blanking period issues

As many of you know, I am surprisingly having blanking period issues. Id like to hear other peoples stories regarding their blanking period and how they were resolved. Ive had 2 three hour episodes of afib since my ablation on 12/17. Prior to to my ablation I went 50 days without an episode. Thanks

John

Dear John,

This is not unusual, despite the fact that many on this list have reported no AF during the blanking period. I had one lengthy episode and one four-minute episode after my ablation (August 12, with Dr. Natale in New York). Dr. Natale told me that I might have some AF during the blanking period. At my four-month follow up with Dr. Danik at St. Luke's, he told me that AF during the first 4-6 weeks of the blanking period is not predictive of the outcome of the ablation. There is a lot of healing during this period and also, new electrical patterns can be formed temporarily as you heart heals. As others have written, it's not a linear process, and a PVI creates new pathways where patterns can also be triggered, usually temporarily (atrial flutter). I also had some tachycardia that was atrial flutter. All this settled down after the first six weeks and each month after that I've been less and less aware of any kind of irregularity. Of course, ectopic beats may be there, and at my age (63) they are likely a part of your "normal" profile if they are infrequent and don't run in long periods.

When you stop to consider what was done to the atrium, I think it would be unusual not to expect some arrhythmia, and I was told that this is not an issue until it extends further into the blanking period. Then it may be indicative of connections that were missed in the ablation or that were masked by the anesthesia. I was not on an anti-arrhythmic drug prior or following my ablation, but Dr. Natale did say that if I had any more AF he would want me to be on Multaq. My two AF episodes were precipitated by supplements that I was trying again post-ablation, and I know that they were a factor (Co-Q10 and later Zyflamend). Both are usually recommended, but I am very sensitive to all drugs and supplements.

I wouldn't compare your situation pre- and post-abaltjon since your heart has been profoundly affected by the procedure. Give yourself time and, as others have also recommended, give yourself the rest that you need to recover. If you are sensitive to supplements and food, then introduce things one at a time and listen to how you feel after trying something new. It takes time and patience but I don't know any other way to get it right for yourself. I do take magnesium, potassium and taurine each day as well as vitamin D and I know that these supplements are a permanent part of my post-ablation plans to stay in NSR. So far, so good.

Best wishes for the holidays and the New Year,

Rob

John - If you were supplementing with the critical electrolytes prior to the ablation but stopped, then it's important to realize you must continue as the ablation does not replete the basic materials you need continually. This would include optimizing the intracellular stores of magnesium and balance out your potassium-to-sodium ratio. If you've never used supplements, then it would be good to start slowly to replete those electrolyte/minerals that are critical to stabilizing heart electrical conduction and NSR.

Jackie

I had six relapses in my first month after my (June 3, 2013) ablation in Bordeaux.

I spoke to the doctor after the first two episodes and he said this could be normal activity and to give it time.

But after six it was obvious that the short circuit was still there.

Fortunately I was still in France and they called me back in for a redo one month (July 7, 2013) after the first one. I was not as careful with food triggers after the first ablation as I was after the second. Following the second ablation I took Nexium daily for a month to make good and sure my stomach issues were not triggering things. All has been good since then. It was much easier the second time around.

When I was in the hospital they tested my blood daily, and administered potassium supplements. I continued to monitor myself with the Cardy meter and found it invaluable as I was having a difficult time maintaining the appropriate levels. Now six months out my potassium levels are starting to normalize as I am getting a handle on my supplement and eating regime.

The magnesium seems to be important, although I have no real way of quantifying it, but the potassium deficiency is indisputable with using the Cardy Meter.

I did not do well on Taurine and have eliminated it.

If you have to go in for a redo, I would suggest you don't hesitate. It is really not that big of a deal and you get your life back and stop worrying about it.

RonB

Rob50:

Your point about your afib being triggered by supplements would, to some extent, negate Natale's skill or needed outcome regarding your ablation. The 90 day blanking period is a given, therefore, vitimin or mineral supplementation was more than likely not the reason for your afib epeisodes. My guess, it was simply the healing process. After all, why should any of us get an ablation, especially from an EP like Natale, if, in fact, we still need to worry about what trace mineral or smidgen of nutrition or lack thereof we consume in our bodies?
This whole notion of one particular supplement verses another or one's eating habits verses another and its triggering effect on afib is literally the same as chasing hundreds of rabbits down hundreds of rabbit holes. It's usless. I truly doubt that most EPs are not concerned about what nutritional supplementation we take, but only about how well they ablated the atria tissue in our hearts.

Chrisdodt,
Well said and that exactly is what Dr Natale told me, why even bother with an ablation if you couldn't have a few beers, drink coffee and had to avoid certain foods and have to avoid triggers. Not saying we shouldn't follow a healthy diet or start binge drinking but live a normal life and everything in moderation the way he put it.Smart guy that Natale I would say.

McHale



Edited 1 time(s). Last edit at 12/25/2013 11:27PM by McHale.

Christdot and McHale, for this once I wholeheartedly disagree with you. Many of us arrive at this point because our systems have been depleted, we are overall in ill health and the warning sign is afib. For others it can be cancers or any other number of ailments. I'm sorry to say there is no magic bullet, whether you hire the best ablationist or not, you still need to get your substrate in order. To say otherwise is misleading, especially to the new afibbers on this site.

It has been said many times, that an ablation corrects the symptoms, but does not correct the underlying health issue. I don't often get my hackles up, but you are making a mistake, and are being flippant to suggest that some ablationist is such a rock star that you can ignore the miriade of recommendations and proof that this website provides that we must get our underlying health in order for an ablation to be successful.

Smart ablationists or not, they are one faction of taming this beast, and do not have the education, or the very time to focus on health issue, diet and supplements needed.

Chrisdot, your last statement that "I truly doubt that most EP's are not concerned about what nutritional supplements we take, but only about how well they ablated the atria tissues in the heart" is exactly correct. They are but one part of the puzzle, and are not the people who are going to help you cure your GERD, or hypertension, or obesity,or diabetes, or excessive stress.

You are way out of line with your statement.

McHale,
Another perspective....If one's original afib was the result of multiple stressors that eventually caused foci hyper-sensitivity, such as inordinate ANS stimulation due to repeated stress over decades (as an example), any undue stimulation after the ablation may cause another generation of afib or other arrhythmia-causing foci failure.

No one, including Dr. Natale, yet understands the essential causes of tissue failure leading to afib in most cases. I'm surprised that he would express such a simplistic viewpoint as noted in your post.

As each of of us investigates and wonders at the cause of our own afib, I look to my old extremely stressful job that eventually broke down my immune system, digestive system, and not surprisingly... simultaneously began the decade's progression of heart arrhythmias eventually culminating in persistent afib.

My second ablation seemingly has cured my afib for now, but the fact that other areas of the heart had also developed rogue hyper-sensitive foci, namely within the right atrium and the AV node, makes me think that a systemic issue caused the afib, not some simplistic "cellular stretching" by way of high BP, for example. (I doubt my blood pressure, diet, or heredity were culprits), If that is so, avoiding anything that would unnecessarily stimulate already "worn" foci to a future failure-point would seem prudent. We, who are afflicted with afib, already know our heart&related systems are susceptible to such arrhythmias, and the isolation of the pulmonary veins changes that not one whit! A PVI offers no "prevention"....only the isolation of what has already failed.

Why bother with the ablation? Come on... so you don't have debilitating afib...so you can travel without the fear of needing medical help in a strange locale, so you can live without the fear of an afib generated stroke, etc. etc....for me, eating carefully, avoiding certain foods, alchohol, etc to remain afib free is of great importance with little sacrifice -

I'm not saying one should be extreme in avoiding all possible triggers, but... "an ounce of prevention....."...as they say.

Tom



Edited 1 time(s). Last edit at 12/26/2013 12:35AM by Tom B.

Dear McHale and Chrisdodt,

Please understand that my statement about supplements was not in any way a comment about Dr. Natale or any EP who can restore NSR to a person who has suffered from AF for years (19 in my case). But during the time prior to my ablation I had ample opportunity to work with nutrition and exercise in pursuit of my health, and I did find that certain supplements were for me strongly correlated with AF episodes. It seems sensible to me that, if something was a trigger prior to an ablation, that it would continue to be a trigger afterward as well, even if the electrical circuits are now broken in the areas where the lesions were placed. In my case, it was early in the blanking period and I experienced a very familiar feeling that I had had prior to the ablation associated with the longer episode.

Dr. Natale has written that longstanding persistent AF is the "metastatic cancer of electrophysiology." Dr. Danik said to me that there is a progression in the left atrium over time that can reach a point where there is not enough healthy tissue to ablate successfully. A successful ablation(s) stops this progression, but it doesn't correct the underlying causes of the arrhythmia, which are not well understood at this point, even if they can be remarkably well mapped through technology. Again, to me, doing whatever one can to ensure that the substrate remains healthy is more than worth the effort, and an ablation provides the foundation for doing this without living a life of fear and constraint. I'm grateful every day I awake with a quiet heart, and it would have only been possible with the medical intervention of an ablation.

Best wishes,

Rob

@Ron50 & TomB: I do realize that a healthy lifestyle is imperative to anyone's health. The problem, of course, is that we're all extremely complex creatures with scores of variations on just what exactly triggers this or that or just what substrate predestines us toward disease or ill health conditions. As an adolescent I was constantly plagued with ectopic heart beats and visited a doctor regularly to find out why I was having heart flip flops and days of ectopy. In the 1970s medical science was not privy to this condition as they are now and so I was told to ignore it. At the age of 51, my irregular beats manifested into afib. Were these ectopic beats a precursor toward afib? Probably not. Why? Because thousands, if not millions of us, have PACs and PVCs and never have afib. So just what causes afib is too much of a mystery for even medical science to grasp. For us to bounce around from one supplement and lifestyle regimen to the next is grasping a straws.
I look at a Pulmonary vein ablation as a way for a skilled gate keeper to build the kind of security gate that will block those aberrant electrical signals from invading the atria and thus keep the heart safe and secure. This, in my opinion, is the ONLY way we're ever going to have any NEAR cure.
I mean, think about it, just the vagal ganglion alone is so complex and extends through so much of our body so extensively that to even think about controlling that predominate trigger toward afib is simply a figment of some nutritionist's imagination.
One EP did tell me that besides an ablation, or a series of ablations, the only future cure for afib will come in the form of genetic engineering. Unfortunately, we're probably decades away from that breakthrough at this time.

chrisdodt Wrote:
-------------------------------------------------------
> the only future cure ...
> ...will come in the form of genetic engineering.
>



LOL....I think that applies to a lot of mankind's issues.

Chrisdodt I'm with you with this, at least for AF. I'm using supplements like R-ALA and so on, but for Peripheral Neuropathy in the hopes of..

Barrett's ablation Oct 2012 seems to be holding up so far and I continue with my old lifestyle

rob50, I also had problems with CoQ10 -- but after my ablation.

From my experience with dysautonomia, the initial cause (such as an adverse drug reaction or illness) can be transitory, but the autonomic symptoms might continue or proliferate, as one domino knocks another over. Symptoms tend to wax and wane as the nervous system attempts to right itself and fluctuates in vulnerability.

That's how I view afib. The pattern of abnormal electrical impulses may have any number of causes. For some, it's an electrolyte or nutritional imbalance, and they see dramatic results from one supplement or another. For others, it's high physical stress over long periods of time accustoming the sympathetic nervous system to unusual stimulatory activity. When there's other heart disease or damage, overall cardiac dysfunction may be the cause.

For others, it's idiopathic.

Atrial fibrillation is multifactorial. Genetics probably will not explain all cases. Supplements are not a cure-all.

______________
Lone paroxysmal vagal atrial fibrillation. Age 62, female, no risk factors. Autonomic instability since severe Paxil withdrawal in 2004, including extreme sensitivity to neuro-active drugs, supplements, foods. Monthly tachycardia started 1/11, happened only at night, during sleep, or when waking, bouts of 5-15 hours. Changed to afib about a year ago, same pattern. Frequency increased over last 6 months, apparently with sensitivity to more triggers. Ablation 6/27/13 by Steven Hao.

Iatrogenia, just curious...what kind of problems did you have with CoQ post-ablation, and how did you know it was the CoQ versus some other factor? I take 300 mg CoQ daily and am less than 30 days out from ablation. Thanks, Randy

Just had my third episode of afib since ablation of 12/17/2013. This one lasted 1.5 hours but now Im on a BB and Flecainide

Randy, I gradually added supplements back in after my ablation. About 4 months out, I tried to ramp up on my CoQ10 again. I had been taking 100mg. I took 30mg with lunch. That evening, I felt an odd sensation in my gut (CoQ10 has about a 6-hour loading time) and later had 3 runs of fast beats, each about 10 seconds long between about midnight and 3 a.m.

Those were the most serious blips I had during post-ablation (so far; heart activity has quieted since). I don't know for sure, but I suspect the CoQ10. It's supposed to be stimulating. I'll give it another try in a while, at a fractional dose.

______________
Lone paroxysmal vagal atrial fibrillation. Age 62, female, no risk factors. Autonomic instability since severe Paxil withdrawal in 2004, including extreme sensitivity to neuro-active drugs, supplements, foods. Monthly tachycardia started 1/11, happened only at night, during sleep, or when waking, bouts of 5-15 hours. Changed to afib about a year ago, same pattern. Frequency increased over last 6 months, apparently with sensitivity to more triggers. Ablation 6/27/13 by Steven Hao.

Chrisdodt,

I fully understand what you are getting at and there is a lot of practical truth to it as well, in that the whole purpose of a highly skilled ablation is to chop up the area of the LA or RA that can support and sustain fibrillating energy into a fully blown AFIB/Flutter episode is minimized, regardless of what triggers we might assault our bodies with.

However, the other side of the coin has validity as well. You are so right about the complexity of AFIB making an easy cookie cutter final solution still beyond our grasp.

Yes top tier ablationist like Dr Natale and the other elites in his stratosphere are remarkably skillful and perhaps with two, and often times even just one ablation these days, he and the other maestros like him are able to bring about what most of us would consider a practical cure. Though I would hesitate still to label myself truly 'cured' knowing all that I do and all that I have experienced on this long and winding road.

I know for a fact that Dr Natale doesn't support re-introducing willy nilly any and all triggers that previously were sure fire stimulants to AFIB. Yes, there is a much longer list of prior triggers that one can be exposed to in moderation and likely be fine, for the most part. But others like alcohol, I know for sure Dr Natale strongly recommends all his ablation patients to at least curtail as much as they can do so, if not avoid all together which is his real recommendation if you ask him the right way.

Like most Docs, he isn't all that eager to tell you what not to do, and his skill does give one a much wider berth to cheat, so to speak, than during pre ablation sensitivity, without question.

But as TomB and RonB both noted, ( there seems to be a lot to Tom's, Ron's and 'B's around here these days :-) Even the best ablationists don't yet fully and totally understand all the metabolic and genetic interactions that predispose us to having a recurrent bout of AFIB or Flutter. And while Chrisdobt is correct too in considering a solid ablation by a top EP to be the closest most of us will ever come to a 'cure', that does not necessarily equate to it being wise to drink a few six packs a day and have four extra strength coffees every day while adding 15 grams of salt in our daily diet as well. All of which theoretically one should be able to do with abandon after a solid ablation.

The point being, is that many of us have found that this is a game of balance and finding the right balance of tradeoffs may well be a unique exercise for each of us, and yet there are some key shared common sense steps that can help make for a smoother road, to one degree or another, for the majority that really do make the effort to follow a few basic principles consistently ... The a Strategy being one example... as well as good trigger avoidance before an ablation and continued at least with common sense for the first year or so after an ablation for the most persistent triggers until one is more certain of not needing a relatively early touch up at least. As complex and varied as we are as individuals, we are not so variable that one might as well not even try and just go for whatever one desires in the moment after an ablation without even considering the possibility of further stimulating the underlying metabolic process that helped make us prone to fibrillation in the first place.

My suggestion from all that I've experienced and observed in so many others is that while a solid ablation can indeed form a barrier toward preventing prior triggers from actively supporting a new episode, it makes all sorts of sense not to take that for granted too early in the process after an ablation.

At least keep the big triggers under wraps moderately so for that first year or so, at least until you see how long range the first ablation is likely to hold up.

And while its true that activity during the blanking period does not necessarily mean you are in for a touch up, it's also generally true that the more activity you do have and the greater the AFIB or flutter burden during your blanking period, the greater the odds are of needing at least a second procedure before you can more fully let down the guards on those most troubling triggers.

Several recent studies even suggest that if you have a cumulative burden of AFIB/Flutter of six hours or more during the blanking period it implies a near 100% likelihood of needing a follow-up procedure. Granted these were studies from more average centers and operators doing only or mostly just PVI or PVAI ablations and likely is not that predictive with the elites like Natale who typically take care of all non-PV sources too beyond just PVI and with greater transmural consistency, but the general principle is sound and it's just far too easy to get cocky far too early in the process after some months of confidence gained from a quiet heart after a first ablation. Its best to play the long game here in my view to give that ablation every chance to really settle in and see how far it is likely to take you as reverse remodeling takes place the longer that quiet heart can be sustained without actively trying to stimulate any remnant instability, before trying out the gasoline on the fire. And I know that there are real and valid reasons to feel confident and maybe a little cocky after an ablation with the likes of a Natale. Believe me, I've been there.

I've heard some people mistakenly presume that having breakthroughs during the blanking period is a good sign that you might really be one and done. This is not the case, even though blanking period breakthroughs do not necessarily imply need for a follow-up, the best and most ideal scenario is zero breakthroughs from the word go. Though many do get long term relief even with a modest amount of blanking period activity.

I think that idea that early breakthroughs during blanking period must be a good sign likely comes from folks hearing that having a high HR after ablation is a good sign that a lasting ablation 'may' have been achieved, as a higher HR tends to indicate that enough quality burning has been done to cause the temporary high HR and thus implies a more thorough ablation, but that is not the same thing as having a good amount of blanking period action which may or may not prove to be temporary.

As far as someone after an ablation being triggered by a supplement well after the blanking period, that might likely fall into the realm of a sensitivity trigger in an otherwise not quite fully buttoned down atrial substrate that could well be eliminated or minimized by a further touch up ablation addressing any still open, or perhaps newly created trigger spots in the LA or that may have been dormant during the first ablation.

But when it comes to more consistent triggers across the board like alcohol and caffeine, while its true many post ablation people can get away with these for a long time and perhaps the rest of their lives in some cases, it is a bit like playing Russian Roulette and tempting fate in which possibly new areas which had not been ablated previously start to become active from too much influence from a previously known trigger used in excess even after an otherwise more or less successful ablation.

Theoretically, when every single possible ablation source in the LA is fully zapped, one might say its very unlikely for the heart to fibrillate, but to get to that point where your heart might be more or less immune to any further underlying progression of this condition, you might need most all of your LA to be fully segmented or cut up into small little 'corrals' to insure zero flippies of any kind are possible, regardless of what kind of indulgences we choose to adopt post ablation.

I fully acknowledge that some will be able to drink like an Irish Sailor after a single solid and complete ablation process with seemingly little impact as far as AFIB goes for quite a long time, and possibly for the rest of their lives, even though said life might well be cut short by the very same binge drinking due to a scarred dysfunctional liver if not with further damage to the heart and brain.

And I fully realize Chrisdodt that you aren't at all recommending or suggesting wanton gluttony of prior triggers here. But there is some practical wisdom as well, particularly when we still know so little about the true primal causes of AFIB, to still tread a little lightly with those things we know irritated our hearts and encouraged our AFIB in the past.

You don't have to be totally abstinent after an ablation with regard to whatever it is you enjoy and missed that caused you grief previously, but being a little cautious too and erring on the side of moderation is often the better part of valor.

In many cases, whether you have a few beers or not , it still may not be the determining factor on whether you will need a touch up ablation and it may happen or not regardless. But in my experience, and that of so many others I have spoken with or followed closely, the trend definitely seems to favor those who kept consumption of previous triggers at least modest, if not avoidance, and not flaunting and taxing their ablations with too much repeat indulgence too soon.

Natale typically hasn't noticed too much effect after a good ablation from Dark chocolate, and even caffeine in moderation, but he still warns to put a lid on the alcohol longer term for those who he has ablated. He won't tell you to totally avoid alcohol for life though and if he senses this is a big issue for you he will likely shrug it off and tell you to just be moderate, but if you ask him in the right way too he will likely tell you too as, he has me, that its in your best interest too to keep it at a real minimum if you can do so without missing it too much.

These things always seem fine and we all want to feel totally cured, at least while we can get away with them. That may go on for many years too if you have a favorable physiology and a good ablation under your belt.

Until suddenly it isn't so fine any more when what seemed to be a perfectly fine ablation with no triggers at all for a year or more duration suddenly starts to misfire again and we can trace those flashes of flutter back to one or more triggers from the past that we got a little cocky about.

That kind of experience is quite humbling I can tell you from experience. I realize too that many will not want to hear that or pay any attention to it as well when they are still doing so well. But taking some extra steps to insure your body has solid nutrition and is well rested and that one pays attention to managing unrelenting stress only makes sense on all sorts of levels, including erring on the side of caution when it comes to doing everything you can to support a good ablation and quiet heart to begin with.

Again, you are very right that having a good ablation, or two, is very often THE major key in establishing and maintaining a quiet heart, but there are other things we can do for ourselves as well as this site, and many of us old timers here, report on and have learned the hard way about over many years, that are worth taking to heart as well.

When I asked Dr N about alcohol he told me it was the single most important trigger he recommends avoiding altogether if one can, or at least minimizing imbibing and keeping it in moderation if you really miss it too much and simply must keep it a part of your life. As such, there are obviously some substances that are more risky than others for post ablation life. And equally relevant, on the reverse side often coin, there may well be some substances that for very many of us are more supportive of a quiet heart than others as well, even if that quiet means mostly just less ectopics like PAC/PVCs which themselves can be precursors to more real arrhythmia activity assuming the heart has enough unablated free space left to even sustain a consistent arrhythmia any longer.

Bottom line, while the theory is sound that the best ablation will certainly make us dramatically less sensitive to prior triggers, the same doesn't necessarily imply that it no longer matters at all what we dump into our bodies since theoretically it should now be almost impossible for doing so to further challenge our hearts simply because we have a solid ablation by a top gun EP.

Once one sees that logic, then its simply a matter of degree that each of us has to find to define our own comfort zone. And, indeed, I agree fully that the best possible ablation will grant one a large amount to leeway in this regard, though after only one ablation and with less than a year duration of mostly NSR, I would be especially careful of falling into the easy trap of assuming that one is truly 'one and done' simply because things have been quiet for many months in a row.

This is a war of attrition and the longer one has been at it, the harder won the good times will typically seem, and the more willing many of us become to go the extra mile if it even just 'might' help hold on to that quiet for the long term and is pretty harmless otherwise and makes good sense for supporting overall health in any event.

Both sides of this debate have real merit and its not really so easy to boil it all down to an either/or question in my book, looking exclusively from either side of the fence alone.

Cheers!
Shannon



Edited 2 time(s). Last edit at 12/31/2013 08:49AM by Shannon.

Hi John - I could not help but think about you as a I struggled last night with that scary feeling and ectopic beats.

I am within days of the end of my 6 month blanking period and have been forced to sit up and pay attention to every little detail.

Yesterday I ignored testing and supplementing of my K for just one day and do not feel good at all right now.

My Cardy Meter has become as essential to me as my diabetic brothers glucose monitor is to him. For some unknown reason, my potassium levels will not stay where they should be without supplementing.

I have discovered that my potassium must be well above 4, and preferably close to 4.5 in order to feel good, and that it is just as scary to have a high potassium level over 5.

I have also discovered that the levels vary, sometimes by quite a large degree, throughout a 24 hour period. Even my doctor was not aware of my very low levels,of potassium at certain times, because any blood work was typically done in the morning.

Even though most doctors will not talk to you about supplements, they do make use of magnessium and potassium in the hospitals to calm the heart.

The ablation protocol in Bordeaux calls for a full 5 day hospital stay during which time they test for serum potassium daily. They found mine registered very low and gave me up to 1800 Mg of potassium chloride at a time.

Low potassium also implicates the other electrolytes for possibly being low as well.

By inference you can also assume that other nutrients are not being absorbed, and that your gut is in need of healing.

So much of the topic of whether to supplement or not is a trial and error process. But testing and supplementing potassium is not, as you have available accurate serum potassium testing in the lab and accurate in home testing with the Cardy meter.

Perhaps I am stating the obviuos and you already use one, but if not, the approximate $300 cost should be weighed against the approximate $40,000 value of your ablation.

Ron

Ron - My FM MD says that in some people, and especially as we age, the kidneys don't function optimally in that they don't hang on to potassium as they should.. but sodium remains a constant and as we know, that ratio imbalance causes problems for those prone to arrhythmia. In others, it could manifest as hypertension.

As long as you have the Cardymeter to monitor your potassium, you'll undoubtedly stay mostly out of arrhythmia but you may want to have a kidney function evaluation by a nephrologist to rule out specific areas of dysfunction.

Jackie

My case is a good example of sodium levels not dropping no matter what the sodium intake. I have kept my lab records for about 15 years and even though my dietary sodium had been consistently less than 1000 mg per day (over a period of many months) as compared to absolutely no salt restrictions in my earlier years, my blood sodium levels remain consistently on the extreme high side of normal - virtually no changes in the lab results. If I go lower than 1000 mg of sodium per day I have increased ectopics. The same goes for potassium, I too own a cardymeter, and if my potassium levels are too low (less than 4), my blood pressure becomes extreme, yet if it goes over 4.3 or so, the ectopics become unbearable. I am convinced this is a kidney function issue that is more about reduced efficiency than dysfunction (in my case) as lab results have always been normal.

Gotta love the aging process.

Ron, many persons, including myself have noticed it takes nearly a year for the heart to heal after an ablation. Even though I still had occasional short afib prior to my second ablation (to fix a gap in the PVI line), the heart had otherwise calmed noticeably by about the 10th month.

Tom



Edited 1 time(s). Last edit at 12/30/2013 03:37PM by Tom B.

Shannon:

Your reply echoes how I feel about my own experience with afib. My intention, however, in my earlier blog, was not to condone excessive alcohol use but to say that it's okay to enjoy in some splurges in life, be they just a tad past the minimum. Personally, I don't even drink; an occasional beer now and then. I'm very health conscious and have been all my life, which, ironically, may have been a determining factor in my getting afib. Exercise comes to mind. I was very much the weekend warrior with racquet ball, weight lifting, basketball, tennis, golf, you name it, played regularly and all balls out (pardon the pun). And along with the exercise came a regular regimen of wholesome, good food, which was predominately vegetarian.
I will say unequivocally, though, that alcohol is about the only sure-fire trigger for afib for most, and it was for me. A glass of red wine and 30-60 minutes later, viola, afib. Chocolate and caffeine are not triggers for me.
The bender induced "Holiday Heart" syndrome has sent many to the ER. So it's safe to say that excessive alcohol is a no no for any afibber..
I'm scheduled March 17 next year with Dr. Natale for an ablation at Scripps, San Diego. It will be my second ablation, the first being 4 years ago by a Kaiser EP with only 70 procedures under his belt, So, needless to say, I'm eager for the maestro to work his magic and put on a long road of NSR.

Sounds good Chrisdodt!

I hear you about the over enthusiastic exercise routine as well. Just when we thought that was good for us, we find out the hard way a bit more moderation even there is the best course, especially for those of us prone to AFIB/Flutter.

Best wishes with Dr N in a few months now, it will be here and past before you know it! Im sure you will find the whole experience to be very confidence inspiring and rewarding long term.

Cheers!
Shannon

Chrisdodt,
This seems to be a common denominator with many here as I may fall into this category as well as far as exercise!
While not extreme as endurance training the cumulative effects are the same. From a kid I was active, played in all kinds of sports and games in the street. From stick-ball, wuffle ball, touch football, many baseball and softball leagues and especially basketball day in and day out at night, in any of the many leagues CYO, YMCA, PSAL, after school night and day centers, college, church and other special leagues I could find, pickup games anytime anywhere. Running competitively during summer after school centers or with the neighborhood friends we were always competing non-stop, biking to the beach 60-80 miles in sweltering heat during the summer , jogging 5-10-15-20 miles a week in heat and cold and weight training in between all those years. The last 15-20 started power lifting crazy weight from 35 years old and benching 345lb regularly then went to 405 at 50 years old....the stress that put on my pulmonary veins...Yikes Yea I guess you can say that was extreme! I also found time for about 15 years to smoke cigarettes, and party on weekends that I stopped by 41 yo!
I was however still binge drinking on weekends up until a Afib was diagnosed at 52 five years ago! I thought if I worked out hard I could overindulge a little on weekends!

Everything in moderation now.

Happy New Year,

McHale



Edited 1 time(s). Last edit at 12/31/2013 10:26AM by McHale.