Ten Year Anniversary

I have my ten year ablation anniversary in November. Here is my story, plus it’s worth noting that I didn’t find this website until a year after my ablation.

71 years old; excellent physical condition; 6', 168 lbs; 11 years of LAF; was on meds for the last 6 years after diagnosis; averaged 33 episodes per year for those 6 years (documented when and how long they lasted). The episodes ranged from a few minutes to 72 hrs (average time per episode was about 10 hrs). Converted only once at the hospital, but after that visit, my Dr. said that since I was so healthy, staying in afib would not be an issue, plus I always converted back on my own.

The only trigger I identified was more than one alcoholic drink/dehydration?

For the majority of my afib, I was on Plavix 75 mg; Toprol XL 25 mg; Norpace CR 200 mg twice a day. With this combination of meds, I lead a normal life 99% of the time. It was typical to not notice I was in afib, unless running up a flight of stairs or trying to sleep on my left side. I was on Plavix because of the bleeding risk of Warfarin and my VERY active lifestyle.

Ablated in November '06 (over 60 "burns" in the left atrium). I had been postponing extensive hiking trips and vacations because of the afib and finally decided it was time. The summer after the ablation, my wife and I spent 7 days hiking in the Dolomites in northern Italy.

Stopped all meds at ablation and was put on Warfarin for 4 weeks post ablation, but no other meds. Still, not on any prescriptions.

Returned to normal activity two days after ablation.

Returned to normal exercise 4 weeks post ablation. Felt like I could have started working out the day after the ablation, but decided it was wise to follow the Dr's advice.

While exercising, I reached my anaerobic threshold much quicker than pre-ablation (reduced atrial function from ablation trauma). This steadily improved during the first year, then leveled off to what I would consider normal. I workout on average 4 days a week (workouts include weights, jogging, windsurfing (40+ days a year) and golf (60+ days a year). In July of 2012, my wife and I did the “Tour du Mont Blanc”, a 100 mile, 10 day hike around the circumstance of Europe’s highest mountain. I pay close attention to staying hydrated while exercising and drink 20oz of Gatorade (plus a lot of water) when working hard and sweating profusely, usually windsurfing and golf.

Resting heart rate was in the 50's pre-ablation while on meds.

Resting heart rate for three months post ablation - 70's.

Resting heart rate for 4 years post ablation – 60's.
Resting heart rate now - upper 50’s/lower 60’s.

Only three episodes of A-fib? since ablation, one in August of 2010 and again in August 2012, and the last in May of this year while windsurfing. Lasted 2 hours one morning, and 4 hours one night, and about 3 hours for the May episode. Felt like A-fib, but heart rate was only in the 80's! Not totally sure what these episodes were since my heart rate was 180 while in afib prior to going on meds. The last one in May while windsurfing caused considerable shortness of breath, like full blown A-fib, but I stayed on the water and hydrated well afterwards.

Occasional (about 1-2 times a month) PVCs? for 2 to 4 seconds. Usually the precursor to an A-fib episode pre-ablation, but now just subsides. By the time I get to my pulse, it's gone. Have been taking Taurine, Magnesium and Potassium daily in lower than recommended doses. The frequency of my PVCs continue to decrease. I try to eat a diet high in Magnesium and Potassium, but nothing special beyond that. I have a cup (16 oz) of caffeinated coffee, a few ounces of mixed nuts, glass of red wine and a small amount of dark chocolate and ice cream daily. I drink beer socially, maybe 3 times a month and usually have two beers. In addition to the A-Fib supplements, I only take a multi-vitamin, 89mg of aspirin and an extra 1000 mg of vitamin D. No prescription meds.

Overall, my ablation experience couldn't have been better. I believe a high level of fitness greatly reduces the impact of afib on one’s lifestyle.

Ablation done by Dr. Kevin R. Wheelan - Baylor Med. Center, Heart Place, Dallas, TX

I am keeping my fingers crossed, and wish the best for those that struggle with A-fib.

Ken

Good to read Ken. Well done and long may your good health continue!

Nice to read. Working on 11.5 years at 77yo. Normally come on the forum only in August and February, just was a bit bored this pm and logged in to find new software. Went from 24/7 afib to NSR for last 11/25 years. I Bicycle, swim, walk, lift weights, stretch almost daily, sometimes doing a mini-triathlon, Keep up the good work!!

Thanks for the feedback. So much for my bragging, two days ago I went into a-fib for two hours and then self converted. Fourth time in 10 years and second time this year. Adding more supplements and watching dehydration, but the new ripples in the see are disturbing.

I guess time will tell how this play out.

Since the overall frequency of my a-fib is very low, and I self-convert, I wonder at what point one should consider the "pill in the pocket"?

Ken - I have similar experiences to your first ablation longevity. It was fine for 11 years and then it wasn't.

You are fortunate that it does self convert. My advice would be to have a small PIP stash on hand just in case you run into a prolonged event. I did that for a while and found it to be great comfort knowing that if I needed it, the protocol was there and I think that helped me significantly ... the knowing that I still had some control.

Continue using the core electrolytes because my experience is that they help greatly to minimize the extra beats... but don't skimp on the magnesium. So much depletes it and it's vital to heart stability. It's difficult to get enough magnesium through diet but you can do fairly well with potassium. I'd also watch the large dose of caffeine.

Best to you,
Jackie

Jackie,

Thanks for the advice. I have my annual physical/wellness exam next month and will ask for flecainide. My caffeine intake isn't high, normally one cup of coffee in the am and a glass (6 0z.) of Mt. Dew in the early evening.

As for the flecainide, what dosage? 50, 100, or 200mg.?

Ken -

Here's my comment from a thread we had on the PIP method a couple years ago... at this link...
[www.afibbers.org]

Realize that not everyone has the same result and it can depend both on the drugs and the person... ie, I only found results with slowing the heart down with metoprolol and then using the flecainide....other drugs didn't work for me. I tried So.. if one method doesn't work for you, there are others.

If you do do an advanced search here for Pill in Pocket, you'll bring up numerous threads on the topic that contain comments and experiences from a lot of afibbers... just so you become familiar with the process and success rate.

As an aside... I really didn't like using 300 mg of flecainide... made me feel terrible, but when I did and it worked, I was always relieved to have NSR again.

Hope you don't have to use it, but it's a comfort knowing you have some control if you get a flareup.
Best to you,
Jackie



Jackie
Re: Pill in pocket strategy for lone vagal afib?
November 30, 2013


Iatrogenia -

The initial PIP protocol was 25 mg metoprolol at onset.
Wait 30 minutes to slow heart rate so the Antiarrhythmic can work.
Then add 100 mg. flecainide. Wait a hour. Add another 100 flecainide after 1 hour.

Now the current protocol is 25 mg metoprolol or even 50 mg if the HR is extremely high.
Wait 30 minutes and take 300 mg flecainide all at once.

When I had the AF breakthroughs last year, I tempered the 300 flec dose with just 200 mg - hoping that would be enough. In a couple cases it was; in others, I had to add the last 100 mg. Sometimes that worked and other times it did not.

Jackie