Has anyone had issues with extreme fatigue post ablasion with exercise?

I'm about 3 months out of my ablasion surgery and I've been told all went good. I'm in my mid-40's, male and very active pre-surgery. I really only had afib a few times and it always corrected itself within half a day or so. The few times I did have it tended to be when I was exercising, generally in the morning, stressed, didn't have much sleep the night before and might had something to drink (not drunk, just a few beers, but I assume enough to make me dehydrated. My resting heart rate tended to be in the 40-50 bpm because I exercised pretty regularly. About 5-6 times a week for an hour or so playing basketball, so fairly strenuously. No issues with fatigue or any other issues. Just occasionally I'd go into afib. This started about 15 months pre-surgery. They tried putting me on some medication (metaprolol, I believe) but the cardiac doc said it wasn't really necessary.

It was starting to get occasionally annoying but figured I could deal with it. Sounded like my risk of stroke was about zero, and it didn't impact me often. But they recommended the surgery because they thought it would get worse down the road. So I had the surgery. Took about 8 hours, I believe. They said all went well. I felt like hell after, huffing and puffing just going up stairs for a few days. But I took it easy. It sounded like I'd be back to myself within a few days, but that definitely wasnt the case. I wasn't even back to work for over a week. But slowly after a month or so I started feeling better enough to start exercising again.

Nothing too much and definitely eased in. First just a bit of cardio work on an eliptical for 10 minutes here or there then a little bit of basketball with breaks every 5-10 minutes. Nothing too bad. I would feel pretty good for a week or so and then over the course of another week, I'd feel really tired. To the point that one day I would just feel totally fatigued and issues with some minor chest discomfort, anxiety, just general feeling like crap. They had me go into the ER to make sure it wasn't a heart thing, it wasn't a heart attack or anything they could identify. So I'm let go and after a week or so feeling like this, suddenly I feel good again. So I wait another week to ten days of feeling good and start exercising again. Again, fine for a week or so and then feel the same way. Stop exercising and a week or so later, I feel like crap again.

So, basically I'm in this cycle where if I exercise, I feel totally wiped out a week or two later. This has been going on now for about two months. I'm at the start of feeling good and starting to exercise again. I've been cleared by the EP doc, he says it isn't the heart. Said that exercise can get tougher as you get older, general stuff like that. Give it another 6 months, etc.

Has anyone else had similar reactions and how did it turn out? It's really frustrating. I'm scared to do any strenuous exercise because I think I'll start feeling bad again eventually. I know it is really vague.

Hello captcashew...

Welcome. Sorry you are struggling. I can appreciate your concern.

I can only tell you from reading here about the aftermath of ablations for the past 14 years that typically ablatees feel the usual fatigue from having anesthesia and the stress of the whole ordeal, but in a month or six weeks, most people feel quite normal although most remain conservative about resuming former exercise exertion levels and many continue to avoid former triggers.

Everyone is different in age and health status going into the procedure and depending on the length and extent of the procedure, recovery varies by individual which would be normal and obvious. Your procedure was lengthy… 8 hours… and if a large amount of burns were required, the lethargy you are experiencing would seem to be normal… again, going on past testimonials from those with more extensive procedures.

My first ablation at age 67 was relatively short… just under 3 hours and I felt virtually normal the following afternoon at discharge. No shortness of breath and only minor discomfort in my chest when I bent forward to tie my shoes… but I was pleasantly surprised to realize that I had “all that done inside my heart” and I felt so normal. I didn’t resume much in the way of strenuous activity until the three month blanking period was over and even then, I was careful and cautious. At three months post ablation, I had the (then) required spiral CT scan of my heart which indicated normal function.

That said, regarding your symptoms of extreme fatigue and other complaints, I’d be asking your EP for some diagnostics and wanting also to know your ejection fraction.

Then, consider on the nutritional side of health, comes the important finding that the majority of afibbers are deficient in magnesium. Other nutrients involved in the heart’s cellular energy production might also be deficient or out of balance. There are many past posts that provide excellent information on this topic and if you are interested in knowing more, I’ll be happy to direct you to them or correspond with your via PM or email. Just let me know.

We are all here to try to help so keep checking as more people sign on and read your story.

Best to you,
Jackie

If your heart rate is between 40-50 I would be cautious about supplementing with Magnesium without advice from a cardiologist. I have a similar heart rate, and I found the Magnesium decreased my heart rate by a few bpm and made me more sluggish.

Thanks for the feedback. A few follow up details I forgot. Post-ablation, I am actually more in the 70-80 beats per minute resting. Strange, I know but I've heard that it can be typical and would expect it to go closer to normal over the next few months. A bit more concerning that my EP doc didn't know this, just what I have read on some articles online.

Another thing that might explain the extra long surgery is that the hospital that did the procedure is a teaching hospital and I think I was used as a bit of a training exercise since I was relatively young and health. Not saying they screwed up or anything, just saying. It also sounded like they had issues with an oddly shaped section of my heart where they were zapping things. They also had difficulty getting me to go out of rhythm. But they mentioned that there were about 150 spots that they ablated. Which sounded like a lot to me.

I don't recall ever hearing of 'ejection fraction' before, I'll have to google that one. They didn't do a final CT either. At least not unless they did it during the surgery, which I highly doubt. They just said my CT looked good pre-surgery. They did do an echo when I was in the ER the month after when feeling strange (I think that was it, the ultrasound like one) and that was all clear for fluid, etc.

Yes SAFIB, there are some afibbers and people in general who cannot tolerate larger doses of magnesium without getting magnesium induced magnesium deficiency too as explained in a recent issue of The AFIB Report with an article shared by Dr Jonathan Wright, renowned integrative holistic MD from Harvard Med School and diector of Tahima Clinic in Washington state Seattle area.

People oversensitive to magnesium can wind up with delayed gastric motility to the point where even just 400mg of oral magnesium can slow the progression of food through the GI tract to cause heavy lethargy and other manifestations of multiple other nutritional deficiencies in addition to magnesium deficiency symptoms.

For such folks, It's worth trying topical magnesium while also measuring GI transit time and symptoms to see if that method does not allow you to take a more therapeutic dose of magnesium without the oral magnesium-induced slowed GI motility syndrome.

You can try taking just 250mg a day of mag Glycinate fur example orally too which is too small a dose to cause GI motility slowing but at least is some degree of baseline repletion and then try add in the topical magnesium sprays or sometimes called 'magnesium oil', though it is not a true oil just feels slippery like and oil.

At times, rarely, though it has happened a number of times over the years I've been doing my now periodic Myers IV cocktail with 3 grams of Mag Sulfate, I can get reaLaly hammered for a full day and sometimes with lethargy extending into the third day after the infusion. This has always been a sign to me that my Mag levels are more than topped off and I take a more extended break on the Myers cocktails for a while.

I mention this, as this happened just yesterday for the first time in a very long time when I took my 4th myers cockail with the 3 grams of Mag Sulfate plus 1 gram of IV Glutathione in under 4 weeks. I did this number of infusions over just under a month when I was feeling like my IC Mag was running a bit short .. the first three infusions were fine and even improved sleep as it is wont to do, but this last one yesterday was obviously over the full up mark as I could barely keep my eyes open when Magdalena wanted to watch a movie with me on the tube last night and felt pretty lousy really so sluggish and really out of it I was. if I had had some calcium on hand I would have downed a gram or two o counteract the excess magnesium.. My BP was low too last night, so no more extra Mag for a while for me :-)

Shannon



Edited 2 time(s). Last edit at 04/23/2016 10:37PM by Shannon.

The heart takes up to a year to fully recover from an ablation. I waited a month (Dr's. recommendation) before I began to exercise again. Clearly, it was much easier/quicker to reach my anaerobic threshold than before the ablation which was predictable because of the month lay off. However, even after a few months of workouts, the problem still persisted, but gradually improved month to month for about a year. Then finally back to normal for me.

In addition, my post workout experience was pretty normal, fatigued, but good sleep and normal recovery by the next day. Your experience suggest that there may be something else going on rather than a "normal" ablation recovery for us athletic types.

Also, my pre ablation HR was in the 50's, and post ablation was in the 60-70 range. It slowly returned to the 50's over the course of the first year.



Edited 1 time(s). Last edit at 04/22/2016 06:38PM by Ken.

The other strange thing is that the extreme fatigue and other symptoms don't normally present at the time of the exercise, but a few days later.

Who was your Dr. that recommended this unnecessary procedure? I imagine they had you under the impression that you would be back to normal within 2 weeks.

Sounds like you need to look at your Echo (ultrasound). The EF (ejection fraction) is a key measurement of the test.
That will tell you alot, and you can get a follow-up echo done in several more months to compare with. The EF tells you the percentage of blood that the Heart pumps out every stroke. It is a measurement of the Hearts pumping strength. You should have also had one done prior to the Ablation. This should be compared to the one you did after the Ablation.

If your Dr. didn't do an Echo before you had an Ablation I would change Dr's of that account alone. If you post your location we can advise you of a reputable EP Dr. in your area.

You might ask your EP for a copy of the records of the procedure, as far as what burns were made, etc. Ask Shannon or some other qualified expert to look at what they did, too see if anything was done way out of line? Not all Ablations are done the same. They way they did yours could have disrupted the Adrenal receptor sites to the Heart more than normal.

Another option would be to do an Exercise Echo. Which is an Echo done while you are exercising.

As far as the post exercise fatigue, obviously we don't really know about that. Maybe with the way they did the 150 burns, your Atria is not healed up as fast as expected. Maybe your body is sensing that something isn't quite right when you are exercising, even though you tolerate the exercise well enough while it is being performed, so your sub-consciously backing off of the exercise afterwards, even though you could do the exercise if you really needed to.



Edited 1 time(s). Last edit at 04/22/2016 03:05PM by The Anti-Fib.

Hello, Captcashew,

I, too, have had a longer than typical post ablation recovery. There are many possible reasons for what you are feeling. One such theory is pre/post ablation adrenal fatigue. I would consistently push my workouts post ablation while feeling well , just to fatigue out days later. This could be from being on the verge of adrenal fatigue prior to your procedure and the surgery tossing you over the edge. Another possible reason could be that you're most likely still having post procedural cardiac inflammation of some sort, and right when your feeling "good" you over do it and increase inflammation again. I was 49 during my procedure and thought I was going to breeze through like a champ due to the fact I was in such outstanding shape. What I found out is that I just had a heart procedure and although most feel fine afterwards it's no walk in the park either. Only you can be the judge of how you are feeling and if you feel something is wrong you should follow up. But, in my case, it just took time and rest with the addition of some basic supplements. I also know, and its not really talked about too much, that Cardiac procedures affect the mind/body and perpetuate a lot of angst about your health. Also, ask questions. The people here have a world of knowledge.

RonM



Edited 1 time(s). Last edit at 04/22/2016 11:07PM by RonM.

Yeah, they did the echo pre-surgery. They did quite a few before, not so much after. And yes, basically what happened was I was playing basketball one morning and could tell that something wasn't right. Just felt like the heart was skipping a beat. I'd felt a few other minor things in the past, but nothing that lasted more than a second or two. Being smart like I am, I kept playing for an hour or so more before finally deciding it was a good idea to stop. It was a Sunday, so I just went home to lay down. My wife said she could tell my pulse was off just by looking at my neck. She said it was very disconcerting. So, I figured since I had two young kids, I better go to the ER to see what was up. They basically checked me into the cardiac unit to keep me overnight and try to snap me back into rhythm. The medicine they gave me dropped my resting HR into the 30's, so they stopped that right away. it corrected itself when I finally was able to fall asleep that night late (it was not the most restful of stays). Checked out the next day, saw my primary a little while later. Checked tests they did on me, all looked good but he wanted to refer me to an EP just to be sure.

EP put me on metoprolol just to be sure, but it was very low dose. Then about every few months I would have issues, but they would always resolve within half a day. I got pretty good at figuring out what would trigger it and what to do to get back. But on a follow up with the EP he said we could either put me on another medicine, but I would have to stay in the hospital for 3 days to make sure I didn't have any reactions or ablation was an option. It sounded pretty low risk and I didn't like the idea of being on medicine for the rest of my life because of something that would just happen every few months and never lasted long enough to put me at stroke risk (it has been my understanding that is more if the afib episode lasts more than 24 hours). Waited a while longer and then had more issues (my mom had been sick and eventually passed away about a year ago, so all the triggers seemed to happen a lot during that time). So I gave the green light on the procedure. But the primary I had who agreed he thought it would be a good option had left. My EP who I had been seeing left and the new EP was supposed to be good. he trained my original EP. Not a great bedside manor, but I don't really care as long as they are good.

One more thing that concerns me, other than no follow up tests post ablation other than the echo they ran when I was in the ER a month after the procedure. I figured they'd do a full CT or something. When I was in the ER, I didn't even have anything other than a nursing assistant stop by to check on me and a doc I never saw made orders and that was a resident. Anyhow, in my final checkup before taking me off the warfarin, I mentioned how my resting heart rate used to be in the 40-50 range and was now in the 70-80 range. But I also said I heard that was typical and would normally go back in a year or so. He said that he wasn't aware of that. And that maybe it was always in the 70-80 range. Well, I KNOW it was in the 40-50 range. After the first afib I got a Alivecor monitor, which I thought was great, by the way, and I checked it all the time. I knew what all my normal rates were. And it is definitely significantly different post ablation. Now, maybe that is a good tthing and doesn't seem to be anything to be concerned with. But I sort of wanted him to tell me, not the internet.

Captcadhew,

Welcome to our forum and I want to be clear that it was your EP who did this ablation that said he had never heard of a mildly to moderately elevated HR post ablation?? If so that would be a stunning admission on his part. It is an absolute established fact that post ablation temporary HR increase
Is very common, it often is the hallmark of a more solid ablation done compared to ablations with no increase in heart rate from insufficient transmural ablation lesions to get the job well done.

An elevated post ablation HR is not always associated with a solid transmural Ablation long term to be sure, but tends to indicate a decent quality index ablation even when a touch up might be needed down the road to really button everything down for the long run. I think a better way to put it is that those with no elevation of HR that are already deeply bradycardic before hand are even more likely to have earlier recurrence than those with a more typical elevated HR.

The higher resting pulse tends to resolve more or less near your old resting NSR pace over 6 months to a year with some, like myself, requiring over two years to return back to my old 60bpm range on wake up.

It's totally expected though and any EP that did Would say they have never heard of a mild to moderate elevated resting HR post ablation would represent a red flag if he truly heard you correctly and meant what he said on face value. Alas, there are a pretty good number of EPs out there who fall far short of being highly recommended ablationist.

Hence our strong mantra here is to make every effort to partner with the most experienced and widely respected EP for his or her skills with an ablation catheter that you can find. A very daunting task I realize for a new Afibber just thrust into the maze of opinions and suggestions in the first months to first year of dealing with AFIB..

No worries though, you may well have gotten a good foundational ablation as it is, and if you need a touch up at some point just take the time to digest all the wonderful resources and collective experience on our forum and website to help guide you to a real maestro should round two be needed in the future. Also get on board with The Strategy protocol now and insure you have fundamental electrolyte repletion on board and work to minimize any life style risk factors in your life like obesity, sleep apnea, hypertension, metabolic syndrome etc while avoiding known AFIB triggers for you.

Cheers!
Shannon



Edited 2 time(s). Last edit at 04/26/2016 11:51PM by Shannon.

Yes, it was the EP who did the ablation who said this about the elevated resting HR. Or at least the EP who supervised the abaltion. I suspect the resident did most of the work as I was probably a good candidate for learning on, since I was pretty young and healthy. I suspect that is why the procedure took as long as it did. Now, I maybe have misunderstood, maybe he was trying to say it wasn't something to be concerned with, but I thought I was pretty clear about the issue and was shocked when he seemed to downplay it and mentioned that my resting heart rate probably wasn't really ever that low instead of saying that was just normal.

I know what I am going through is strange. With symptoms that aren't very defined and don't seem to be triggered easily and not at the time. So figuring out what is going on is difficult. And maybe I am just pushing too hard too soon. But it has been tough to feel good enough to exercise, feel fine while exercising and then seem to have issues later as a result.

I am in Eastern Iowa, in Iowa City.



Edited 1 time(s). Last edit at 04/24/2016 03:38PM by captcashew.

I know with my experience in Athletics and exercising myself and observing others is that its possible we can subconsciously protect ourselves, in we think something is wrong, and this can be done on a subconscious level. So its possible since you don't really need to exercise, that your are playing it safe, and limiting yourself for awhile. Or maybe something is causing it.

What is your HR during the exercise? Have you been monitoring your HR during the exercise, and shortly afterwards?

About the increase in HR post-ablation. The references to this that I have heard of talk about a 10 maybe 15 bpm increase. That both from published studies, and feedback on this site. You had a 30 point increase. Assuming you had an average HR of 45 that jumped to 75, this is a 67% increase. Compare this to an average Ablatee who starts out about at 80 and goes to 90, only a 12% increase. Could the 67% jump in HR cause your Heart Muscle to weaken, or be causing Adrenal overload and contributing to this unusual fatique you are experiencing?

I would compare your pre and post Ejection Fractions (EF) from all of the Echo's that you have had done.
What medications are you on? Metropolol can cause sedation. Ablatees have had success using a Cardio-selective Beta-Blocker like Bystolic at a low dose 2.5-5mg to keep the post-ablation HR down. These special Beta-Blockers cause less tiredness and sedation as they target the Heart muscles and don't impact the rest of the system as much.



Edited 3 time(s). Last edit at 04/26/2016 08:31AM by The Anti-Fib.

Heart rate has been tough to track during the exercise, it generally is pretty high, but not too high. Not nearly as high as it would have been if I was really going hard pre-surgery. I would guess in the 120-130 range. My monitor seems to have trouble tracking it, probably be cause I am still moving around a bit after just stopping. But I do notice my heart rate stays in the 90's for a few hours after exercise though.

I'll have to follow up to get my pre and post EF numbers.

No medication now. And all I was taking post-surgery (and even pre-surgery) was warfarin. The original EP took me off meaprolol after about 6 months because he said the dose was so low and given that I was pretty young, had no other heart issues and in pretty decent shape, he thought the risk of stroke was virtually zero. I was only on the warfarin because of the procedure. But that stopped about 2 weeks ago after my final check in with the new EP doc.

So, if I were looking for a doc to do a follow up, second opinion, etc., are there recommendations for the eastern Iowa area (Iowa City)? If anyone wants to PM me, that is fine. The more I look at what I am going through, every step, compared to other people's stories, things just don't seem to add up.

The top centers in the area if you were going for an Ablation would be:

The Mayo Clinic in Minnesota (Dr. Packer)
Maybe the Cleveland Clinic.

Just for a good second opinion locally, I don't know. I have gotten alot of good info on Doctors from other people working with them, Nurses, other Dr.s people who work in the Hospitals or assist or are associated with treatment somehow.

I would PM Shannon if doesn't respond here after several days.

I would definitely follow up with a 2nd opinion from a completely different practice.
I take it you had the full Ablation, not just a PVI Isolation.
Did the EP Dr. discuss just doing a PVI Isolation vs a full Ablation? They recovery wold have been less traumatic if they only Ablated the Pulmonary Veins.

Keep us posted, there has been several other cases like yours were a patient in very good shape, with not much AF and its not even Symptomatic AF is talked into an Ablation, only to find out that the recovery is 10 times harder than they thought.
Its like the the less Symptomatic a patient is when they had AF, they worse the recovery is after the Ablation.

I assume it was the full ablation, not entirely sure. They probably told me and I just didn't understand the difference. And actually I'm not sure if I still know the difference. It sounded like they were going to try and find the nerves (or whatever) that triggered the afib and then isolate those. Once they found them, they would try to trigger the afib while I was in surgery. It sounded like part of the reason the surgery took so long was that it took a long time to find this and trigger the afib. They said they did eventually get it though.

Well, I guess that is good news to hear that there are others that have had a similar experience to mine. It stinks but at least I know I'm not some sort of unique case. Curious, do you have any info on their outcomes? Even just anecdotally? Did they eventually feel like they recovered? Just it took longer, like a year or so? Or were they sort of this way for even longer?

I've changed up my exercise to try to exercise just once every 5 days. Hopefully that is slow enough to let things recover. So far, so good 8 days in (but I never really felt that bad doing 3-4 times a week until 10-14 days in. The problem with this is I'm getting into pretty bad shape and think I feel bad just from that now.

If it was just a PVI isolation, then it wouldn't have taken 8 hours. Most AFIB episodes ans even Ectopy and PAC's originate from the Pulmonary Veins. Doing a PVI Isolation helps to stop an episode from starting, but once its started then it doesn't help with that, so that is why they do a what they call a full Index Ablation in which they Ablate over the whole of the Atria. In Patients with mild sporadic episodes that terminate on their own, they often just do an PVI Isolation Ablation, although the tendency has been lately to bypass the PVI Isolation and just go straight to the Full Ablation as they think that your AFIB would have gotten worse, and they would have had ended end doing the Full Ablation anyway.

I don't agree with that, especially in relatively Asymptomatic Patients, as it ignores the beneficial Efforts at remediation that many have accomplished using the Natural methods espoused on this site.

As for others like you, RonM comes to mind, and he responded on this thread. There was another one about a year ago, but I don't remember who it was.

There was the case of JohnM

[www.afibbers.org]

[www.afibbers.org]
[www.afibbers.org]
[www.afibbers.org]
[www.afibbers.org]



Edited 1 time(s). Last edit at 05/01/2016 08:49PM by The Anti-Fib.

[www.afibbers.org]

Thanks for those. Sounds like I'm definitely better off than JohnM. I hope things turned out well for him.

In general, would you say that people in a similar situation to mine just needed longer to heal or did they need some sort of follow up treatment. I'm trying to decide what my next step should be. As long as I don't exercise, I seem to be fine. Now obviously that isn't something I want long term, but if it means taking it easy for another 3-6 months, I can deal with it. The frustrating part is just everyone says "you're good, give it time" without really giving me an indication of what is going on and a time table. Pre-ablation, if they just gave me more realistic expectations, I think it would be much easier.

A bit more info. I saw my general doc today and was able to see my EF from the first time I was in the ER in October 2014 and the time post surgery (feb. 2016, about 4 weeks after surgery. Both were right around 62%. I think one was 62 and the other was 63 or both were 62. Sounds like that was fine, right?

She is going to have me run some more blood tests tomorrow to just make sure readings on other stuff are good, then we will go from there.

62% is very good.
I had Heart Failure with an EF as low as 20% and it only produced increased fatigue for several hours afterward.
Although if your Heart is somehow not pumping right, then your Adrenalin kicks in to help the Heart contract harder.
That could contribute to Adrenal Fatigue and Burnout, but in your case, your Heart is supposedly doing well.

To answer your question each person is different, but yes both time and intervention were necessary.
Your dilemma is that you don't know why your feeling fatigued, so you can't really treat unless you can figure out a diagnosis.



Edited 1 time(s). Last edit at 05/05/2016 08:21AM by The Anti-Fib.

So, I had gone back last week and saw my GP just for a general check up. Talk to her about stuff, etc. She didn't think that I was crazy, so that was good. She just had a lot of blood work done to check thyroid, testosterone, other stuff that it could be. Mostly to rule all that out. 17 different tests in all. All came back normal, which I sort of expected. I didn't mention the adrenal issue at that time.

Since then, I had the chance to talk to Shannon for quite a while on the phone, which was great. Really set my mind at ease, confirmed things that I suspected, stuff like that. I can't say how much I appreciated that. After talking to him, I asked for a copy of my ablation report and also mentioned to my GP about the adrenal issue it could be. She didn't run any tests for that but was able to ask that they did a cortisol text from the draw they had done. I'm pretty sure for a fuller analysis, they need to do several tests throughout the day, but figured it couldn't hurt to see what the first test said. The draw was done at 8am, before I had eaten for the day (I don't think that mattes). Finally a test that came back not normal range. It actually said I was high. I want to say in the 25 range when normal according to them was in the 6.2 - 19.4 range. Not sure what that means yet, but it is something.

It sounds like the best course will still be just giving things a few more months to let things heal. But ultimately, the main thing was just knowing that something is going on and I'm not imagining it and that there is hope for improvement.

Cortisol levels are highest in the morning. If Adrenal fatigue was the issue, I would think the morning levels would be low. Increased Cortisol is usually related to stress; either physical or psychological. Give it time as I'm sure you and Shannon discussed. Take it slow as to not over do it and go backwards. Read my threads as I had a very slow recovery and at times still over do it. Fyi..... I just jogged a quick 20 flights of stairs on my break. It takes time.

RonM

Thanks Ron. How far out are you from your procedure again?

My procedure date was 6/29/15....a little under 11 months. My only question is you said your procedure was 8 hours......I don't think I have ever heard of an 8 hour procedure. Yours should have been similar to mine at about an hour or so.

Yeah I talked to Shannon about that too. I had my procedure done at the hospital which is also a teaching hospital. After doing a little bit of research and getting my ablation report, looks like a fellow did my procedure. I asked the nurse how many procedures he had done prior to mine, she just said that the main doctor was the one who had done hundreds of procedures but didn't know how many the fellow had done. I'm not saying he screwed anything up but that might explain some things. I never met the fellow prior to rolling into the operating room.

So what percent of the way back would you say you are? I don't know if I could have done 20 flights of stairs in the last 15 years, even before surgery.

I would say I'm back to 95-100%. I tend to over do it;like a lot of afibbers. I also have a theory that younger healthier non-symptomatic paroxysmal afibbers that feel fine are the ones hit the hardest from the surgery. Symptomatic afibbers feel better as there afib load is substantially decreased along with there symptoms. Also, if you were in good shape your conditioning can decrease rather quickly which adds to the fatigue.

Did they ask you prior to your procedure if it was ok to be part of the training process that could potentially extend your surgery by 8 fold? I don't like that part at all.



Edited 1 time(s). Last edit at 05/11/2016 03:22PM by RonM.

No, didn't ask or tell. I asked my wife if she remembered seeing him and he was there as they prepped me before surgery. But she agreed that she thought he was just going to observe. You get residents like that all the time at appointments. But a big deal. I've had two other surgeries there (hernia and lasik) and didn't have it happen, so I didn't think to ask. I don't know for sure it was primarily him but he did the ablation notes and mentioned the main doc was present the whole time. So...

Yeah, just need to be more patient. I've decided to limit cardio for a while. My muscle tone is that of a 12 year old, so figured some weight lifting will be good for a while.

Captcashew:

I think the Ablations take longer if they have trouble getting the Arrythmia to manifest itself, as you said earlier in this thread.
It doesn't mean they were burning the whole time.
If a patients Arrythmia is that hard to reproduce, maybe they should back out and just do an EP Study. Particularly if the Patient is largely Asymptomatic.
Has Shannon or anyone commented on the 150 Burn Statistic? That is higher than average.

Yeah, I did get the impression that the majority of the time wasn't burning. Just testing things out, trying to get me to go into afib, etc. But I haven't seen anything official about the 150 burns. Just something they mentioned post-surgery. I'm pretty sure my wife was there and confirmed it with me later a few times to make sure I wasn't imagining it. I've talked to Shannon, but I don't think we lingered on the 150 burn number specifically. Mostly talking about the technique, what Natale does a bit differently, etc. I definitely feel like I should have researched more and probably gone a different route. not saying I wouldn't have had the surgery. Just probably not with the place I had it done. I was getting bad vibes early on and should have trusted my instincts, which I normally do. But figured I was just being paranoid since I didn't like the idea of anything foreign in my heart.

Still, I figure I should be ok eventually. At least to back to where I was pre-surgery, which is all I want now. Then I could try some supplements or a touch up procedure. And having a better idea of what to expect. I feel pretty good today, but it has been 2 weeks since I've exercised in any way other than mowing the lawn.

150 burns would be a heck of a lot Bill. I did not have anywhere near that many even with my soup to nuts very extensive persistent AFIB ablation with Dr Natale in 2008. There must have been a miscount or not hearing it correctly to get a figure around 150 burns. Otherwise, if true this could be a clue as to your longer than average recovery process. After reading your ablation report nothing jumped out as out of the ordinary and it read like a fairly standard PVAI type ablation.

Unless he decided to play tic-tac-tou inside you heart with the ablation catheter after finishing up the PVAI

Shannon

any updates?

In a regular PVI it doesn't really matter whether or not AFIB is induced, though, most EPs like to so as to count the stats for how many either convert or do not convert to NSR from the ablation itself. But the end point of a PVI is simply confirmed isolation of the pulmonary veins which can be achieved and confirmed with either an entrance block, or more preferrable these days both entrance and exit block across the PV to LA lesion lines.

Another reason an EP will push for inducement to trigger AFIB if the person is in NSR when they come into the EP lab is if they are going to add real-time detection and ablation of other non-PV sources ranging from the left atrial posterior wall (LAPW) to the Left atrial septal wall, the SVC (Superior vena cava), CS (coronary sinus) and/or Crista terminalis, or the roof line, mitral isthmus and Left atrial appendage (LAA) as other possible non-PV target areas. However, more and more EPs now include the LAPW in the overall PV Antrum zone, as it rightly should be considered and included in an extended PVAI, as the LAPW tissue is embryologically, morphologically and histologically identical to PV Antral tissue and thus has the same arrhythmogenic nature. Not addressing the LAPW in many cases of AFIB is tantamount to not completing the PV isolation as far as likelihood of recurrence of AFIB/Flutter and need for a follow up ablation.

Shannon



Edited 1 time(s). Last edit at 05/26/2016 03:19AM by Shannon.

Not much to update other than I haven't really exercised in the last 3 weeks and have felt great. Which sort of stinks, but it is what it is. I didn't really intend to do so little, just worked out that way. I did find it interesting I was gong somewhere the other day and I thought to myself, when I was here a couple months ago, I felt HORRIBLE and I feel fine now. I'm almost 100% sure it is some sort of adrenal issue or something is going on. But I was going to take it easy on any high intensity exercise until I get to the 6 month mark if I can and then ease back into. I've been very tempted a few times to do something and then though to myself, better make sure I give it time to really heal.

The scale and overall cardio fitness probably isn't liking me for that, but thought I'd rather go through the feeling of being out of shape and getting back into shape than what I was feeling before. Definitely wasn't the same. I've gotten into bad shape from not exercising for a few years before. Getting back in shape wasn't fun, but it wasn't the same.

But officially, I never had any more tests ran, etc. From the EP's perspective, he thinks everything is fine. From my GP perspective, she isn't sure what is going on but advised just take it easy and try to exercise 5-10 minutes a day, increasing slowly. If I get 9 months out and am not getting better, then I'll be more proactive in getting help. For now, just hoping time will be the best medicine.

Thought I would check in and give the latest updates. I've generally been feeling pretty good. But I have also been doing very little exercise. July was pretty good as I started to do more strength training with the occasional basketball and bicycling. But no more than 15-20 minutes of basketball or 3-4 miles at a time biking. Some of that was a bit tough, I'd get winded, but I think that is as much because of being out of it for so long.

August and so far in September I just got busy and didn't keep up. Vacation and other work stuff coming up. Which is a bit disappointing, I really wanted to start pushing a bit more.

Some days are good, some not great. I've found that anything with anxiety seems to get me more than I remember before. Maybe that is just in my head or maybe that is related to some adrenal issues, I'm not sure. I've had some chest discomfort lately, but I think that has more to do with chest muscles and lack of use than anything heart related. I was feeling this way in late June too but then after I started doing some strength training, it went away. So I assume it is more a part of lack of activity. Today is rough too, neck and upper back is all messed up, but I'm sure that is a work stress thing.

How is everyone else doing? Ron, are you feeling back to normal?

My resting heart rate still is pretty high, in the upper 60's to lower 80's almost any time I check it. I have a follow up with my general practitioner this week and the electrocardiologist next month. So I'm going to try to ramp up and see what is going on. My family tends to seem pretty anxious so I'm wondering if the surgery just feeds on that and I'm just having anxiety.

Thanks and I hope everyone is doing well.