1st TEE amd Ablation next month. I'm freaked out!

I started having symptoms about a year ago and was put on Propenfanone 3x daily and Xarelto 1x daily. My Dr has scheduled an TEE amd afib ablation in 4 weeks (Jan 23). I'm kinda freaking out and nervous about the procedure. Any advice or what I should expect. I've never had anything like this before. I've always been an active person ( lift weights, run 5k and a few Halfs marathons) I'm 37 and scared. Help!

Hi Wade,

The advice around here is to choose your ablationist very carefully. There are EP's who do relatively few ablations/year and others who do >400/year and have done 8,000+ in their career. A very good friend in Houston was referred to a local EP who "had done a lot." I suggested (insisted) he see Andrea Natale in Austin. Upon investigation he found that Natale had done >8000 afib ablations with 75% of his patient population being very difficult cases. He called the Houston EP to find out how many he'd done, 800 was the answer. Actually, 800 isn't a tiny number - there are many with much fewer - however it pales in comparison to 8,000.

Many afibbers who have their first episode < age 50 come to afib via chronic fitness (I did, 12 1/2 years ago). I iterated to a solution to keep my afib mostly in remission. It included magnesium supplementation to bowel tolerance, potassium and taurine supplementation. Lastly it included significant detraining. I do not train with cardio. I do not enter endurance races (I previously competed in the Pikes Peak Assent Race for 10 years, 13.3 miles, ~7800' elevation gain topping out at > 14100'). I remain very active but I consider any endurance activity as depleting a finite asset. I look at high heart rate duration as a negative. Hence I do Tabatas (8x20:10) about once a week on a Schwinn Airdyne fan bike. This is intense, but only lasts 4 minutes. I also do strength training (TRX Military fitness), but it is always body weight. I also rock climb and ski off piste, but avoid hiking with my skis on the laps as that adds an unnecessary endurance component.

See: <[www.afibbers.org]
<[www.afibbers.org]
<[www.drjohnm.org]
<[www.medscape.com]

Since you are an endurance exerciser, you may have vagal triggers <[www.afibbers.org]
Propenfanone has beta blocking properties. Because of this, it may not be the best choice of a rhythm med for someone with vagal triggers (if you are in fact vagal - beta blockers can make vagal triggers more likely). Flecainide may be a better choice.

In your shoes, I would a) detrain; b) add supplemental electrolytes, especially magnesium; c) ask the doc to change your med to flecainide. I would give this a try before I had an ablation (are you continually in afib now, or does it come and go?). If I was going to have an ablation, I would do a lot of due diligence on who would be my ablationist.

George

Wade,

Same here. I was 41. Runnng 30+ miles/week. Vagal afibber. Beta blockers were a disaster and propafenone only worked if it went down with beer. No joke. The vagal form of AF really can't be medicated with any degree of success approaching the adrenergic form.

Choose the EP wisely but be assured it is the right choice. 37 years of age is no way to be contemplating a lifetime of medication nor, in my opinion, should any medical provider be suggesting it. Drop the nuclear bomb on that AF and get on with life.

Best wishes!

Pay attention to what George said, as good as advice as your going to get.

In your post you stated "My Dr has scheduled an TEE/Ablation for next month."
Maybe that's why you are having anxiety over this. Sounds like he decided this for you, sort of imposing it on you. You could probably make this decision yourself. Can you give more info on your symptoms and efforts to resolve this? Is there driving reason why an Ablation needs to be done right away? What is the frequency of your episodes, have you tried Electrical Cardioversion?

Hello,
I freaked out about the TEE especially, but really, apart from some minor anxiety when I started spraying the throat numbing spray, there was no pain because they fully sedated me almost immediately and I woke up back in the hospital ward.