Post Ablation Bout of Afib

Greetings Fellow Afibbers: I had an ablation November 7, 2024. Did well, not one bout of afib during my blanking period. Nothing until recently. I have been put on CPAP starting in February and its been a royal pain adapting to it. I think my moderate rated apnea was the likely cause of my having Afib. As I said its been a struggle to adjust to. A couple different night s I said to hell with it and slept without the cpap. Two different mornings I woke up in AFIB. I was shocked and scared thinking this should not be happening. My anxiety the first time lead me to the ER by which time I got there I was back in NSR. The 2nd time about a week later. I lived with it and NSR returned about 30 minutes after getting up. I can only assume that by not using CPAP is what triggered these 2 events. OR they were triggered by a medication one of my other docs put me on, a low dose of doxepin, 50mg. But I also assume that if it was the doxepin Id be in AFIB during the day when I am awake and not on CPAP??? I am in the process of tapering off the doxepin as it has not helped me at all for what it was intended and its not conducive for an AFIB or CPAP patient for which I don't know why my doctor that prescribed it did not know that???? Many of these doctors dont seem think beyond their area of expertise

I shared all this with my EP. His suggestion was 2 options. Do what he called a Tikosyn loading in the hospital, which requires a 3 day stay, to do a titration see if I should/could be put on that medication. Or a redo ablation. I've read up on Tikosyn and it does not sound like anything I want to take on a regular basis at all. Must be a majorly nasty drug if you have to be hospitalized to see how you might react? .Talk about nasty side affects!! One more minor one being trouble sleeping. I have enough trouble with that as it is. I guess I think I need to see how my CPAP progresses and monitor if I have any recurrent AFIB episodes. If they come back on a semi-regular basis redo the ablation. Also apparently I am not a good candidate for cardio version as when I had my ablation in November they had to zap me 3x at increasing joules to put me back into NSR. Any thoughts here on Tikosyn vs redo ablation appreciated??
Pokey

May I make a suggestion? Buy the air cushion F20 full face mask. It has a foam-not hard silicone perimeter.

Set the machine to ramp the pressure. You can set it to 4 to start so you don’t feel it. Then hopefully when you do fall asleep you don’t be bothered when it ramps up.

I like the full face F20 air cushion mask because I am a mouth breather and it’s very comfortable.
[eshop.resmed.com]

Obviously you need to use a cpap so a comfortable mask is important.

I stopped wearing the mask for 6 months and then developed daily afib. I tried many masks until I found one that was tolerable. You will get use to it eventually. Give it some time.



Edited 1 time(s). Last edit at 04/27/2025 08:45PM by susan.d.

I've been on Tykosin and I think you greatly overestimate the risks because Dr. Google makes them sound scary as hell. The reason for the hospital monitoring is a single side effect. It's known as QT widening, which is the time between the Q wave of your heartbeat and the T wave. If that time difference becomes too large, it can become dangerous. Tikosyn can widen the QT interval in some people, so that's why they want to monitor you in a hospital while they give you the drug. You'll be wearing a monitor that lets them see your EKG remotely and continuously, so you're in no real danger. If the QT interval becomes too wide, they'll stop the drug and send you home because the drug isn't for you. Once you've been cleared for that risk, the drug isn't heavy on side effects, or at least wasn't for me.

As for a repeat ablation, I would get the CPAP stuff under control before I did that. And if you decide to do it, I would go with the best, not just the doc you know.

Apparently per my EP my QT is relatively narrow. I was taking Flecainide before my ablation as a pill in a pocket and it seemed to work fine. Supposedly I can’t take it now because I’m on doxepin which is a tricyclic antidepressant which reacts negatively supposedly with all anti arrhythmic. But apparently I have a narrow QT interval so my EP doesn’t think it would be a problem from that perspective. But he apparently doesn’t think Flecainide is the “right drug” for me now. I have no idea why. Buggy that’s why he brought up the Tikosyn. I need to know more but one of the listed dude affects is sleep disturbance. Sleep disturbance is my life’s “ Waterloo” of physical difficulties. If anything can disturb sleep in anyone it for sure will mess up mine. All I know so far is only through messages thus far through my patient portal with my EPs nurse. I need to make an appointment to have a more meaningful discussion.

Just keep in mind when you look up drug side effects that every single thing anyone ever reported is listed on most sites, and often with no reference to how common they are. That means you'll see things like nausea, vomiting, headache, sleep problems, etc. listed under almost every drug there is. All you can do is try it and see if it applies to you. But since your doc said you have a narrow QT I definitely wouldn't be afraid of Tikosyn.