6.5 weeks post ablation - had a 4 min episode today

I have sailed along following my 8/21 ablation for afib and flutter.......today at 4:30 I left work and as soon as I got in my car a fast rate afib began, felt different, can't explain.....rate was fast, seemed almost regular too.......but on my drive home it stopped after maybe 3 to 5 minutes. Freaked me out but did stop quickly on it's own....I know that episodes can occur for a while following ablation. but I have had perfect rhythm since the ablation......I have read about something called Left Atrial Macroreentry Tachycardia???

Anyway any thoughts? I as only taking 12.5 metropolol and wafarin still.......

Tom

Tom, don't worry I dealt with afib issues for 4 months after my ablation, nice that it went away on its own, that's your ablation kicking in.

Hi Tom it s just a little reminder not to get too overconfident or cocky and start drinking the wine and alcohol and other prior triggers :-).

The regular rate sounds like a possible Atrial flutter.Good that it stopped on its own.. respect the triggers and just don't go there... Give the ablation every possible chance to settle in without throwing any optional monkey wrenches in the works when you start feeling invincible... Best bet is to eliminate alcohol for good as a consumable liquid in your case ... Period... That's you're best friend now. Same with caffeine and any other sure triggers of the past.. Do this whether or not alcohol or caffeine was a major issue previously. Just don't roll that dice.

Take it easy and relax rest of the weekend.

Shannon

thanks Tom, this one felt very different? and yes it quit quickly.........TP

Shannon yes I was getting cocky, I had some wine last night and some chocolate today....not alot in either case but some.......yep it was a real wakeup call as I have had no afib since mid July

TP

Tom,

I suffered Left Atrial Flutter about 5 weeks after a successfull ablation for Afib. In my experience Left Atrial Flutter does not stop at all by itself but it was stopped by a cardio version around three months later - they would not give the electric shock until my INR scores were between 2 and 3 for two weks running which seemed to be impossible to achieve due to a few different things at the time. Absolute nightmare with heart rate of 99BPM 24/7 but regular.

Would seem your issue was just one of the many iccups that can happen post ablation but probably not not Left Atrial Flutter.

Barry G.

Hi Tom P.

If you had some wine and chocolate within the last 24 hours, one or both may well have been the likely culprit(s).. Good it was just a short wake up call, but anyone who takes the early good results from an Ablation or Mini-maze lightly and thinks they got it all whipped for sure, even up to and past a full year or more of total quiet, and starts rolling the dice again is asking for it! AFIB is a very humbling condition and it pays to remember that and make it one of your new mantras.

Dr. Natale told me that alcohol has been a real problem for far too many people after an otherwise successful ablation. Far more so than anything else and it's the main thing he strictly insists on avoiding now after too many times seeing it disrupt an otherwise quiet and successful ablation. Some people might seem to get away with it for awhile, but its a huge risk and in most cases it will catch up to you sooner or later with the real disappointment of more breakthroughs.

Just when you think you've got it all licked for sure, The Beast jumps back in for another appearance to remind you 'not so fast' hot shot! Stay with the Strategy supplements, eat well and avoid as many trigger as possible. Perhaps you can have a small glass of wine every now and then after a full year or more, but if you are wise you'll keep it VERY infrequent and far between and never more than one glass or less of wine. Better yet to just write it off the list for good and then you don't have to concern yourself with it. It isn't that hard and not that big a sacrifice to just decide to avoid that very real risk.

Cheers!
Shannon

thanks Barry and Shannon! humbling is correct, and I was feeing like wow no more afib.........thing is I know better......chocolate, wine and MSG have always been "my" triggers and I endulged in 2 of those in close timing..............I would be surprised if this was flutter as I did have flutter ablated........who knows but the encouraging this is, it stopped quickly which has never been my pattern!

TP

Barry, I would think that a simple TEE test was all you needed to rule out a possible clot, then a quick Cardioversion and a few of weeks of Coumadin, some docs are remiss to use the TEE, to me they are worried about possible legal problems or they don't have or want to use the equiptment needed for the procedure. I would find a new EP. I went through all of this prior to my ablation, you need to find an EP that you can call and get to see ASAP, one that has seen you before as a regular patient and is familiar with your history. I still see my EP even after the ablation once a year just to keep current and updated with his records because you never know when you will need their help.

Hi Tom C.

Thanks for your info however my story is long and complex, i.e. I remember Dr Jais in Bordeaux looking at me after the ablation ( No 2 ) like I was an alien specimin and saying " I have done more than 4000 ablations and you are one of three the most difficult I had come across and if not in the worse three then definitely one of the worst 10 - words long since recorded in this BB.

At another time between my 5 ablations I was and still am living in Hong Kong and at that stage I went to the local Hospital in Full Left Atrial Flutter, my opinion at the time, - 5 weeks after ablation No 4 - so the hospital decided that I needed to be kept in overnight for observation.

The hospital told me I was in Flutter so I asked "Left or Right" and the doc said left or right what???????? - now there is left or right flutter and a great difference between both. I said again is it right or left and the docs said what do you mean but whatever it is we can sort it out. I said thanks but no thanks and three months later I was re-ablated for Left Atrial Flutter - Not Right Atrial Flutter - in Bordeuax just as I expected from info gained from this BB.

I am still in full NSR after ablation No 4 (2010) but know full well I am an afibber and always will be, should I push my trigger i.e running. I believe this website, if any, will be the first to inform us all of the 'cure'

Barry G

Hi Tom,
You had right atrial flutter potential ablated, Not left atrial flutter which is almost always a consequence of the burn patterns in a first ablation setting up in an unpredictable fashion, a more atypical left flutter circuit in which the fibrillating energy that used to drive the AFIB ... and is still active since an ablation 'really addressing the core metabolic cause of the fibrillation energy to begin with but is mostly just blocking its potential for sustaining AFIB .. or flutter as the case may be.

But it these very regular feeling breakthroughs do continue to happen and get longer and yet stay regular and fast ( thoight they may stay fairly low speed in the 125bpm range or even lower which you are still on Toprol) tyehn it may well be the development of some ablation enduced atypical left atrial flutter.

Most often this is not very easy to get out of and is not amenable to spontaneous conversion or drug conversion and has to be either ECV cardioverted back to NSR or requires a follow up left flutter ablation to do the trick/.

Hopefully, your first post ablation episode was just a run of the mill isolated and short AFIB run and no big deal.. Just be aware that your flutter ablation during the first ablation was almost certainly as a preventative measure against the very typical and easy to address right atrial flutter.

Shannon

Shannon interesting.....yes I had right flutter ablated.....I have been in flutter (ekg proof) many times....I had fluter for sure.......I have not heard of left atrial flutter and do not totally understand as you are more technical than I ........I have my EP meeting appt tomorrow at 3 PM and will ask him about this left flutter......on Saturday it did convert quickly....minutes.....I never had a chance to use PI as I was driving......I took my pulse but while driving had a hard time feeling if it was regular or irregular.......I feel like it was some of both??

anyway always appreciate your insight! thankyou

I am 7 weeks post ablation and only 4 mins of an episode so far......and I did consume wine the night before and chocolate that day!

Tom

Tom further to Shannons last post I would add that Left Atrial Flutter did not just happen one day, it kinda sneaked up on me over a week or so.

It showed up with a regular BMP of say 77BPM as against about 70BPM 4 weeks after the ablation. Over the next week or 10 days it proceeded up slowly every day until it got to around 85BPM after which the Omron BP/heart rate monitor started indicating ERROR now and again. The last reading I got before it showed ERROR all the time was 99BPM.

I believe the ERROR indication has something to do with the hearts electrical 'circuit' actually going in the wrong direction but I could well be wrong on that.

Barry G

So Barry, what has happened to your left atrial flutter? ....you did'nt finish your story!

Tom

Tom,

my story does get confusing but my earlier post points out that I am still in NSR after ablation No 4 in Bordeaux, ablation No 5 was for Left Atrial Flutter. Five weeks after ablation No 4 I started getting the higher heart rates as noted above after which the ERROR message started appearing. It was about this time that I had to accept that things where definitely getting worst and it was not just a blip. A local doctor put me on Sotalol?? which even he admitted was a shot in the dark and in the end I had to attend E&R one day for what could only be very high heart rate, no reading apart from ERROR on the monitor. It was at the E&R that I was diagnosed with Flutter though they had no idea what Left Atrial Flutter was.

They decided I had needed a cardio version but I had to get my INR between 2 & 3 whatevers at two consecutive weekly checks which seemed impossible to do. At one check I had a reading between 2 & 3 so things where looking good but at the following weekly check the reading was 1.99 and they still would not give me the electric shock treatment. This went on for three months if I remember correctly and I was so frustrated I told them to get the machine out and I would lie on the floor do the thing myself - they wouldn't budge. Finally I got the correct reading and had the cardio version which changed me from an apparent old man into a teenager within the 1 hour visit to the hospital, fantastic feeling after those three months of dragging myself around.

All good things come to an end and within about three weeks I was getting full daily bouts of either Bigeminy, Tridgeminy and Quadgiminy so I contacted Bordeaux where they said that obviously there must be a break in the ablation lines and they could do another ablation'" if you are interested". Another three months and I was back in Bordeaux having ablation No 5 which to date has been 100% apart from one or two very minor PACs events.

I would note that all my arrythmias stopped dead the day after I made that last phone call to Bordeaux about the B, T & Q arrythmias - amazing, but this is far from uncommon from what I have read on this BB.
Dr Jais reburnt the 'linear line' where the LAFL was originating 'partially due to the difficulty' his words, but I've had no problems since..

Barry G

For what it's worth, my very short drama with B, T & Q was resolved by consistent potassium supplementation (I use Knudsen low sodium veggie juice, because it's a whole lot tastier than V-8). 20 ounces a day and B,T&Q disappeared.