What will be different this time? There are other procedures more invasive than an ablation that it might be time to discuss (usually the "Heart Surgery for AFib or "maze").
Here is where I am... What are you going to do to heal... Will that action is permanent... What will the consequences be of long term drug use or this recommended procedure... Are you the right person to perform this procedure...
I hope this helps. Also please note, I am on the extreme end. Do not base your info on what I experienced.
In the Sunlight
JonIngalls, August 19, 2019 1:20pm EST
Thank you for sharing your experiences and journey. Your input is valuable to me as I formulate the right questions to ask as far as what to do next and what would be different this time around. I’m probably headed towards ablation 3.0 but want some details/assurance on what will be different this time to achieve sucess.
Thanks again and best wishes to you!
Spencer, August 19, 2019 1:46pm EST
Jon - No problem. By the time you are on number three it is pretty old hat. Tell us how it is going and what you decide.
In the Sunlight
Myrna, August 19, 2019 4:19pm EST
Do you have sleep apnea? Have you been tested? Mellanie said that if you have untreated sleep apnea, the ablations may not work as well. Good luck.
Spencer, August 19, 2019 4:34pm EST
Yep. I was tested three times and it came back with a large number of times I stopped breathing. There are two types of "events", one where it is your pallette restricting your breathing and the other is where your brain forgot to tell your lungs to work for a while. I have the later and they still have not come down that much after a year of treatment. But I use the machine each night. If you have not been tested do so. Apnea is a major cause for AFib.
Thumper2, August 20, 2019 8:31am EST
Jon, why was your cardioversion "harrowing"? Surely you were given light sedation for the process. I had 3 cardioversions, but no recollection of them except for the slight "burned" patches on my front and back (which were not painful and went away easily).
OTOH, your cardioversion seems to have worked for you, at least for now (mine did not). I'm glad you are open to a 3rd ablation. For many on this forum, that has had the best results. I guess it's too late to ask your electrophysiologist what his/her overall success rate is, but for some here, getting another opinion and another EP led to success in staying in NSR. Please also check into whether or not you have sleep apnea, and keep us posted!
afibabit, August 20, 2019 10:13am EST
I was in persistent arrythmia several times, the longest was over 3 months. They finally put me on Amiodarone, which was effective, but not something you want to take long term. Next up was open heart with the maze procedure along with fixing other issues (replace aortic valve and aneurysm repair). My heart has now been in rhythm 15 months straight.
Spencer, August 20, 2019 11:10am EST
15 Months is great to be in NSR. Many of us are in NSR but not that long. Amiodarone is a really bad drug with a lot of side effects, but there are those that swear by the drug.
JonIngalls, August 20, 2019 12:16pm EST
Thank you for your thoughts. The cardioversion was done in our local ER and I don’t recall the actual zap and no ill side effects. The harrowing part was the drug cocktail used... propofol and ketamine (special k). The ketamine took me to what is called the K hole that gives you a very bad trip... a feeling of complete detachment and I truly thought I died and was in the afterworld. The most scary and unpleasant experience of my life for sure.