Waiting for Ablation and Questions

I'm a long time lurker on this forum, and I want to thank everyone for all of the wonderful posts and information shared. It has been very helpful to me. For 4 years I had paroxysmal afib that was progressively worsening, but I always self converted within 1-6 hours. I was on no drugs. Just before Thanksgiving 2018, a switch flipped and my afib would not go away. After much trial and error, I am now taking 50 mg of metropolol 3xs per day, 150 mg. of propafenone 3xs per day, and Eliquis. Oh, and while I was wearing a monitor, I had 59 pauses some of which were as long as 8 seconds, and much to my dismay, I now have a pacemaker that was implanted in December 2018 (by the way, I called Natale's office for a third opinion on this, and he said I should have the pacemaker put in). I'm the last person anyone would expect this to happen to. I'm 57 years old. I've always been active and fit. I eat very healthy, I'm not overweight, I have great blood test numbers, and my echocardiogram showed that I have a normal heart. I called Natale's office in early December (before the pacemaker) to schedule an ablation. I was accepted. At the time, I had no insurance and was going to do a self pay. It took St. David's a while to get those numbers together, and in the meantime, I was lobbying for health insurance with my employer, which I ultimately got. Natale's office didn't want to schedule the ablation until the self pay/insurance issue was resolved. It has been, and I'm now waiting very impatiently for them to call me with a date for the ablation. I feel like I've been waiting forever, and based on information I've read here, it looks like I may not get in until the summer. That would not be so bad, except we are having a difficult time lowering my heart rate. With changes to the dosage of propafenone, I seem to be staying in rhythm consistently, but my heart rate at rest is high 90s low 100s; it's around 84 before I get out of bed. I can't do any form of aerobic exercise (even walking doesn't seem to work so well), and when I do, my HR stays elevated for quite awhile afterward; I also get short of breath with minimal exertion so I stick with yoga and light weight training. I'm close to maxing out on the metropolol dosage, and increasing it doesn't seem to help anyway. I was taking a small amount of Digoxin (I know all the downsides and I resisted, but tried it because my HR wasn't going down as much as it needed to on the Metropolol), but I had to quit taking it because it was causing me to have gastrointestinal issues. It did bring my HR down into the 80s, but it's not even an option for me now. So here I am with pretty high heart rates, which don't bother me too much as long as I don't move around too fast or too long, but I'm concerned about the long term effects. My cardiologist wants to get them lower, and I'm waiting to hear from him today on where we go from here. I thought if the irregularity went away, my HR would go down, but that hasn't happened (that's how it used to work, and my HR was around 60 at rest). I'm looking for some insight from some of you who may have experienced something similar. I know everyone is different, but I value any information or suggestions you may have. I'm praying Natale will be able to help me, and I hope soon. There is no way I would have an ablation done by anyone else. Sorry for the lengthy post. Trust me, I left a lot out in the interests of trying to be as brief as possible.

Addendum: Right after I posted this, I got an email from St. David's, I'm scheduled for May 31st. It's a ways off, but at least I have a date.



Edited 1 time(s). Last edit at 02/25/2019 02:37PM by Deela.

Deela:

I had a pacer put in similar to what your problem was---when I was in an AF episode and going back into NSR my heartrate almost flat lined for a few seconds so I got a pacer, no more problem. As to your fast heartrate do you know what they set your pacing at? About a year ago I went for my pacer interrogation, after that my heart rate stayed a lot of times in the 80s, my heartrate always before was in the 60s, I finally complained and they checked my pacer and put the pacing at 60, my fast heart was gone after they quit pacing me at 80. I don't know why they did that in the first place because I just needed the pacer to stop my heart from dropping too low when going back into NSR. I would complain about your fast heartrate and have your pacer checked.

Those drugs that you are taking 3 x a day could cause your pauses in your heartrate, only thing is I guess you weren't on them too long before your pacer, is that right? But now that you have the pacer you are ok as the pacer will stop your heartrate to drop.

Glad you will be seeing Dr. Natalie.

Liz

Thanks for the response Liz. My pacer is set at 60. I haven't been in yet for the adjustment to the settings. That happens at the end of March. I was having noticeable pauses before I was taking any drugs, but it did cross my mind that the beta blocker may have had an effect. I really struggled with having the pacer put in--everything happened so fast and I hoped the ablation might solve my problem. I felt reassured that it was the right move after consulting Dr. Natale's office and receiving confirmation that I should do it. Now it's done and there's no going back, so I just need to accept it and move forward. As I understand it, my pacer is only triggered when my HR slows below 60. My main problem now is needing to slow my HR. Since my bout of persistent afib in November and continuing well into December, my HR even without afib has been staying in the 90s and into the 100s when I do anything as non-taxing as walking around my house. The metropolol and propanafone aren't controlling the HR well enough, although before I started taking them, my HR was staying in the 120-160 range (with afib), so it is an improvement. Dr. is now suggesting I add a low dose of verapamil. The absolutely fabulous news is that I managed to get an ablation date with Dr. Natale in mid-March. I have to go to Austin visit about 10 days before instead of doing it all in one trip, but hey I'll do anything to get this done and hopefully to start regaining a semblance of my former active life. I'm also hoping I can get off the drugs, and the ablation will address the tachycardia.

Deela:

That is good that you have an appt. with Dr. Natalee so soon, to have your heart rate that high is very tiring, a beta blocker should slow it somewhat. I wish you all the best and let us know how you are.

Liz