Beginning of Sixth Week Post Ablation

Hey all, I took myself away from the forums for a few weeks as I was over thinking everything and reading too much! Past few weeks I've gone back to work following my ablation and I'm now entering into my 6th week post.

Anyway, by this Thursday it will have been exactly six weeks so just thought I'd share how I'm getting on.

Well.. it's been a mixed bag so far really. Some days good, some days my heart still feels a bit more sensitive. Likewise, some weeks are good, others I'm a bit more stressed.

One thing that has remained is I seem to have a few PACs or random beats/pauses now and again (most days, actually) if I lean over too fast, or change my body position quickly. One thing I've become familiar with, is I regularly get 10 seconds worth of PACs and slightly raised heart rate when I lie down at night to go asleep. After 10-20 seconds this passes and I may get one or two irregular beats in the 20-30 minutes following that, before I drift off. It's not hugely uncomfortable but can be pretty jarring.

With that in mind, I was curious what other people's experience was of hitting the end of their "blanking" period. Did any/all activity you were still experiencing post ablation gradually subside toward the end of your blanking period or was it quite abrupt in how it stopped happening? I suppose I'm just getting a little trepidatious the nearer I am to the end of my own blanking and I'm still experiencing occasional activity.

Thanks all. I hope you're doing good.

Hi DavrosT,

Glad to here you are 6 weeks into your blanking period and so far only report what seems to be short runs of PACs/PVCs. These are NOT signs of arrhythmia activity and are very common to variable degrees after an ablation, so do not count them as breakthroughs at all.

The rapid temporary rise of HR often from bending over too quickly is also very common in the early months post ablation and is nothing to be on concerned with, just as having an elevated overall elevated resting HR for some months to a year or more in some cases ( though gradually declining toward your prior resting HR, is also not only a typical occuran it is fully expected as part of the healing process after many pacing cells in the endothelial lining of the left and right atria have been temporarily stunned or zapped and those exert looser control over HR homeostasis than before until they slowly recover full function again.

While excess ectopy PACs/PVCs can be annoying due to our hyper-awareness of any 'irregular.' heart activity, in the vast majority of cases these ectopic runs typically will also gradually lessen in frequency and duration over the coming six months. In some less common cases higher ectopic activity can go on for one to two years before they tend to finally recede into the normal background level most healthy people have if 500 to 1500 or more a year even for those who have never had one beat of AFSiB or AFlutter and who never will. We humans all get ectopic reset beats, but in non-arrhythmia prone people they hardly notice as they have not been conditioned to be on red alert noticing every and any little squiggle in HR by long term visits from the beast.

Just keep all this in mind DavrosT and also that having an elevated resting pulse is fully normal for quite some time and is actually a sign that some real effective ablation work has been accomplished during the ablation.

Normally, on average, the actual blanking period ends by end of the 8th week post ablation. This is a statistical average though and not a hard line in the sand, and some folks can have some one off, or two, after 8 weeks and still go on to a durably quiet heart (not including ectopy) for a very long time.

Most EPs confirm ... and from our anecdotal experience following so many people over the years as well ... that excess ectopy rarely last more than two years on the outside though even then it has usually greatly reduced in frequency and duration of ectopic runs well before two years.

Much less common will be longer term experience of excess ectopics and often those can be managed with mineral mineral electrolyte repletion and/or low dose Flecanide even in cases where it goe on longer term and is highly annoying.

PVCs of around 40,000 a day can be candidates for a dedicated PVC ablation !, but again these are more rare occurrences post AFIB ablation.

Your report above sounds really good actually and reason for optimism. Hopefully, by end of 8 to 10 weeks you still remain arrhythmia free which is another good sign that you may well be done for the long term!

Don't be a stranger going forward and for these annoying ectopic runs just try to practice the time honored cliche that so often winds up being very true ... 'This too shall pass'.

Be well,
Shannon



Edited 1 time(s). Last edit at 08/28/2017 02:11AM by Shannon.

Hi Shannon,

Thanks again for your great response, your advice has always been very detailed, comprehensive but mostly helpful and reassuring.

I'm moving along trying to be optimistic, so hopefully by about 8-10 weeks I'll be enjoying life after a successful ablation.

DT

Hi Davros, I couldn't explain it better than Shannon. I had an ablation 12 weeks ago tomorrow. During the first two weeks it was rough but after that it started getting much better. The PVC's or PAC's do start diminishing after about 6 to 8 weeks. I hardly get them anymore and when they happen, they are not as jarring as before. It's as if they are muffled. So far, I feel like I am getting my life back. Getting an ablation has been one of the best decisions I've made in my life.

Hey Oldticker,

Glad to know that you're feeling good following yours. My first week was fairly uneventful, had one 2 hour episode a week later but since then any activity has decreased. All I get now are some PACs and elevated heart rate for a short time when I lie down at night. One thing I have noticed is that these experiences are much less aggressive than they used to be.

What I found quite ironic was that the activity since my ablation has been much more frequent than prior but it does seem to be decreasing a lot and my resting hr has come right down.

Here is to us all finding the best way to get our lives back and cope.

Hi guys, I am now coming up to 9 weeks post and the activity is kind of the same.

Still having little short episodes when I lie down at night. Usually for no more than 10-15 seconds then it levels out. On Sunday night though, this happened as it usually does, a few premature/irregular beats, a bit of palpitations and then I'd get little prem/irreg beats every few minutes until I fell asleep. It seemed to have resolved by morning but jarred me awake a few times as I was drifting off.

I am due to go on holiday for about 10 days on Friday and I'm off at the moment. Was sat on the couch an hour or so ago and had a little run of ectopics for about 5-10 seconds. My HR jumped to about 84 for a while afterwards. Was a bit unexpected so caught me by surprise! I'm going to ask the typical question - considering I'm not at 9 weeks, would any of the above yet be considered breakthroughs?

Thanks, guys..

Quote
DavrosT
I am due to go on holiday for about 10 days on Friday and I'm off at the moment. Was sat on the couch an hour or so ago and had a little run of ectopics for about 5-10 seconds. My HR jumped to about 84 for a while afterwards. Was a bit unexpected so caught me by surprise! I'm going to ask the typical question - considering I'm not at 9 weeks, would any of the above yet be considered breakthroughs?

I wouldn't consider a brief run of ectopics to be a breakthrough. In fact, I wouldn't consider anything other than a sustained episode to be a breakthrough, and by sustained I mean more than a minute or two. However, the question is what was going on during that period with the elevated HR? Was that really just NSR at an elevated rate or was it afib? Do you have an AliveCor or something like that? It would be useful to see what was actually happening during those periods.

And to throw my two cents in on your original question, I just underwent my sixth ablation and post-procedure ectopy was a prominent feature of all the first five. I would consider it almost surprising for someone not to experience some degree of PACs, brief runs of tachycardia, and brief runs of afib and/or flutter in the months following an ablation. Don't read too much into them. If they don't produce a sustained arrhythmia then they're probably just more annoying than meaningful. Remember, your heart got beat up pretty good by the procedure. It's not happy and it will take a while to calm down.