Afib episode following cryoablation

Hello,
I am 71 years old. Live in Israel. I experienced my first Afib when I was 18 and was in great stress preparing for my exams. Since then the afib occurred from time to time. Can't remember the frequency. I endured it without medication. I have a bad tolerance for medication. in 2004 when the situation became bad, i had an ablaion in the right atrium for atial flutter. The EP told me that I although I show trial Fibrillation in the left atrium as well, back then in Israel he did not have the technology to handle it.
Since 2004 I had ocationally an afib episode but it was not often and I could handle it until it passed on it's own without medication.
A few months ago i entered a period of stress and anxiety with no visible reason. Maybe hypothyrodism effected it. I started suffering from insomnia and frequent episodes of afib usually during the night. I could not take the afib any longer. It ruined my life. consequently had my cryoablation last april 26 in Israel. My EP told me after the procedure that all went well. He ablated the 4 pulmonary veins and also some ganglia in the left atrium. For 12-13 days after the ablation I experienced no afib and was so happy and hopeful. Until last evening at 7 pm (2 days after the ablation). Suddenly I felt a wave of warmth engulf me (my afib usualy starts with this sensation) and a funny feeling which I recognize and the afib started. It was a rather bad afib not a light one. It lasted almost 5 hours. Since I do not take any medicines, I took Klonopin which is a tranquilizer but it did not help much. I was both scared when it happened and very depressed. The EP told e that this could happen during the blanking period, but I am concerned that it lowers the chances for the ablation being successful. I cannot think of going through another ablation. The fact that I feel the wave of warmth prior to the afib, does it mean that it is vagal or not? I need some encouragement!! And what can I do to lower the chances of a second recurrence? what supplements can I take? Any advise and encouragement would be greatly appreciated.
Leah H.

Correction: The afib occurred 12 days after the ablation (not 2 as mention before by mistake)

Welcome to you, Leah. I'm sorry you experienced this.
As you wrote, you're in the "blanking period", so don't worry too much. I know it's not easy, I'm in this "blanking period" too.
I think the sensation isn't different, the afib being vagal or not. The way you feel afib (and the moments before it starts) is personal. The differences between "vagal" and "adrenergic" is in the triggers.

I'm sorry I can't help you a lot more, but there are many kind people here who can. Take heart!

Thank You Pompom

Pompom, How long have you been in the blanking period and have you had any episodes of afib during that time?

I'm 1.5 month in the blanking period, but it was a "touch-up" procedure.
My cryoablation was in sept 2016 and I quickly had afib after the procedure. Hence 2 other procedures.
I'm still having afib for about 1hr, 1-2 times/week (so, a tenth episodes since my last procedure).
But I've no regrets about the ablation: my symptoms are now bearable.
I'm taking magnesium, potassium and probiotics; and I'm getting gradually better.
Fingers crossed!

POMPOM,
Thanks for your answer,
Where did you do the touch-up ablation? I hope I will not need a touch-up as it scares me so much. I was very nervous and anxious before my last ablation about 2 weeks ago.
What kind of Magnesium and potassium are you taking and in what dosage?

Leah,

Are you not at least anti-coagulated in the wake of your ablation? That is a minimum standard just about everywhere. You should have been on Eliquis or an equivalent for at least one month prior to the procedure and then for at least 3 months afterwards.

Breakthroughs during the blanking period are to be expected, and don't necessarily portend a bad outcome. Stroke risk remains elevated, however, due to the inflammation in the atria from the procedure whether there is arrhythmia or not.

Thank you Wolfpack for your reply.

I did take Eliquis but only about a week before the ablation. After the ablation I was taking 5mg twice a day. As I felt that the Eliquis causes my blood pressure to drop and I felt weak, and since I weigh only 51 Kg, I asked my EP if I can lower the dose to 2.5 mg twice a day. He agreed reluctantly that I take 7.5 mg a day (5mg and 2.5mg). When I had my afib yesterday that lasted near 5 hours I raised the dose to 10mg per day. What's your opinion?

Quote
Leah H.
POMPOM,
Thanks for your answer,
Where did you do the touch-up ablation? I hope I will not need a touch-up as it scares me so much. I was very nervous and anxious before my last ablation about 2 weeks ago.
What kind of Magnesium and potassium are you taking and in what dosage?

Leah,
Here in Belgium we have an obligatory health insurance. I've had 2 EP for my procedures. The recent touch-up was made by an EP connected with the team at Bordeaux. It was an interesting procedure, and I was happy having it done only with a local anesthesia. Feeling all the HR changes during the procedure and talking with the EP was (for me) an exciting experience. I wasn't very anxious and, should I have to do it again, I would be even more relaxed.
I'm taking 900 mg potassium citrate and 1080 mg magnesium bisglycinate. I could probably take more than this (good kidneys), but I don't really know how much (people here surely have the answer...)
Probiotics are fine too, I'm feeling somewhat less bloated. The PPI drugs I took for ten months were really bad for my bowels.

That sounds OK if you're working with your doctor. The important thing is to keep it up for the duration of the blanking period. We all hate it, I know, but this is the one time that it really matters more than any other.

Pompom,

Have you ever taken anti-arrhythmic medication? I wonder if I should try it, as I am so miserable and suffering when I am in afib. I really feel I cannot go on as it is now. I feel that my quality of life is terrible.

Quote
Leah H.
Pompom,

Have you ever taken anti-arrhythmic medication? I wonder if I should try it, as I am so miserable and suffering when I am in afib. I really feel I cannot go on as it is now. I feel that my quality of life is terrible.

Leah,
Usually, we take a rhythm drug and an anticoagulant after the procedure. The RD is there to control and reduce the afib and premature contractions frequently appearing during the "blanking period". They are considered "normal". Our heart needs time for the burns to heal. The AC is to prevent clots forming in the atria.
Ask your EP. You'll probably feel a little short of breath with the rhythm medication, but you'll likely have less or no afib and, if you have, symptoms will be reduced.
With time, you might be fine, progressively reducing then stopping the drugs.
Don't fear a second procedure. Statistically, most afibbers need a touch-up after their PVI.

Thanks, Pompom, for your encouraging words. I usually do not tolerate medications well. But maybe I should try them all the same. Now that I am experiencing afib episodes during he blanking period almost every day for hours, I fear it means that my ablation (2 weeks ago) is not working. I find it very hard to tolerate the afib episodes and I feel quite desperate. I so need encouragement. My EP is abroad and for a few more days and I cannot contact him. I am in afib right now for 5 and a half hours and I do not see it stopping soon,

Leah,

Given your weight of 51kg, the minimum dose of 50mg 2x/day of Flecainide is an option. Along with, say, 12.5 mg 2x/day metoprolol. Ask your EP about that combo. It's about as low as you can go on either med.

I like you LEAH had a cryo ablation on nov. 8 2017 and the next night after getting home i had 1 of the most violent AR i ever had (out of the 300 or so AR up to that point) and keep believing the blanking period blanking period....but like it appears with you...no change whatsoever....till i started taking Taurine but thats another story......i again like you do not want to go on daily drugs...tried a couple for a short period of time and they made me feel like a zombie and lowered my heart rate into the 40's and worst of all DID NOT STOP MY AFIB...they did make my AR when i got it 2-3 times a week very mild though...aka not pounding through my chest so there was a little to be said about them. I have tried every procedure to get out of AR when i get it like bearing down, coughing, cold water face plunge and they rarely work although for me urinating in the 1st 2 min. gets me out of it about 50% of the time but the key is it has to be within about 2-3 min. of the time your heart starts going haywire or you are off to the races.
My advice to you is ask your doctor about Propafenone. Its a pill in the pocket type drug or take only when you get an AR like flec although each of those are used as everyday drugs also but not for you here....you want to get out of AR right now without daily drugs and this 1 IMOP is the best....now the normal treatment is to take 2-3 150mg propafenone's after you start your AR and you will convert in between around 3-6 hours give or take an hour and that's what i did for 2 years until the last 6 months when i had an AR i would do kinda what they do to you in the ER to convert you......pump you full of heart slowing drugs in a quick barrage to try and convert you quick then if that does not work it's shock time....but my point is instead of 2-3 propafenone's and wait 4.5 ave. hours to convert.... i CHEW 3/4 of a Propafenone...as to get it in your blood stream quick like they do in the hosp.....wait 45 min. and if not converted to nsr i chew another 1/4 propafenone pill every 15 min. untill i convert....rarely does it take more than 1 hour from start to finish.....either 3/4 pill does it in 45 min. or 3/4 pill + the 1/4pill chewed at the 45 min. mark..... a total of 1 pill/150mg. in 1 hour is all thats needed to covert (tastes terrible tinny so drink imed. lots of water with it) and the best thing about this drug Leah it goes right through you with little to no side effects in the PIP (pill in the pocket) way we are talking about......normally this drug is in effect in your system for 8 hours in the whole swallowed pill form....but when chewed its prob. half or less that time but you get that effect up front when your AR is most vulnerable to be eliminated because generally AF is like a freight train...stop it early cause when it gets going its much harder to stop and that's what chewing this drug does...so ask your doctor...or better yet TELL yes TELL your doctor you want to give this a try....... like i did mine after the ER doctor gave it to me in the ER after a failed cardiovert att. and 1 hour later after being in AR for 48 hours BANG nsr...... TY propafenone and not only LEAH will this convert in all likelyhood when you get AR...in your mind you know you have something to help when you get your next AR and that is a great relief believe me....for 2 years i called Propafenone my best friend and would not even go out of my house without 1-2 pills in my pocket so until you get better with the right supl. or a better Ablation...PIP with Propafenone.
GL LEAH and do not take no for an answer from your doctor...if he insists on no......get another to per. you this drug.
BTW do not mention to him anything about chewing this drug or that will make it harder to get it from these str. laced doctors who go only by the book and don't know squat about natural supl. either.....almost totally clueless about them.



Edited 7 time(s). Last edit at 05/16/2018 05:38PM by vanlith.