I'm over two years post successful ablation. I woke up at 0400 with a relatively high and very irregular heart rate (around 100 bpm) combined with many irregularly spaced strong thumps. I got up, took about 2 gms of potassium, wired myself up to the Holter, and went back to bed. My heart settled into what seemed like NSR after about 40 minutes. When I got up this morning I examined the four hours of Holter recording. There was no a-fib and there was no a-flutter and there were only seven PVCs during the four hours of data (most of which occurred after my heart rate steadied) and there were only three PACs (most of which occurred after my heart rate steadied). There was a highly irregular NSR heart beat which faded into a steady normal heart rate after some 40 minutes, but the perceived symptoms perfectly mimiced the very familiar symptoms of a-fib/flutter combined with numerous strong PVCs. I've reported on this before. My data is still consistent with having a normally dormant pacing node located near the AV node. That normally dormant node occasionally comes to life and competes with the AV node for control of heart rate for a while, before becoming dormant again. The result perfectly mimics an a-fib/flutter episode. At one pole we have "silent a-fib". At the other pole we have "imaginary a-fib". I wish more of you had some serious ECG instrumentation. https://www.afibbers.org/forum/read.php?9,62781,62781#msg-62781 Thu, 24 Sep 2026 19:38:19 +0000 Phorum 5.2.23 https://www.afibbers.org/forum/read.php?9,62781,64402#msg-64402 https://www.afibbers.org/forum/read.php?9,62781,64402#msg-64402
If you remember I had my ablation a couple of months after yours with Natale. I was in 24/7 Afib with slight symptoms and reluctant to have the ablation until reading your research and perspective on the long haul deterioration 'theories' based on what I think is decent research .

I'm merely checking in to say that your mentined monitoring equipment practicalities really may become essential at some period.

After an over stimulation session with caffine (non organic) I went into what I thought for sure was afib. Checked into the ER quickly hoping for the 'non penalty' within 24 hour cardiovert. After 3 ECG's showing perfect NSR in the midst of my pulse jumping all over the place the Er Dr. came in, listened to my heart while watching the monitor and said I was experiencing PVC's (my first known). Now I know about PVC's and how they feel and seem to be Afib.

This post is really about the caution that perhaps there could be some anxiety relieved if we were to include in the ole 'knowledge is power' bank (I could be 100 years late on this) the possibility that for the new one PVC;s are not afib and then of course could be afib and/or a precoursor to it. For the slam bang 200ppm wild pulse its a no brainer but for the slight and subtle yet undeniable symptom it may not be what one thinks it is and maybe only equipment can distinquish the difference.

mike

mike]]> mike c AFIBBERS FORUM Tue, 28 Apr 2009 18:43:57 +0000 https://www.afibbers.org/forum/read.php?9,62781,63516#msg-63516 https://www.afibbers.org/forum/read.php?9,62781,63516#msg-63516 Wil Schuemann AFIBBERS FORUM Fri, 07 Dec 2007 14:22:13 +0000 https://www.afibbers.org/forum/read.php?9,62781,63364#msg-63364 https://www.afibbers.org/forum/read.php?9,62781,63364#msg-63364
Gee i wish Kagey could hear about this, she feels she is the only one with this 2 rhythm condition.

PeggyM]]> PeggyM AFIBBERS FORUM Thu, 06 Dec 2007 00:51:29 +0000 https://www.afibbers.org/forum/read.php?9,62781,63273#msg-63273 https://www.afibbers.org/forum/read.php?9,62781,63273#msg-63273
Barry - I am hypothyroid and take thyroxin and tertroxin as well as the propafenone and it is the balance between the thryoid medications and the propafenone which has started to "get me down" this year.

Previously, I have taken the propafenone happily for 3 years, until I developed the hypothyroidism as a result of Hashimoto's.

Yes, I have always known heart block is serious and one is susceptible to SDD. Because I have had all this (not the AF though) since I was a teenager I have always taken the attitude of not worrying about it. Nothing can be done about it so I just got on with it. Hence I competed (equestrian) and pushed on as hard as possible, I'd rather have quality than quantity.

Here is the link to the info ref 25% etc. www.bcs.com/pages/page_asc.asp?pageID=255

Thanks for your interest.

Kate]]> kate AFIBBERS FORUM Wed, 05 Dec 2007 04:34:23 +0000 https://www.afibbers.org/forum/read.php?9,62781,63270#msg-63270 https://www.afibbers.org/forum/read.php?9,62781,63270#msg-63270
could you expand on the cardiac arrythmia is currantly the No1 killer in the UK.

I'm guessing that any diseased heart will function improperly/irregulary which will termed an arrythmia so this would not really be relevant to Laffers.

The statement that 25% of patients with AF die within 2 years of diagnosis again goes against the grain when dealing with laffers but its surely a warning against all this stuff about 'learning to live with it'.

For my money try the meds /suppliments for a while and if things don't improve dramatically then get on the ablation route even though there's no guarantee of 100% cure.

Been there, got the tee-shirt.

Don't waste time, you're only here once

Barry

]]> Barry AFIBBERS FORUM Wed, 05 Dec 2007 04:12:09 +0000 https://www.afibbers.org/forum/read.php?9,62781,63267#msg-63267 https://www.afibbers.org/forum/read.php?9,62781,63267#msg-63267 if you fall under type2 or complete i would be concerned, im sure its not complete heartblock or you wouldnt be here right now.
pacemakers save soo many lives its amazing. ppl are afraid of the word pacemaker but it is a rather easy procedure.

and for anyone else reading this & you need to have an ablation done you need to see dr. frances marchlinski at university of pennsylvania in philadelphia PA
google him & you'll see what i mean. i have seen his work & he is the best period]]> inthebiz AFIBBERS FORUM Wed, 05 Dec 2007 03:37:52 +0000 https://www.afibbers.org/forum/read.php?9,62781,63264#msg-63264 https://www.afibbers.org/forum/read.php?9,62781,63264#msg-63264
My EP is considered to be the best in the UK, one of the best in Europe and lectures all over the world. He is very focussed on passing on knowledge and skill to the next "generation" of EP's. Anyone else who I go to has been taught by him and will not have superior skills or knowledge. Back in the early 90's when ablation for rhythm was very new I was 11th to be done. When I consulted with him I was 7th, he did 3 more the next 3 weeks and I was 11th. Having been inside my heart for three and a half hours (I was awake the whole time, it was fascinating to watch on the screen) and listened to it and studied graphs of my heart for nearly 14 years, he has my total confidence.

I still have the heart block, I don't consider that an irregular rhythm in the same sense that WPW or AF is an irregular rhythm because it doesn't impede my life in any sense at all. I simply have an odd heart beat. When I say my heart beat steadily after the WPW ablation, I mean without WPW.

Incidentally, cardiac arrhythmia (of one kind or another) is currently the number one killer in the UK. A recent UK statistic shows that 25% of patients with AF die within 2 years of diagnosis. That doesn't sound like a benign condition to me!

Kate]]> kate AFIBBERS FORUM Wed, 05 Dec 2007 02:58:38 +0000 https://www.afibbers.org/forum/read.php?9,62781,63250#msg-63250 https://www.afibbers.org/forum/read.php?9,62781,63250#msg-63250
I worry that Kate's dedication to her physician may represent justified loyalty, because of what he did for her, but she should consider another physician for her next ablation, partly because her present physician has already indicated some hesitancy about addressing her new problem.

It is also interesting that Kate may be the fourth post-ablatee with "two rhythms", whatever that means.]]> Wil Schuemann AFIBBERS FORUM Tue, 04 Dec 2007 19:00:57 +0000 https://www.afibbers.org/forum/read.php?9,62781,63241#msg-63241 https://www.afibbers.org/forum/read.php?9,62781,63241#msg-63241 inthebiz AFIBBERS FORUM Tue, 04 Dec 2007 17:10:01 +0000 https://www.afibbers.org/forum/read.php?9,62781,63184#msg-63184 https://www.afibbers.org/forum/read.php?9,62781,63184#msg-63184
Another comment is that the effect of exercise on a-fib in the short term is not necessarily indicative of the effect of exercise in the long term. In other words, exercise may have bad effects long term in spite of exercise terminating a-fib short term.]]> Wil Schuemann AFIBBERS FORUM Tue, 04 Dec 2007 09:14:53 +0000 https://www.afibbers.org/forum/read.php?9,62781,63179#msg-63179 https://www.afibbers.org/forum/read.php?9,62781,63179#msg-63179
I decided not to take a tablet and put on my boots and went off to feed the animals, which is strenuous exercise. After about ten minutes I think I had frightened my heart into submission!! I was really surprised. Afib stopped. Back in NSR again. How odd. I shall have to think about this. I have often thought of giving my heart something to fibrillate about when it starts to muck about!!

Now that I am sitting quietly I can feel the heart starting muck about again.

Structurally I suppose the ventricles were thinking " hell she's working hard, we better get beating faster and stronger" which over rode the atria and shut them up. There, that's pretty much as medical-minded as I am!!

Kate]]> kate AFIBBERS FORUM Tue, 04 Dec 2007 08:15:01 +0000 https://www.afibbers.org/forum/read.php?9,62781,63160#msg-63160 https://www.afibbers.org/forum/read.php?9,62781,63160#msg-63160
I have recently purchased a new horse a little Dutch warmblood mare, only 4 years old and I will be putting in a lot of phsyical work which I haven't been doing for a few years!! I'll see if the AF improves if I can get back to a high level of fitness.

I was not aware, incicentally, that I have a "straight forward no-nonsense communcation style".

I am in the UK so would use my EP from when my WPW was done. He won't "do" me at the moment, I asked him about a year ago, he says I am unusual in that I have 2 rhythms and he is reluctant to go "in". He has promised he will have a go before he retires in a couple of years time. I trust him implicitly, he is a genius, a sort of an English Dr Natale!!

I don't think my insurance would cover me for a US based operation anyway, only the high level hospitals here in the UK are specified on my insurance. There are small, private clinics in London where all the rich Arabs etc. go and that is the place to have this type of work done.

Kate]]> kate AFIBBERS FORUM Tue, 04 Dec 2007 04:57:30 +0000 https://www.afibbers.org/forum/read.php?9,62781,63123#msg-63123 https://www.afibbers.org/forum/read.php?9,62781,63123#msg-63123 Wil Schuemann AFIBBERS FORUM Mon, 03 Dec 2007 10:41:53 +0000 https://www.afibbers.org/forum/read.php?9,62781,63122#msg-63122 https://www.afibbers.org/forum/read.php?9,62781,63122#msg-63122
You probably did have "Wolff-Parkinson-White (WPW) syndrome consist[ing] of ventricular pre-excitation associated with paroxysmal supraventricular tachycardias." ... "The paroxysmal tachycardias of the WPW syndrome are usually supraventricular and include atrial tachycardia, A-V nodal tachycardia, atrial flutter (rare), and atrial fibrillation."

The ablation probably treated the auxilliary pathway and the superventricular arrhythmia (most likely a-fib). A-fib reappeared after ten years, and will have to be treated again. That is consistent with the expectations of the more realistic of us here.

The technology has improved a lot since your ablation. I'd suggest you contact Dr. Natale in California. He clearly has a special knack for eliminating supraventricular (atrial) arrhythmia. He will like your straight forward no-nonsense communication style.]]> Wil Schuemann AFIBBERS FORUM Mon, 03 Dec 2007 10:38:50 +0000 https://www.afibbers.org/forum/read.php?9,62781,63121#msg-63121 https://www.afibbers.org/forum/read.php?9,62781,63121#msg-63121
When you go in and kill a lot of tissue, the boundaries of that killed tissue will contain a lot of damaged living tissue. I'm not surprised that some of that damaged tissue would subsequently exhibit abnormal behavior. In my case the symptoms are a mildly irregular rhythm about 30 minutes total per day (as many short bursts of irregular rhythm). Such behavior is consistent with the hypothesis of damaged tissue near the SA node displaying some pacing behavior, which competes with the SA node pacing during about 2% of each day. That, to me, is pretty insignificant.

I'll also not be surprised if the misbehavior of this damaged tissue will either get better or worse with time. Lately, it seems to be very slowly getting better. Six months ago the irregular rhythm time was 4% per day. Before that it was 0% per day for a year. Before that it was 33% per day for most of a month. Before that (post-ablation-medication) it was about 2% per day for two months. So the current amount of irregular rhythm is about the same as experienced post ablation for two months, and the irregular rhythm time per day has been both worse and better in the meantime.

As I said above, the long term Holter data allows for a peaceful tolerance of variations in the amount of heart misbehavior. Over the two years SVT, tachycardia, irregular rhythm, PACs, PVCs, heart rate, and blood pressure have all been varying, sometime dramatically, especially during the first eight months after the ablation. Once I documented that misbehavior comes and goes, and therefore doesn't seem to portend anything serious, and in most cases gets slowly, if erratically, better, then it is relatively easy to remain philosophical about the changes.

Minerva has called a few times after I submitted a three month report, acknowledging its receipt, and to chat about how life is going. But, apparently they also don't see anything which disturbs them enough to comment on it.

As George said, I probably have more long term data on a successful ablatee than has ever been gathered. The fact that I am finding evidence of things that otherwise would have gone unnoticed, should be regarded as interesting, but not necessarily reason to act to fix something that is probably just normal variations in heart misbehavior post-ablation.]]> Wil Schuemann AFIBBERS FORUM Mon, 03 Dec 2007 10:20:45 +0000 https://www.afibbers.org/forum/read.php?9,62781,63117#msg-63117 https://www.afibbers.org/forum/read.php?9,62781,63117#msg-63117
After about ten years I started to sense a "chaotic" heart beat and after about another year or so I complained to the EP and was monitored and they found the AF.

The wenkebech and type II stuff was all there 32 years ago when I was diagnosed with WPW.

One of the things that happened about 4 years ago when the AF got going properly was that I had become less physically fit. I was no longer playing polo. My EP had always warned me that because I had always been very fit (as a teenager I was a runner and then always rode horses all my life) I had to be careful as I got older because as I lost my physical fitness the atria would become "floppy". He has told me time and time again that if I could get back to a high level of physical fitness the AF would improve a lot. But it is a Catch 22 situation, and I can't exercise hard enough to get fit enough to improve the strength in the heart muscle and stop the "floppiness".

Kate]]> kate AFIBBERS FORUM Mon, 03 Dec 2007 08:59:29 +0000 https://www.afibbers.org/forum/read.php?9,62781,63105#msg-63105 https://www.afibbers.org/forum/read.php?9,62781,63105#msg-63105
The same heart behavior has been present in each of the subsequent complete ECGs I've sent to Dr. Natale every three months

Did Dr. Natale or his staff respond to your sending and if so what were his comments?

Did they support your own conclusions?

It would be helpful to learn what they determined.

Jackie]]> Jackie AFIBBERS FORUM Mon, 03 Dec 2007 04:51:53 +0000 https://www.afibbers.org/forum/read.php?9,62781,63086#msg-63086 https://www.afibbers.org/forum/read.php?9,62781,63086#msg-63086
Two years ago, after the successful ablation, I recognized that the ECG: (1) required immobility; and (2) was limited to short data gathering periods. Those limitations were unacceptable to me then.

It is true the Holter has been useful for measuring heart misbehavior in more physically and emotionally stressful situations, but while that misbehavior is more extreme than experienced when immobile, I believe the two levels of misbehavior are proportional to the stress level, rather than being different in kind.

I could also argue that the 24 hours of Holter data every week shows how much heart misbehavior varies from week to week and month to month. That tends to provide perspective on days when my heart gets cantankerous.]]> Wil Schuemann AFIBBERS FORUM Sun, 02 Dec 2007 14:43:58 +0000 https://www.afibbers.org/forum/read.php?9,62781,63082#msg-63082 https://www.afibbers.org/forum/read.php?9,62781,63082#msg-63082
I would agree that for someone such as Kate, personal 12 lead or holter monitoring makes sense. However, I'm not sure the cost and hassle of a personal holter is justified in "run of the mill" lone afib cases. I do value simple monitoring.

Here are the questions I try to answer with my monitoring:

- what is my heart rate in or out of afib
- am I in afib
- am I in aflutter
- what are my PAC and PVC counts per hour

I can answer all of these with a relatively simple beat to beat heart rate monitor. I have mentioned that I do have my own ECG monitor. However I use it rarely as it generally does not give more information, for the above questions, than the recording HR monitor (Polar S810).

In addition, for several years I've had access to a friend's holter that I can use whenever I please. I have used it a number of times, but again do not find it worth the extra bother. It always confirms my Polar recordings.

This is not to criticize your monitoring, as I'm sure it has great value to you. In fact, I would venture that more holter data exists for you than for any other single individual.

I eagerly await your rebuttal.

Cheers,

George]]> GeorgeN AFIBBERS FORUM Sun, 02 Dec 2007 12:34:51 +0000 https://www.afibbers.org/forum/read.php?9,62781,63077#msg-63077 https://www.afibbers.org/forum/read.php?9,62781,63077#msg-63077
During the period after your ablation and before the appearance of a-fib did you have a somewhat irregular heart rhythm?

What is the history of your a-fib symptoms, and what data has been gathered about your a-fib?]]> Wil Schuemann AFIBBERS FORUM Sun, 02 Dec 2007 09:39:19 +0000 https://www.afibbers.org/forum/read.php?9,62781,63076#msg-63076 https://www.afibbers.org/forum/read.php?9,62781,63076#msg-63076 Wil Schuemann AFIBBERS FORUM Sun, 02 Dec 2007 09:34:44 +0000 https://www.afibbers.org/forum/read.php?9,62781,63075#msg-63075 https://www.afibbers.org/forum/read.php?9,62781,63075#msg-63075
just a thought]]> inthebiz AFIBBERS FORUM Sun, 02 Dec 2007 06:42:04 +0000 https://www.afibbers.org/forum/read.php?9,62781,63073#msg-63073 https://www.afibbers.org/forum/read.php?9,62781,63073#msg-63073
Kate]]> kate AFIBBERS FORUM Sun, 02 Dec 2007 05:20:23 +0000 https://www.afibbers.org/forum/read.php?9,62781,63071#msg-63071 https://www.afibbers.org/forum/read.php?9,62781,63071#msg-63071 inthebiz AFIBBERS FORUM Sun, 02 Dec 2007 03:35:06 +0000 https://www.afibbers.org/forum/read.php?9,62781,63030#msg-63030 https://www.afibbers.org/forum/read.php?9,62781,63030#msg-63030
You are correct that there was a partial variable AV block, in multiple variations.

"Second degree A-V block type II (Mobitz)" ... "Type II (Mobitz) second degree A-V block results from prolongation of the absolute refractory period of the A-V node or of both bundle branches" ... "Long ventricular pauses may allow idionodal or idioventricular rhythms to escape; the arrhythmia may then mimic complete A-V block."

The latter means the ventricle could possibly fire on it own, independent of the atrial electrical activity, because the ventricle fired spontaneously before the atrial signal arrived.

But, in genera,l the firing sequence of the ventricle will be related to the atrial electrical activity as (atrial waves to ventricular waves) 2:1, or 3:2, or 4:3, or 5:4, or ..., or in any sequence of these ratios. Your heart rate would mimic a-fib's irregular rhythm, but the average ventricular heart rate would be lower than the atrial rate because of lost atrial signals.

Wenckebach, Type II, and Mobitz all seem to refer to minor variations of the same problem.

"Wolff-Parkinson-White syndrome (WPW)" ... "Ventricular pre-excitation occurs when sinus impulses activate some part of the ventricles through an accessory pathway, earlier than through the normal conduction pathways. The Wolff-Parkinson-White (WPW) syndrome consists of ventricular pre-excitation associated with paroxysmal supraventricular tachycardias." ... "The paroxysmal tachycardias of the WPW syndrome are usually supraventricular and include atrial tachycardia, A-V nodal tachycardia, atrial flutter (rare), and atrial fibrillation."

It would seem that you may have had: (1) some kind of atrial problem like a-fib or atrial tachycardia; and (2) prolonged conduction delay along the normal pathway from the atrium to the ventricle; and (3) an auxilliary direct pathway from the atrium to the ventricle.

So, the odds are that your ablation involved both blocking the direct pathway between the atrium and ventricle, and eliminating whatever atrial misbehavior (most likely either tachycardia or a-fib) was present.

My texts do not mention any fix for the prolongation of the atrial signal passage. Do you still have a somewhat irregular heart rhythm?]]> Wil Schuemann AFIBBERS FORUM Sat, 01 Dec 2007 10:21:40 +0000 https://www.afibbers.org/forum/read.php?9,62781,63027#msg-63027 https://www.afibbers.org/forum/read.php?9,62781,63027#msg-63027
My understanding of WPW is that in WPW there are two pathways to the AV node. A fast and a slow one. You can end up with a circular conduction - down the fast and back up the slow. The WPW ablation kills the extra pathway.

Afib can occur after heart or lung operations (i.e. trauma to the heart). I'm wondering if this might be the reason for WPW patients getting afib. Pure speculation.

George]]> GeorgeN AFIBBERS FORUM Sat, 01 Dec 2007 09:11:57 +0000 https://www.afibbers.org/forum/read.php?9,62781,63025#msg-63025 https://www.afibbers.org/forum/read.php?9,62781,63025#msg-63025
To my knowledge, there was no AF back in 1993, that has only developed the past four years, which is approximately ten years after the WPW was knocked out. The WPW has never returned, thankfully.

Kate]]> kate AFIBBERS FORUM Sat, 01 Dec 2007 08:21:10 +0000 https://www.afibbers.org/forum/read.php?9,62781,63024#msg-63024 https://www.afibbers.org/forum/read.php?9,62781,63024#msg-63024
It is like any source - you have to use discrimination. On many technical subjects, I've found it to be pretty good. One guy who analyzed a number of Wiki pages said he found it generally to be at the level of a grad student knowlege - not necessarily at the level of the best authority in the field. If the answer really mattered, I'd certainly check the footnotes and other references. Many Wiki pages are referenced.

It is kind of like the information off this board - anybody can post and you have to use your brain (and possibly other sources) to determine if it makes sense.

I certainly have no problem using it for providing backup to an answer like the above. The Wiki author(s) is/are probably much more of an authority than I am.

When my daughter was in high school and would ask me questions on AP calculus, AP chemistry, physics & etc. (topics I've generally not thought about for more than 30 years), I found the Wiki answers did a nice job of explaining things and were accurate.

I've thought that the Wiki format might be nice for some of the information we try to present here, as it is editable as opposed to our posts which are static. Of course if I edited one of Peggy's posts, she might not take kindly to it (just kidding Peggy).

The idea is that the knowledge of the group is collectively pretty good and better than any individual. For an interesting read on this topic I recommend: "Wikinomics: How Mass Collaboration Changes Everything" by Don Tapscott and Anthony D. Williams.

In summary, I wouldn't trust anyone piece of information, if it really mattered, without backup, but collectively it is a good reference.

George]]> GeorgeN AFIBBERS FORUM Sat, 01 Dec 2007 07:37:46 +0000 https://www.afibbers.org/forum/read.php?9,62781,63022#msg-63022 https://www.afibbers.org/forum/read.php?9,62781,63022#msg-63022
Just a question - I'm not sure of the answer other than what is on their home page (below).

How reliable is the science provided in wikipedia answers? Is wikipedia the best resource to quote or should it be something out of one of the medical websites, heart institution websites, Gray's anatomy or other scientific reference? I've seen criticism of facts not always being accurate from wikipedia.

Comments?

The home page of wikipedia says:

Visitors do not need specialised qualifications to contribute, since their primary role is to write articles that cover existing knowledge; this means that people of all ages and cultural and social background can write Wikipedia articles. With rare exceptions, articles can be edited by anyone with access to the Internet, simply by clicking the edit this page link. Anyone is welcome to add information, cross-references or citations, as long as they do so within Wikipedia's editing policies and to an appropriate standard. For example, if you add information to an article, be sure to include your references, as unreferenced facts are subject to removal.

Jackie]]> Jackie AFIBBERS FORUM Sat, 01 Dec 2007 06:40:25 +0000 https://www.afibbers.org/forum/read.php?9,62781,63015#msg-63015 https://www.afibbers.org/forum/read.php?9,62781,63015#msg-63015
A few months ago I did a pseudo-analysis here and came up with a guess that, on average, our a-fib would return about five years after a successful ablation.

I assume that your ablation in '93 addressed pre-existing a-fib, in addition to the auxiliary pathways from the atrium to the ventricle. Is this true?

I, and I'm sure others here, would be interested in when and how your a-fib re-appeared after the successful ablation in '93?]]> Wil Schuemann AFIBBERS FORUM Sat, 01 Dec 2007 03:49:36 +0000