4 Weeks Post Ablation - My Ablation Story & Editorial

During the many years I have read and posted here, it was always the "ablation stories" I was most interested in. Probably because I felt that the day would come when I would be ablated. It did, Aug. 21, 2012. I gleaned every ounce of ablation info I could, sometimes connecting with people off forum to get more details. So I am posting my cliff notes version from 8/21 in that some out there might want to read, especially those contemplating ablation.

A little history - first episode Jan. 2006, lasted one minute. This was 2 months after a bout of pneumonia and the antibiotic Levaquin.....but I fit the afib profile to a T ! I was 53 at the time, excessively athletic, lean (not tall though) 5'10"......moderate alcohol, moderate HBP, Type A, chocolate eating, red wine drinking, buisness owner....driven.

After 18 months of every 2 months episodes that lasted a few minutes I finally had one that did not quit. Converted in the ER and diagnosed with LAF. During the next 6 years infrequent episodes but about one of every 5 had to be cardioverted.......always at night, typical triggers....MSG, alcohol, chocolate, indigestion etc......had a few long runs of NSR.....11 months, 8 months etc.......onw a Natural Food Store so I take all supplements. Maintain 4/1 K - Na ratio

My EP, Warren Holshouser of the Sanger Clinic Charlotte NC wanted to ablate me 2 years ago.....I canceled......but this past July I had 3 episodes...a cardioversion.....3 hours and 4 minutes...I gave up.....Ablation scheduled for 8/21. I am 59, fit, lift weights....low body fat, low cholesterol....good BP......

Now, as you read keep this in mind - on a scale of 1 to 10 with a 1 being a Navy Seal and a 10 being The Cowardly Lion from the Wizard of Oz - I am a 12.

I arrived at Carolinas Medical Center at 6:10 AM on 8/21......an empty and erie parking garage. I had my duffle bag with IPOD (that I never listened to) and preseason college football magazine (which I never read) coconut water, magnesium, co q10. By 6:45 I was in a gown, caught a glimpse of myself in the mirror and almost decided to be naked instead. By 730 I had an IV in the top of my left forearm, Holshouser was there and stopped by to chat......he went to The Naval Academy, was a nuclear sub commader! Then anesthesiology came by.....young female in charge, maybe 40? Saying I seemed a little uptight she said we're gonna give you something in your IV to help you relax....I thought great! something I might actually enjoy......3 seconds after they started it I went out and it's the last thing I remember........I woke at 1:15 PM (seemed like 10 mins went by)......my ablation was 4 hours and 15 mins.

How I felt: my left wrist hurt! breathing hurt some.......and of course I was a bit groggy for an hour. The groin puncture sites had a strange clear plastic bubble over them (taped) I would later find that they apply a pressure to the wound. I had a urine cath too.....still an IV also......after 2 hours I was moved to my room.....feeling pretty good...I did notice the higher heart rate......
At 7 30 PM the nurse began removing the groin bandages....everything was fine, no bruising no bleeding! now I wanted the urine cath out......I asked "will it hurt" ? she said "some".......the nurse said take a deep breath.......the catheter was removed in a fast motion......I almost went from the 6th floor to the 7th right through the ceiling tile! She gave me a plastic jug to urinate in......15 mins later Holshouser walked in.......and I sat up on the edge of the bed and got a strong sick feeling.....lying back down I was OK.....he told me that I had 5 pulm veins! that he thought the ablation went well but that my esopgagus was very close to where he ablated! but that he had never had a fistula occur ........the Cowardly Lion kicked in and I began to dwell on esopagus damage........at 9 PM I took a walk! with the noise, lights, nurses and BP checks I never slept one minute....I watched the Little League World Series.

At 8 30 AM Holshouser was back and I had 20 mins of skipped beats but got back in rythm....he sent me home on Lovenox shots, warfarin, Metropolol and PPI's......telling me that if I ran a fever or had trouble swallowing to call him immediately! I almost threw up the horrible breakfast they served me......so I got home and got in to our 1960's Eames Lounge Chair in fron of the TV....armed with a themometer......now I forgot about the ablation and worried about my esophagus....as it's can take a week or two for the ulceration to show........after 2 days the deep breathing no longer hurt and I went for a one mile walk.

4 Weeks later - I am doing great, have had no afib or any irregular heart beats of any kind, my reating heart rate is 78 - 81 and was 64 prior to ablation..I did not have a fistula!...I had no bruising except where the Arterial PB Line was in my wrist, and hurt like hell for 2 weeks......I am back in the gym, back walking, back doing push ups back on the stationary bike....my workouts are about at 75% right now as I have held back not wanting to push it.
I have struggled with the INR....was 2.2 yesterday and now taking 12.5 MG of Warfarin. Honestly I feel 100%.

EDITORIAL - is my ablation a success? time will tell, I need to go many months. Knowing what I know now am I glad I did it...? yes. Was the ablation horrific? not even close. Is my EP an all star......no...but I like him, and felt good about his expertise.......he's on my All Star Team.
I am hopeful that my resting HR will recede over time. I had no CT scan so my radiation was lower? When I meet with Holshouser Oct 9 I will ask him why I was on aspirin prior to ablation.....why he ablated my Superior Vena Cava, how he ablated the 5 PV, and what he thought of my heart in general. Waht do I think? I do not think afib can happen right now....just an strange intuition feeling.....my hope is that I will at the least be better and can convert on PIP easier if afib happens...there is the possibility that I am a persistant afibber? and that a PVI will not work? we'll see....this Thanksgiving I am planning on a scotch and water come hell or high water!

Tom P
Weddington NC

Good write up Tom! Hopefully no more cardioversions for you-

If you feel like you need a jolt you will have to stick your finger in an electrical outlet...

Take Care-

Thank You Tom for posting this! I did not go to work today emotionally drained trying to figure out what my next step is and who do I see a rock star like Natale or highly skilled EP's like Dr Reddy or Chinitz. You had to tell me about the urine catheter!

Hi Tom - Glad you had such a positive experience. Nothing 'beats' NSR.
Best to you,
Jackie

Tom Poppino Wrote:
-------------------------------------------------------
> > Now, as you read keep this in mind - on a scale of
> 1 to 10 with a 1 being a Navy Seal and a 10 being
> The Cowardly Lion from the Wizard of Oz - I am a
> 12.
>
>> Tom P
> Weddington NC

LOL, that cracked me up!

Glad to hear you're doing well. One of the reasons I'm kind of happy with the EP that will be doing my ablation is that he advertises that due to the average 2 hr procedure, he doesn't use a urine catheter. He also hasn't killed anybody yet....both are worth a lot to me!!! Afib...barf.

Tom

Tom, that's great news. It sounds like you are doing awesome. I really like how you described things, some of which brought on a good chuckle.
I don't believe I have ever heard of a urine catheter being used during an ablation procedure. I had one when I had a prostate operation three years ago, and can honestly say,
it's not a whole lot of fun.
Don't be in to big of a hurry getting back to your full fitness regime. Build it up slowly over the next few months. I have the same triggers as you. As much as I enjoy having a
social drink now and again, it remains my number one trigger and is best avoided.

All the best for continued success.

Lou

The most pain I eccountered with my ablation was first the insertion of the catheter(Tom you were lucky to be out for that), second the removal of the catheter and third the removal of the bandages, they taped me up quite extensively. But hey its only pain.

Tom P,
Glad to hear you are doing well. Thank you for your detailed description of your procedure. I have been following your story for months. I am sitting in Charleston right now after having my first appointment with Dr. Wharton at MUSC. It looks like an ablation is in my future as the anti-arrhythmic drug (Multaq) is not completely working. I also do not like being on those drugs. While the Dr. explained all about the procedure, he didn't give as much detail as you. I wondered about the urine cath but didn't think to ask. Like you I am nervous about proceeding but your story makes it a little easier.
Thanks again,
Chuck

Tom P:

Thanks a million for sharing your story - I have been following it closely. I am scheduled for ablation on Oct 23 and it has helped me to keep up with your experiences. I love your "chicken meter" - I peg that thing from time to time myself.

Thanks to Tom and others who share their ablation experience on this forum - it is awesome to be able to hear the patient's perspective shortly after a procedure like this.

Regards,
Gary

Great story---------Welcome to the Post Ablation Club---you are no longer a 12, but a 2

We're all lining up like aircraft on a runway...........

Tom - I too enjoyed your story and identify with the cowardly lion example! Glad to hear that things went so well and that you seem to be moving to a new phase - consistent NSR!

I have an appt. with my cardiologist tomorrow, and will be discussing her thoughts on an ablation...it helps to read here on "real" people's stories and experiences.

Thanks for sharing ~ Barb

Is is typical that the resting heart rate goes up after ablation? Any idea why that is?

AFhound99,

The resting heart rate goes up temporarily after an ablation due to the burning of many pacing cells lining the inner walls of the left and right atrim which also act as a kind of speed regulator cells as well. The degree of Heart rate increase is relatively porportional to the amount and location of burning that took place to end your AFIB/Flutter/

It is actually a good sign to have a robust rise in heart rate post ablation as it has been shown to be associated with better long term freedom from the flippies .. likely because it indicated a more thorough job of rooting out more offending focal points and trigger areas.

Don't worry about it, you will get back to tyour normal pre-ablation rate .. or at least fairly close to it ... after 6 months to a year in the vast majority of cases.

Shannon