Three months since Dr Natale ablation

I'm just past the three month milestone since my ablation with Dr Natale in Austin. The best we can tell I have been in continuos NSR since the procedure! I have not worn the Holter yet. I have discontinued Metoprolol but remain on Xeralto. My resting HR continues to be elevated but has slowed a bit. I'm at about 85 bpm down from 92 bpm. Prior to the ablation I was in the low to middle 60's. No episodes of bradycardia like prior to the ablation.

So far I have experienced great results but my recovery has not come without concerns. I'm also aware I'm relatively early in the total recovery period. If I've learned anything in this process it is that everyone recovers differently and to expect it to take time for recovery ( at least in my case).

Dr Natale considered me to be an excellent candidate for an ablation. My ablation was initial treatment for afib. Prior to the ablation I was only on Xeralto for a week. No other medications. My DX for afib was made 6 month before the ablation. It is likely I had undiagnosed afib for at least two years prior. I was otherwise relatively healthy.

My biggest struggles in recovery have been SOB, fatigue and chest discomfort. I had a scare on my way home from Austin when my vision went weird, i ended up with an overnight stay in a hospital and lots of test to rule out stroke or TIA. The doctors concluded the event was most likely a result of dehydration and not stroke related. One test did reveal an occluded caroitid which was later determined to be incorrect by more accurate testing.

A pulmonologist was brought into my case to deal with my SOB. Of interest he had two ablations himself and was very familar with the recovery process. His initial thought was my SOB was just part of the recovery process but he wanted to exclude any possible pulmonary stenosis. He ran a multitude of test and found no evidence of stenosis and my lungs were in outstanding condition. I scored as high as 127% of capacity for my age! He also ruled out asthma. He suspects my SOB is a result of damge to nerves and/ or cells inside my heart during the ablation. He said that is to be expected and that they should recover over the next year. My SOB has diminished significantly. I can easily walk 3 miles over hilly terrain. My stamina is almost back to normal. I can do just about all I was able to do before ablation.

The pulmonologist also had me do a sleep study. I have very mild sleep apnea. He did not prescibe a cpac. I just require measures to keep from sleeping on my back. He showed me an expensive pilow thing but said a couple of tennis balls in a sock pinned to the middle of a t-shirt works just as well.

I still experience some chest discomfort. The intensity and frequency has diminished significantly. When it does occur a few times daily it is a dull ache feeling. No more sharp stabbing pains. I wonder if the sharp pains were actually muscular originating in or about the shoulder. I've had surgery and arthritis in the left shoulder. Following the ablation, if I held my arm over my head I felt sharp pain over my heart area. It took very little movement to trigger that pain. It has now totally resolved,

So there you have it! It's looking good as we move forward. Thank you all who have helped me along the way!

Good report Craig,

Sounds like you are doing well indeed, the temporary SOB is just that in almost all cases, and your pulmonologist is right, minor transient occurrence of SOB can be a part of the ablation process inherently, though typically its so minor few notice it much after the first few days to first few weeks. Very active endurance exercisers are likely to notice it more in the first few months than those with more modest exercise programs, but in any event, even if it is a noticeable nuisance, it tends to be self-limiting meaning that its not all the time and is usually activity-induced, and is also temporary, meaning it returns more or less to your pre-ablation status anywhere from as little as a few days or weeks up to around six months on the outside in some cases, while gradually improving all along during those first months post ablation. After which the vast majority of highly active, fitness-oriented ... and now reformed afibbers ... can return to their fully active and exercise intensive lives with little to no deficit.

And It can certainly help hearing that from those of us who have been there before, so as to lessen any concerns while such symptoms can still be making an appearance.

It varies some as well depending on the degree of prior disease and fibrosis we bring to the table, but its typically not a long term issue for the vast majority. Any chest transient chest discomfort that is solely related to the ablation tends to be very minor, if at all at this point, so what you describe may well be a combination of your prior injury and referred shoulder/chest pain along with some possible small residual from the ablation but from my experience and so many others most chest pain from the ablation is basically before the three month mark.

From your report though it sounds like another bang up job by Dr N and having passed the full blanking period with no arrhythmia and not having required an LAA isolation to begin with, then passing the three month mark in total NSR is a very good sign that you could hopefully be one and done already!

You made an excellent choice and thanks for sharing your experiences along the way, everyone has their own unique process and experiences at each step and its great to see all the difference nuances of experience as we take the journey back to a stable guiet heart for the long run.

Be well,
Shannon

PS, I realize too that your hour and a half wait for a 15 minute first appointment with Dr Natale in Austin that first time is likely mostly all my fault. It is too bad I didn't know you then as we could have met as I had to quickly fly there the day before on May 12 for an urgent TEE and meeting with Dr Natale that very day of May 13, and he did have a packed room of patients that day as it was his typical office day too and yet he also and two ablations that morning as well.

Alas, I had just experienced what turned out to be a small stroke in Sedona the day before flying suddenly to Austin, and as such Dr N felt it important to get my situation sorted out as quickly as possible so as to hopefully prevent another stroke, but my unexpected presence there did throw a bit of a monkey wrench into their schedule on May 13, so my apologies for the delay and Im very glad it was so well worth it for you and your wife in any event! :-)



Edited 1 time(s). Last edit at 08/16/2014 03:31PM by Shannon.

Oh my gosh Shannon.....no need to oppologize! Your circumstance was well up on the priority list! Actually, I was blown away by how fast I got into Dr Natale. He is obviously one of the best cardiologist in the world. It took me a whole two weeks from my intial call to his Austin staff to ablation! Unreal! I expected it to take many months before I could even get a consult. His staff bent over backwards to get me in quickly and to make my experience seamless. There was some urgency in getting the consult because my afib was unexplainably getting much more prevelent quickly. I was having short but numerous daily episodes. The duration, frequency and intensity were increasing. It was complicated by worsening bradycardia. A concerning ekg resulted in a hospital admission and further testing a week before I saw Dr Natale. My cardiologist was worried because he couldn't explain the rapid changes nor was he confident to put me on rate or rythum drugs because of the tacky/ brady dx. My Austin appointment happened so quickly I was still on a two week event monitor when I saw Dr Natale. We didn't even have the results. It was my forth monitor in a 6 month period. I am very greatful for Dr Natale and his staff. As a matter of fact, I didn't even take the time to tell my cardiologist of my appointment with Dr Natale before my consultation /ablation. My follow-up with my cardiologist was actually scheduled to discuss the results of my event monitor. I remember the look on his face when he came into the exam room. The normally jovial doctor looked like he was carrying the burdens of the world on his shoulders. He said, " We need to discuss the results of you monitor". He really didn't even greet me. I replied, " First you need to know I've had an ablation by Dr Natale in Austin, Texas." He said, " You did? Thank God"! He then smiled and the atmosphere in the room immediatly lightened significantly. We were both so jazzed I never did discuss the specific findings from the monitor. Kind of irrelevant at that point. He only said it was very active and not good.

An hour and a half delay.......that ain't no thing! I'm also glad for your improving condition Shannon. You have been through the ringer but still stay so up beat and help so many people. That tells me you are a class act! Keep well!

Craig