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My Dec. 31 ablation and a few questions
Posted by Stan B.
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Stan B.
My Dec. 31 ablation and a few questions January 01, 2004 10:36PM |
I was very pleased with my ablation on Dec. 31 with Dr. Wharton at the Medical University of South Carolina. I was extremely impressed with Dr. Wharton's expertise, skill, experience, and confidence. He truly deserves his reputation as one of the finest EPs in the world for RF ablations. Also, it meant a great deal to me that he spent over an hour with me in my pre op evaluation. I never felt hurried during our appointment and he answered all my questions. He is very friendly, very easy to talk to, and never (ever) hurries his patients. I felt both before and after my ablation that I couldn't possibly have been in better hands.
Also, his facilitiy for doing ablations is state-of-the-art. The Heart and Vadcular Center at MUSC is a special wing of the hospital that is space-age. It is circular, all glass, and overlooks panoramically the whole city of Charleston. There is a central pod in the center of the wing with technicians and all kinds of monitoring eqjuipment. Built in circular fashion around this pod are glassed-in surgical and procedure theaters. It is incredibly impressive. As you are being prepped for surgery, you look up at gorgeous photos on the ceiling of flowering gardens in Charleston and great beach scenes. It has a very calming effect.
My ablation took eight hours. Dr. Wharton first did a PVI abaltion and then a focal abaltion where he spent hours searching for other afib sites in other areas of the heart. That is why it took so long. He wants to do everything possible so that the patient doesn't have to come back for a "touch-up" procedure. My case was interesting in that I was told afterwards that my right two pulmonary veins almost overlap one another, and that Dr. Wharton felt it was better to ablate them both together as one vein (which he did) rather than trying to ablate them separately. He picked up afib signals from these two common veins and from one other, but not from the fourth pulmonary vein. However, to be safe, he ablated all four pulmonary veins. He then tried to speed up my heart to about 150-180 beats per minute because at that speed the heart almost automatically goes into afib if there are afib sites. He told me he couldn't get my heart much above one hundred beats per minute, and even wondered if I had some traces of a beta blocker in my system. (I didn't because I haven't taken a beta blocker in over a year and a half). He just assumed that my heart--for whatever reason--just does not speed up that much. Anyway, while my heart was accelerated, he didn't find any other afib sites. He told me that also did a flutter ablation. The end result is that he felt very good about the ablation when it ended. He feels confident that he eliminated my afib.
Since MUSC is a teaching hospital, Dr. Wharton worked with a fellow. I didn't know this was going to happen, and at first I was upset by this news. I wanted Dr. Wharton to do the WHOLE procedure, but this is not what happens at teaching institutions. I was upset because I didn't want someone to be training on my heart. If it were my leg or ankle, I wouldn't have cared, but not on my heart. Dr. Wharton assured me that I was his (Dr. Wharton's responsibility), and that the quality of my ablation would not be compromised in any way. Dr. Wharton and the fellow both told me that Dr. Wharton did 95% of my ablation. I met the fellow the morning of my procedure in the pre room. I was impressed with him. He had been through medical school, finished his residency, and had done two years of open heart surgery, and was within 6 months of being out on his own. He was very bright and knowledgeable and stressed that Dr. Wharton would be in control of my ablation.
I have two negatives about my ablation. After the ablation they transferred me to the cardiac floor of the main hospital, and my care there was terrible. I was put in a room at 7:00 and HOURS went by before anyone checked in on me. And then the only times they would come in was if I pushed the call button. That , too, was a problem. I would push the call button, they would say "just a minute," and it was sometimes an hour before they came in. The room itself was antiquated, and more like a hotel room than a hospital room. Nothing was user friendly. For example, there was no light switch near the bed to turn on the light. The light was on an end table, and you had to get out of bed to reach it. The bed itself seemed especially narrow, even for a hospital bed. Things got so bad, I asked for the nursing supervisor to stop by my room. She did stop by, and was very concerned about my problems and told me what I had experienced was inexcusable, not typical for the hospital. She took many notes on my complaints, and said she would personally deliver them to the hospital administration and that they would be in touch with me within 48 hours. I could tell she felt they strived for quality care there, and she was upset that care was not delivered to me. Perhaps what I experienced was a one night anomaly. It was New Year's Eve, they were filled beyond capacity almost on my floor, and I was there on a 23 hour observation stay. Maybe I was not considered a high priority patient. I don't know. Still, though, there was no escuse for the type of care I received. The hospital is old, (except for the Heart and Vascular Center, which is brand new), and they are getting ready to build a new hospital. A positive about the hospital is that they have a guest relations representative. This woman was wonderful, and went beyond the call of duty to help me. She arranged hotel accomodations, was there when I went for my ablation, was there when it was over, gave me her home phone number if I had any questions or problems, and even volunteered to keep my dog. She was invaluable to me, and the hospital is to be commended for having a position like this. Also, the hospital was very good about giving me rides back and forth from the hospital to my hotel.
The other negative was that I didn't see Dr. Wharton after the procedure, even afterf he promised during my pre op evaluation that he would see me in my room before I left. He sent his fellow in about 8:30 the next morning, and the fellow explained the whole ablation to me and told me that Dr. Wharton would be in about 10:00 or 11:00. Well, 10:00 came and no Dr. Wharton; 11:00 came and no Dr. Wharton, 12:00 came and no Dr. Wharton. Finally, the nurse paged him, and at 12:30 he PHONED me in my room and talked at length about my procedure and took his time and answered all my questions. Still, though, I would have preferred that he would have dropped by my room as he had promised. By not coming by, he didn't have access to all the monitoring of my heart that they had done in the night.
When I put everything into perspective, I am very pleased. The main thing is that I recieved an excellent ablation by one of the nation's best EPs. That is the important thing. The negatives fade away in comparsion to the high quality ablation I received.
Now for some questions:
1.) the fellow who saw me the morning after said I was in normal sinus rhythm (and had been since the ablation), but that I was having some PACs. Are PACs fairly common after ablations, and do they go away as the heart settles down?
2.) I have felt some very brief (a matter of seconds) accelerated heart beats, or skippings, and maybe some thumps in my beat since my ablation two days ago. I don't know if these are PACs or not. Has anyone else ever experienced some brief accelerated heart beats or some thumps or some skipping feelings after an ablation? If so, did they go away and how long did it take them to to go away? Do you think such feelings are fairly common after abaltions?
3.) Right now I feel that my heart is not beating completely normally. Do you think it is because I just had an ablation less than two days ago, and my heart is still very irritated? My heart fees like it is beating a little faster than normal.
4.) I am feeling some soreness in my chest when I breathe, especially deep breaths. Is this normal after an ablation?
5.) He told me that I should gradually increase my activity level, and within two weeks I could return to normal (in my case, strenuous) exercise. How gradual does this increase have to be? When can I feel safe riding my exercise bike at my normal level on intensity or swimming or jogging?
Oh, yes, something else interesting I wanted to report. I was not sent home on any antiarrhythmic drug and no Lipitor. Dr. Wharton feels that if I were taking an anitarrhymic drug after the procedure, then he couldn't tell how successful the ablation had been. By not taking any antiarrhythmic, he gets a clearer, better, faster idea of how successful the procedure was. The antiarrhythmic drug might mask some afib, and he wants to see without the drug how well my heart beats. He told me that if I do experience afib, to go back on my flecainide for the next two months.
I would be most appreciative of all responses to this report. I will read each posting with great care and interest. I am especially interested in what you would say to the questions I asked. Thank you so much.
Gratefully,
Stan
Also, his facilitiy for doing ablations is state-of-the-art. The Heart and Vadcular Center at MUSC is a special wing of the hospital that is space-age. It is circular, all glass, and overlooks panoramically the whole city of Charleston. There is a central pod in the center of the wing with technicians and all kinds of monitoring eqjuipment. Built in circular fashion around this pod are glassed-in surgical and procedure theaters. It is incredibly impressive. As you are being prepped for surgery, you look up at gorgeous photos on the ceiling of flowering gardens in Charleston and great beach scenes. It has a very calming effect.
My ablation took eight hours. Dr. Wharton first did a PVI abaltion and then a focal abaltion where he spent hours searching for other afib sites in other areas of the heart. That is why it took so long. He wants to do everything possible so that the patient doesn't have to come back for a "touch-up" procedure. My case was interesting in that I was told afterwards that my right two pulmonary veins almost overlap one another, and that Dr. Wharton felt it was better to ablate them both together as one vein (which he did) rather than trying to ablate them separately. He picked up afib signals from these two common veins and from one other, but not from the fourth pulmonary vein. However, to be safe, he ablated all four pulmonary veins. He then tried to speed up my heart to about 150-180 beats per minute because at that speed the heart almost automatically goes into afib if there are afib sites. He told me he couldn't get my heart much above one hundred beats per minute, and even wondered if I had some traces of a beta blocker in my system. (I didn't because I haven't taken a beta blocker in over a year and a half). He just assumed that my heart--for whatever reason--just does not speed up that much. Anyway, while my heart was accelerated, he didn't find any other afib sites. He told me that also did a flutter ablation. The end result is that he felt very good about the ablation when it ended. He feels confident that he eliminated my afib.
Since MUSC is a teaching hospital, Dr. Wharton worked with a fellow. I didn't know this was going to happen, and at first I was upset by this news. I wanted Dr. Wharton to do the WHOLE procedure, but this is not what happens at teaching institutions. I was upset because I didn't want someone to be training on my heart. If it were my leg or ankle, I wouldn't have cared, but not on my heart. Dr. Wharton assured me that I was his (Dr. Wharton's responsibility), and that the quality of my ablation would not be compromised in any way. Dr. Wharton and the fellow both told me that Dr. Wharton did 95% of my ablation. I met the fellow the morning of my procedure in the pre room. I was impressed with him. He had been through medical school, finished his residency, and had done two years of open heart surgery, and was within 6 months of being out on his own. He was very bright and knowledgeable and stressed that Dr. Wharton would be in control of my ablation.
I have two negatives about my ablation. After the ablation they transferred me to the cardiac floor of the main hospital, and my care there was terrible. I was put in a room at 7:00 and HOURS went by before anyone checked in on me. And then the only times they would come in was if I pushed the call button. That , too, was a problem. I would push the call button, they would say "just a minute," and it was sometimes an hour before they came in. The room itself was antiquated, and more like a hotel room than a hospital room. Nothing was user friendly. For example, there was no light switch near the bed to turn on the light. The light was on an end table, and you had to get out of bed to reach it. The bed itself seemed especially narrow, even for a hospital bed. Things got so bad, I asked for the nursing supervisor to stop by my room. She did stop by, and was very concerned about my problems and told me what I had experienced was inexcusable, not typical for the hospital. She took many notes on my complaints, and said she would personally deliver them to the hospital administration and that they would be in touch with me within 48 hours. I could tell she felt they strived for quality care there, and she was upset that care was not delivered to me. Perhaps what I experienced was a one night anomaly. It was New Year's Eve, they were filled beyond capacity almost on my floor, and I was there on a 23 hour observation stay. Maybe I was not considered a high priority patient. I don't know. Still, though, there was no escuse for the type of care I received. The hospital is old, (except for the Heart and Vascular Center, which is brand new), and they are getting ready to build a new hospital. A positive about the hospital is that they have a guest relations representative. This woman was wonderful, and went beyond the call of duty to help me. She arranged hotel accomodations, was there when I went for my ablation, was there when it was over, gave me her home phone number if I had any questions or problems, and even volunteered to keep my dog. She was invaluable to me, and the hospital is to be commended for having a position like this. Also, the hospital was very good about giving me rides back and forth from the hospital to my hotel.
The other negative was that I didn't see Dr. Wharton after the procedure, even afterf he promised during my pre op evaluation that he would see me in my room before I left. He sent his fellow in about 8:30 the next morning, and the fellow explained the whole ablation to me and told me that Dr. Wharton would be in about 10:00 or 11:00. Well, 10:00 came and no Dr. Wharton; 11:00 came and no Dr. Wharton, 12:00 came and no Dr. Wharton. Finally, the nurse paged him, and at 12:30 he PHONED me in my room and talked at length about my procedure and took his time and answered all my questions. Still, though, I would have preferred that he would have dropped by my room as he had promised. By not coming by, he didn't have access to all the monitoring of my heart that they had done in the night.
When I put everything into perspective, I am very pleased. The main thing is that I recieved an excellent ablation by one of the nation's best EPs. That is the important thing. The negatives fade away in comparsion to the high quality ablation I received.
Now for some questions:
1.) the fellow who saw me the morning after said I was in normal sinus rhythm (and had been since the ablation), but that I was having some PACs. Are PACs fairly common after ablations, and do they go away as the heart settles down?
2.) I have felt some very brief (a matter of seconds) accelerated heart beats, or skippings, and maybe some thumps in my beat since my ablation two days ago. I don't know if these are PACs or not. Has anyone else ever experienced some brief accelerated heart beats or some thumps or some skipping feelings after an ablation? If so, did they go away and how long did it take them to to go away? Do you think such feelings are fairly common after abaltions?
3.) Right now I feel that my heart is not beating completely normally. Do you think it is because I just had an ablation less than two days ago, and my heart is still very irritated? My heart fees like it is beating a little faster than normal.
4.) I am feeling some soreness in my chest when I breathe, especially deep breaths. Is this normal after an ablation?
5.) He told me that I should gradually increase my activity level, and within two weeks I could return to normal (in my case, strenuous) exercise. How gradual does this increase have to be? When can I feel safe riding my exercise bike at my normal level on intensity or swimming or jogging?
Oh, yes, something else interesting I wanted to report. I was not sent home on any antiarrhythmic drug and no Lipitor. Dr. Wharton feels that if I were taking an anitarrhymic drug after the procedure, then he couldn't tell how successful the ablation had been. By not taking any antiarrhythmic, he gets a clearer, better, faster idea of how successful the procedure was. The antiarrhythmic drug might mask some afib, and he wants to see without the drug how well my heart beats. He told me that if I do experience afib, to go back on my flecainide for the next two months.
I would be most appreciative of all responses to this report. I will read each posting with great care and interest. I am especially interested in what you would say to the questions I asked. Thank you so much.
Gratefully,
Stan
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Bob G
Re: My Dec. 31 ablation and a few questions January 01, 2004 11:41PM |
Stan,
That sounds great. I had an ablation in S. Floirda at Cleveland Clinic on the 19th. I had tried to go see Dr. Wharton, over a year ago, but my insurance would not allow it at the time. They wanted me to find someone in Florida. (HMO) I had heard great things about Dr. Wharton, and your report only indicates that it was true. I feel that i had a good Dr too. I trusted him and that was important. I had tried a couple of others and they said i was not a good candidate for ablation. i guess they were afraid i would chnage their success rate. I was a very bad case, and had been very sick with heart failure before the proceedure. Mine went well too, and i was very happy with my Dr, but the hospital stay was NOT a good one. Not bad, but certainly not what I expected. I had my ablation on Friday, and was released to go home on Monday morning about 10: am. I was left on my antiarrythmic for the surgery, and after. He wants to wait to see how i do before taking me off of it, since without it, I was unable to function very well, not even able to walk a few feet with out horrible AFib.
Since the surgery, I have done well. I have had several bad days, having fib almost all day, but never more than just a day of it, which is good for me. I am hopeful that in the two to three month waiting time, that things will get less and less, and that I will be AFib free, and able to come off of the Tikosyn. He is not sure about that, but because i was so bad I will have to at least stay on Coumadin the rest of my life.
Pac's are normal, as well as skipping and a feeling of your heart not beating right. I have experienced those as well as A-flutter and Afib since the proceedure. Some people do not have any, and others have some. Considering that before the proceedure I had a pacemaker that recorded events, and I had a period of time where I had Pac's almost 500,000 of them within a 2 month period, only having some now seems pretty good. The heart is irritated and during healing can, not alwyas, but can do some strange things. Chest soreness is definitely a result of the ablation, and should go away within several days or so.
I too had many other burns than the P V. I also had 5 Pulmonary veins which is unusual. He burned all five, and di over 100 burns of other areas including the flutter in the right side. Was sore for a few days.
I wish you well, and as you heal from this, that you will experience healing and that you will find that the ablation has been a successful one. It will be great to not be an AFIBBER!
Bob G
That sounds great. I had an ablation in S. Floirda at Cleveland Clinic on the 19th. I had tried to go see Dr. Wharton, over a year ago, but my insurance would not allow it at the time. They wanted me to find someone in Florida. (HMO) I had heard great things about Dr. Wharton, and your report only indicates that it was true. I feel that i had a good Dr too. I trusted him and that was important. I had tried a couple of others and they said i was not a good candidate for ablation. i guess they were afraid i would chnage their success rate. I was a very bad case, and had been very sick with heart failure before the proceedure. Mine went well too, and i was very happy with my Dr, but the hospital stay was NOT a good one. Not bad, but certainly not what I expected. I had my ablation on Friday, and was released to go home on Monday morning about 10: am. I was left on my antiarrythmic for the surgery, and after. He wants to wait to see how i do before taking me off of it, since without it, I was unable to function very well, not even able to walk a few feet with out horrible AFib.
Since the surgery, I have done well. I have had several bad days, having fib almost all day, but never more than just a day of it, which is good for me. I am hopeful that in the two to three month waiting time, that things will get less and less, and that I will be AFib free, and able to come off of the Tikosyn. He is not sure about that, but because i was so bad I will have to at least stay on Coumadin the rest of my life.
Pac's are normal, as well as skipping and a feeling of your heart not beating right. I have experienced those as well as A-flutter and Afib since the proceedure. Some people do not have any, and others have some. Considering that before the proceedure I had a pacemaker that recorded events, and I had a period of time where I had Pac's almost 500,000 of them within a 2 month period, only having some now seems pretty good. The heart is irritated and during healing can, not alwyas, but can do some strange things. Chest soreness is definitely a result of the ablation, and should go away within several days or so.
I too had many other burns than the P V. I also had 5 Pulmonary veins which is unusual. He burned all five, and di over 100 burns of other areas including the flutter in the right side. Was sore for a few days.
I wish you well, and as you heal from this, that you will experience healing and that you will find that the ablation has been a successful one. It will be great to not be an AFIBBER!
Bob G
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Jeanne
Re: My Dec. 31 ablation and a few questions January 01, 2004 11:42PM |
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Jim C. Rose
Stan..... January 02, 2004 12:48PM |
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njb
Re: Stan..... January 03, 2004 02:05AM |
Stan - my chest felt sore & raw for at least 6 weeks after my PVI ablation by Dr. Natale. My referring EP examined me after 2 weeks and said everything sounded normal.
After about 6 months my HR seems higher than it used to be--runs about 85 - 106 BPM.
When I had some monitoring recently, I had a lot of PVC'S
After about 6 months my HR seems higher than it used to be--runs about 85 - 106 BPM.
When I had some monitoring recently, I had a lot of PVC'S
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njb
Re: Stan..... January 03, 2004 02:09AM |
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Re: Stan..... January 03, 2004 09:26AM |
Registered: 6 years ago Posts: 18,881 |
Hi Stan - Thanks for the good news and a great report. I just want to reiterate that we are all told to expect some soreness in the chest or actually deep in the chest as heart area. I had some soreness for one day...and that was only when I moved a certain way.
Be prepared for some little jiggles of activity and don't be alarmed if some PAC's start up.
Because I went right back on the flecanide, I didn't experience any true PAC's initially, and over the past few months, just an extra beat now and then... probably no more than three occasions.
You will do fine. You've had a very fine EP and his fellow looking after your heart and now all you have to do is relax and let the heart heal. It will.
Be well. Jackie
Be prepared for some little jiggles of activity and don't be alarmed if some PAC's start up.
Because I went right back on the flecanide, I didn't experience any true PAC's initially, and over the past few months, just an extra beat now and then... probably no more than three occasions.
You will do fine. You've had a very fine EP and his fellow looking after your heart and now all you have to do is relax and let the heart heal. It will.
Be well. Jackie
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jack
Re: Stan..... January 03, 2004 09:21PM |
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bee
Re: Stan..... January 03, 2004 11:28PM |
Stan...the flip and flops are common. Everyone has different results..some are totally free of any extra beats....flutters et c. I choose to go back on my beta blocker as I still have some extra beats that go to some runs of PVC but as long as I take the toprol I am symptom free except for occasional extra beats ...which all people have at one time or another and some flip flops that quickly leave..and no afib. Its been a year and a half. Had mine done at Hershey hospital in Pennsyvania. Good docs ....good after care and improving everyday from what I hear. Things will settle down for you. I spoke with my doc and she said that within a three month period if you still experience Afib...it was not successful and a touch up if you are a candidate might be the answer....it takes that long for nerves to re generate. For those whose Afib is cut drastically down and they can live with it....thats fine. I would have gladly signed on for a touch up if I had needed to but so far I am ok. I had alot of anxiety associated with mine and any afib would have continued to send me up the wall and into the ER. Everyone is different on what they can tolerate. Good luck to you and keep us posted.
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Glenn Camp
Re: Stan..... January 05, 2004 05:49AM |
Stan did you ask Dr. Wharton any of these questions? Seems he should have told you what to expect and if you had beats that are not normal how they would feel and if you would be sore when taking a deep breath, etc.. All the care and taking of time you talked about that Dr. Wharton did prior to the ablation doesn't fit with leaving you out in left field on what to expect post ablation to me.
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Glenn Camp
Re: njb..... January 05, 2004 06:00AM |
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Re: njb..... January 05, 2004 11:18AM |
Registered: 6 years ago Posts: 18,881 |
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bee
Re: njb..... January 08, 2004 05:31AM |
I agree...you know when its time...whether you are laying in the ER...saying ...this is it and I am going for it or getting your co workers to take you to the hospital for the umpteen time or just as the Afib accelerates into what you know is coming..you just cannot take it anymore....I agree 100%. Some people have a high tolerance and others like me after the increase etc the last few years...just couldnt take the anxiety related with it also. Everyday procedures improve....take the chance if you are a candidate and you have the financial means. Even if you get a 75% result..its worth it. If it ever sneaks up on me again....I am there.
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