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My Afibbers Journey
Posted by Gobears
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My Afibbers Journey March 26, 2017 10:56AM |
Registered: 7 years ago Posts: 21 |
Through the incredible assistance of Shannon Dickson, our editor – and the great luck that I found this website – I write this on the plane returning from my “index” (first and hopefully last) ablation in Austin at the ultra-capable hands of Dr. Andrea Natale.
Here’s my story.
I am 55 years old. Back in my late 20s, I first experienced some runs of tachycardia. The first time it happened (or at least I noticed it), I was in my apartment drinking a beer and watching tv. Suddenly my heart was racing. I called 911. Firemen crowded into my cramped studio, banging their gear against the furniture. They took an EKG and saw …nothing. Totally normal. They looked at me like I must have been doing drugs and freaked out. “You’re fine guy.”
About a week later, it happened again. This time I was at work. A colleague drove me to UCLA medical center. Another EKG. Another normal result.
I went to a well-known cardiologist in LA. I was fitted with a “Holter monitor” for two weeks. Again nothing.
But the episodes kept happening. Finally, I was given a “high tech” device where I could transmit an EKG over the phone and to a fax machine when I was feeling an episode (this was 1990 after all). This way, we finally tracked it down – Supraventricual Tachycardia. My cardiologist said my condition was benign and that I could take beta blockers if I was bothered by the occasional runs but, if not, I could go about my life and not worry.
For over 25 years, the knowledge that this was a benign condition was all I needed to conduct myself as if I had no heart issue whatsoever. I was a moderate alcohol drinker and serious caffeine addict. The cardiologist, of course, suggested I cut down on the coffee, but wasn’t too concerned about the drinking. Sometimes I would feel like my heart was especially “squirrelly” and would cut down on coffee and my heart would calm down.
Every five years or so, I’d have some runs of arrhythmia that seemed more pronounced. I would go to the cardiologist, have an echo stress test, and everything would check out as normal.
This pattern continued until December 2015 when my younger brother gave me an Alivecor heart monitor as a gift. After a couple weeks of “normal” readings, I got one that took me by surprise. “Possible atrial fibrillation.” I didn’t know what it was, really, though my mother had been diagnosed with atrial flutter the prior summer. I made an appointment with my loyal cardiologist of 25 years plus. “You are having atrial fibrillation,” he confirmed from the Alivecor EKG. He scheduled a stress echo test. Everything was relatively normal, except my left atrium was slightly large 40-41mm. And then I went into flutter at the end of the test. It went away within 30 minutes. I was put on a two week Zio patch and continued to drink alcohol and coffee like “normal” to get a realistic view of things. The Zio report said I had 6% afib burden (meaning I was in afib 6% of the time during the two week study).
When I was in afib and/or flutter my heart would go quite fast – sometimes over 150bpm. I would notice it, especially lying in bed at night.
I took this seriously. I told my cardiologist I did not want to take any medication and would simply cut down on alcohol and caffeine. I took a baby aspirin sort of once a day – I was not very disciplined about the aspirin . But I was able to pretty much eliminate my episodes of afib/flutter when I would not drink alcohol. The fact that the episodes seemed so directly related to alcohol gave me confidence that I could control my own destiny.
I began to return to my old confidence that all was well with me. Over time, I began to feel like I didn’t have any heart problems whatsoever. I started drinking alcohol occasionally and barely used my Alivecor monitor and didn’t feel a lot of afib or flutter.
Then this past Christmas, my brothers and I and our families had a ski vacation together in Lake Tahoe. I was drinking a lot of alcohol for a few days, eating chocolate and got the flu. My heart went into flutter at about 150 bpm and basically did not stop for a week!
I was a wreck. Upon returning from Tahoe, I went to my cardiologist. He immediately scheduled me for a cardioversion and put me on Eliquis, metropolol, flecanaide and digoxin. These drugs barely reduced my heart rate down to 120-110 bpm (when they “worked”) and often my heart was running still at 150bpm. I was waking up sometimes in the middle of the night in total sweat – presumably from my heart pounding at a mountain climbing pace.
Since there was not enough time for the blood thinner to assure no stroke during the cardioversion, they did a TEE procedure beforehand. I was cardioverted on Jan 13. Just one shock – 100 joules – and I was back in normal sinus for a grand total of, wait for it, one day.
My cardiologist said my racing heart was seriously concerning and wanted me to have a flutter (right atrium) ablation with a well-known EP in my cardiologist’s practice. This was Tuesday and the ablation was scheduled for the coming Friday. I freaked out.
I didn’t want to rush into an ablation. First, I still hoped that this “Christmas episode” of arrhythmia would subside and things would go back to “normal.” Second, I wanted to know more about ablations and their risks. Given that I am a little overweight (6’2” 225lbs) I figured I could make some lifestyle changes that might make it all go away. But through the rest of January and February, I was in and out of flutter and did not seem able to “hold onto sinus rhythm” for more than a couple of days. Needless to say, I was having these issues despite not drinking ANY alcohol since Christmas and decaf coffee only (and barely any of that) since then, too.
I also didn’t know whether, if I chose an ablation, I should just have a flutter ablation or a left atrium (afib) ablation, too. My cardiologist recommended the minimal approach first (right side flutter) and then, if it didn’t work, do something more extensive. The EP recommended was leaning to both the flutter and a PVI ablation. He would decide while in the procedure.
I started researching the issue of ablations and the best EPs for the procedure.
The very best thing that happened during this research was I found Shannon and this website!
After learning about Dr. Natale on this website and also reading many other afib accounts, I recognized that letting the afib/flutter continue would “remodel” my heart and make my condition worse. On the other hand, I also learned how vitally important the “operator” (EP who does the ablation) is to the success of an ablation.
I cancelled the Friday ablation in order to make a more deliberate and orderly choice on the subject. In the meantime, since I still didn’t know if I would use the EP recommended to me, we prepared for an ablation in the future. The EP wanted to know if I was having mostly flutter or afib so I wore another Zio patch for 10 days – it came back 100% flutter; that is, flutter the entire 10 days, 24/7. I also had a pre-ablation CT. Unfortunately, the CT scan occurred while I was in flutter. Metropolol was not able to reduce my heart rate to the 50 or 60 bpm ideal for the CT and they had to take a little more time to get good images. The good news is that I have virtually no coronary artery disease – calcium score of 0 except 2 on my descending coronary. This is consistent with my very low cholesterol: total cholesterol 138; HDL 65; triglycerides 64. My left atrium was measured at 46mm – up from 40-41 mm (via echo stress) 9 months earlier (though I am told that the CT measurement is different – and can’t necessarily be compared to – the echo measurement).
I interviewed an LA-based EP who was highly recommended by a friend – Dr. Shephal Doshi. He was impressive and recommended I have an ablation ASAP. He could put me on his schedule in April. But I had already decided that ideally I would have Dr. Natale as my EP. I wanted the best operator in the world and from everything I could get my hands on, he is indeed the best.
I posted a message on this website asking for advice. I was in almost constant flutter at this point and, in all honesty, feeling somewhat desperate.
As many of you have experienced, what happened next was totally unexpected and life changing. Shannon Dickson, the editor of the site, contacted me personally and provided superb information. I contacted Dr. Natale’s office and was able to get me a “two day” appointment, March 21 and 22. I would fly to Austin on March 20, see Dr. Natale for a consultation on March 21 and, assuming all was a “go,” would have my ablation on March 22.
It is now March 25 and I am flying home with my wife. All went according to plan.
Although he’s obviously extremely busy, Dr. Natale was very accessible and relaxed during our consultation before the ablation. I talked a little about the background above, going back to the SVTs in the early 1990s. I told him that my afib/flutter seems particularly sensitive to alcohol. Since I was in NSR when I saw him, he told me I had permission to have a few drinks the night before the ablation. I thought he was joking. He wasn’t. He said ‘go for it!” He wanted my heart to show its problems to him. So I was able to have my first India Pale Ale and some wine since Christmas. (My wife, however, insists that I will not be drinking anymore. Period. She’s “not going through this **** again!”) (Needless to say, although I did have a few runs of short flutter after drinking, my heart was in NSR at the time of the procedure. After driving me crazy for weeks on end, my heart decided to calm down for the ablation.)
After the consultation, I got a call telling me my ablation would be the third of the day and I was to report at 9:30AM.
On the morning of the ablation, I (shockingly ☺) met with a representative in the business office regarding insurance and billing. I was then taken to a staging area where a blood sample and a urine sample were taken. I got into a gown and waited to be taken to surgery -- until I got a little stir crazy. I walked out to the courtyard garden where folks were having early lunch. I must confess it was a little windy and I had to hold tight to my gown to prevent it from going Marilyn Monroe. But it’s a beautiful garden area.
At about noon, I was taken to the second floor, said goodbye to my wife and was quickly put to sleep. My ablation was a “textbook” procedure per Natale’s methods. He isolated my pulmonary veins, the left atrial wall, and the superior vena cava and ablated my right atrium for flutter on his way “out.” He found that all my pulmonary veins had “potentials” (until he ablated same). He found my superior vena cava was causing some PACS and ablated that away. He found a few other hot spots, but not a lot. There was no scar tissue or fibrosis. He did not seem particularly concerned about the flutter as he said it has to be triggered by something else – and hopefully he took care of all the “something else’s.”
I was back in my room by 4pm. The worst part of the experience was the urinary catheter and having to lie still for six hours to allow the leg and neck catheter access sites to fully clot. I did not feel any crushing weight on my chest as others have. There is definitely some esophageal pain but that has mostly gone away now. There is some tightness when I breathe deeply.
While I was recovering in the hospital, Dr. Natale popped in twice, first just after the ablation and again the next morning. Other than me thanking him profusely, there was not a lot to say. He exudes well-earned confidence. I did not ask him to predict my ultimate outcome. Everything had gone according to plan. Knowing that is enough for me.
I was walking around the hospital by 10:30PM and was discharged the next morning at 10AM.
I was able to walk a mile with ease that afternoon and had to hold myself back from pushing more.
I was given Lasix and potassium to use at my discretion to keep fluid retention down. I took this combination twice – the first and second night out of the hospital. Now, four days later, I don’t anticipate taking the Lasix again.
As of now, I am on Eliquis and one 120mg Cardizem per day.
I have had a few ‘skipped beats” but my heart seems to be in solid NSR. I will keep you all updated over the coming months.
I cannot thank Shannon and those who post on this website enough for all of the information (and more) you have provided me on this journey. For anyone suffering afib, this website is truly a God-send.
Kevin
Edited 4 time(s). Last edit at 03/27/2017 01:45PM by Gobears.
Here’s my story.
I am 55 years old. Back in my late 20s, I first experienced some runs of tachycardia. The first time it happened (or at least I noticed it), I was in my apartment drinking a beer and watching tv. Suddenly my heart was racing. I called 911. Firemen crowded into my cramped studio, banging their gear against the furniture. They took an EKG and saw …nothing. Totally normal. They looked at me like I must have been doing drugs and freaked out. “You’re fine guy.”
About a week later, it happened again. This time I was at work. A colleague drove me to UCLA medical center. Another EKG. Another normal result.
I went to a well-known cardiologist in LA. I was fitted with a “Holter monitor” for two weeks. Again nothing.
But the episodes kept happening. Finally, I was given a “high tech” device where I could transmit an EKG over the phone and to a fax machine when I was feeling an episode (this was 1990 after all). This way, we finally tracked it down – Supraventricual Tachycardia. My cardiologist said my condition was benign and that I could take beta blockers if I was bothered by the occasional runs but, if not, I could go about my life and not worry.
For over 25 years, the knowledge that this was a benign condition was all I needed to conduct myself as if I had no heart issue whatsoever. I was a moderate alcohol drinker and serious caffeine addict. The cardiologist, of course, suggested I cut down on the coffee, but wasn’t too concerned about the drinking. Sometimes I would feel like my heart was especially “squirrelly” and would cut down on coffee and my heart would calm down.
Every five years or so, I’d have some runs of arrhythmia that seemed more pronounced. I would go to the cardiologist, have an echo stress test, and everything would check out as normal.
This pattern continued until December 2015 when my younger brother gave me an Alivecor heart monitor as a gift. After a couple weeks of “normal” readings, I got one that took me by surprise. “Possible atrial fibrillation.” I didn’t know what it was, really, though my mother had been diagnosed with atrial flutter the prior summer. I made an appointment with my loyal cardiologist of 25 years plus. “You are having atrial fibrillation,” he confirmed from the Alivecor EKG. He scheduled a stress echo test. Everything was relatively normal, except my left atrium was slightly large 40-41mm. And then I went into flutter at the end of the test. It went away within 30 minutes. I was put on a two week Zio patch and continued to drink alcohol and coffee like “normal” to get a realistic view of things. The Zio report said I had 6% afib burden (meaning I was in afib 6% of the time during the two week study).
When I was in afib and/or flutter my heart would go quite fast – sometimes over 150bpm. I would notice it, especially lying in bed at night.
I took this seriously. I told my cardiologist I did not want to take any medication and would simply cut down on alcohol and caffeine. I took a baby aspirin sort of once a day – I was not very disciplined about the aspirin . But I was able to pretty much eliminate my episodes of afib/flutter when I would not drink alcohol. The fact that the episodes seemed so directly related to alcohol gave me confidence that I could control my own destiny.
I began to return to my old confidence that all was well with me. Over time, I began to feel like I didn’t have any heart problems whatsoever. I started drinking alcohol occasionally and barely used my Alivecor monitor and didn’t feel a lot of afib or flutter.
Then this past Christmas, my brothers and I and our families had a ski vacation together in Lake Tahoe. I was drinking a lot of alcohol for a few days, eating chocolate and got the flu. My heart went into flutter at about 150 bpm and basically did not stop for a week!
I was a wreck. Upon returning from Tahoe, I went to my cardiologist. He immediately scheduled me for a cardioversion and put me on Eliquis, metropolol, flecanaide and digoxin. These drugs barely reduced my heart rate down to 120-110 bpm (when they “worked”) and often my heart was running still at 150bpm. I was waking up sometimes in the middle of the night in total sweat – presumably from my heart pounding at a mountain climbing pace.
Since there was not enough time for the blood thinner to assure no stroke during the cardioversion, they did a TEE procedure beforehand. I was cardioverted on Jan 13. Just one shock – 100 joules – and I was back in normal sinus for a grand total of, wait for it, one day.
My cardiologist said my racing heart was seriously concerning and wanted me to have a flutter (right atrium) ablation with a well-known EP in my cardiologist’s practice. This was Tuesday and the ablation was scheduled for the coming Friday. I freaked out.
I didn’t want to rush into an ablation. First, I still hoped that this “Christmas episode” of arrhythmia would subside and things would go back to “normal.” Second, I wanted to know more about ablations and their risks. Given that I am a little overweight (6’2” 225lbs) I figured I could make some lifestyle changes that might make it all go away. But through the rest of January and February, I was in and out of flutter and did not seem able to “hold onto sinus rhythm” for more than a couple of days. Needless to say, I was having these issues despite not drinking ANY alcohol since Christmas and decaf coffee only (and barely any of that) since then, too.
I also didn’t know whether, if I chose an ablation, I should just have a flutter ablation or a left atrium (afib) ablation, too. My cardiologist recommended the minimal approach first (right side flutter) and then, if it didn’t work, do something more extensive. The EP recommended was leaning to both the flutter and a PVI ablation. He would decide while in the procedure.
I started researching the issue of ablations and the best EPs for the procedure.
The very best thing that happened during this research was I found Shannon and this website!
After learning about Dr. Natale on this website and also reading many other afib accounts, I recognized that letting the afib/flutter continue would “remodel” my heart and make my condition worse. On the other hand, I also learned how vitally important the “operator” (EP who does the ablation) is to the success of an ablation.
I cancelled the Friday ablation in order to make a more deliberate and orderly choice on the subject. In the meantime, since I still didn’t know if I would use the EP recommended to me, we prepared for an ablation in the future. The EP wanted to know if I was having mostly flutter or afib so I wore another Zio patch for 10 days – it came back 100% flutter; that is, flutter the entire 10 days, 24/7. I also had a pre-ablation CT. Unfortunately, the CT scan occurred while I was in flutter. Metropolol was not able to reduce my heart rate to the 50 or 60 bpm ideal for the CT and they had to take a little more time to get good images. The good news is that I have virtually no coronary artery disease – calcium score of 0 except 2 on my descending coronary. This is consistent with my very low cholesterol: total cholesterol 138; HDL 65; triglycerides 64. My left atrium was measured at 46mm – up from 40-41 mm (via echo stress) 9 months earlier (though I am told that the CT measurement is different – and can’t necessarily be compared to – the echo measurement).
I interviewed an LA-based EP who was highly recommended by a friend – Dr. Shephal Doshi. He was impressive and recommended I have an ablation ASAP. He could put me on his schedule in April. But I had already decided that ideally I would have Dr. Natale as my EP. I wanted the best operator in the world and from everything I could get my hands on, he is indeed the best.
I posted a message on this website asking for advice. I was in almost constant flutter at this point and, in all honesty, feeling somewhat desperate.
As many of you have experienced, what happened next was totally unexpected and life changing. Shannon Dickson, the editor of the site, contacted me personally and provided superb information. I contacted Dr. Natale’s office and was able to get me a “two day” appointment, March 21 and 22. I would fly to Austin on March 20, see Dr. Natale for a consultation on March 21 and, assuming all was a “go,” would have my ablation on March 22.
It is now March 25 and I am flying home with my wife. All went according to plan.
Although he’s obviously extremely busy, Dr. Natale was very accessible and relaxed during our consultation before the ablation. I talked a little about the background above, going back to the SVTs in the early 1990s. I told him that my afib/flutter seems particularly sensitive to alcohol. Since I was in NSR when I saw him, he told me I had permission to have a few drinks the night before the ablation. I thought he was joking. He wasn’t. He said ‘go for it!” He wanted my heart to show its problems to him. So I was able to have my first India Pale Ale and some wine since Christmas. (My wife, however, insists that I will not be drinking anymore. Period. She’s “not going through this **** again!”) (Needless to say, although I did have a few runs of short flutter after drinking, my heart was in NSR at the time of the procedure. After driving me crazy for weeks on end, my heart decided to calm down for the ablation.)
After the consultation, I got a call telling me my ablation would be the third of the day and I was to report at 9:30AM.
On the morning of the ablation, I (shockingly ☺) met with a representative in the business office regarding insurance and billing. I was then taken to a staging area where a blood sample and a urine sample were taken. I got into a gown and waited to be taken to surgery -- until I got a little stir crazy. I walked out to the courtyard garden where folks were having early lunch. I must confess it was a little windy and I had to hold tight to my gown to prevent it from going Marilyn Monroe. But it’s a beautiful garden area.
At about noon, I was taken to the second floor, said goodbye to my wife and was quickly put to sleep. My ablation was a “textbook” procedure per Natale’s methods. He isolated my pulmonary veins, the left atrial wall, and the superior vena cava and ablated my right atrium for flutter on his way “out.” He found that all my pulmonary veins had “potentials” (until he ablated same). He found my superior vena cava was causing some PACS and ablated that away. He found a few other hot spots, but not a lot. There was no scar tissue or fibrosis. He did not seem particularly concerned about the flutter as he said it has to be triggered by something else – and hopefully he took care of all the “something else’s.”
I was back in my room by 4pm. The worst part of the experience was the urinary catheter and having to lie still for six hours to allow the leg and neck catheter access sites to fully clot. I did not feel any crushing weight on my chest as others have. There is definitely some esophageal pain but that has mostly gone away now. There is some tightness when I breathe deeply.
While I was recovering in the hospital, Dr. Natale popped in twice, first just after the ablation and again the next morning. Other than me thanking him profusely, there was not a lot to say. He exudes well-earned confidence. I did not ask him to predict my ultimate outcome. Everything had gone according to plan. Knowing that is enough for me.
I was walking around the hospital by 10:30PM and was discharged the next morning at 10AM.
I was able to walk a mile with ease that afternoon and had to hold myself back from pushing more.
I was given Lasix and potassium to use at my discretion to keep fluid retention down. I took this combination twice – the first and second night out of the hospital. Now, four days later, I don’t anticipate taking the Lasix again.
As of now, I am on Eliquis and one 120mg Cardizem per day.
I have had a few ‘skipped beats” but my heart seems to be in solid NSR. I will keep you all updated over the coming months.
I cannot thank Shannon and those who post on this website enough for all of the information (and more) you have provided me on this journey. For anyone suffering afib, this website is truly a God-send.
Kevin
Edited 4 time(s). Last edit at 03/27/2017 01:45PM by Gobears.
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Re: My Afibbers Journey March 26, 2017 07:19PM |
Registered: 11 years ago Posts: 4,222 |
|
Re: My Afibbers Journey March 26, 2017 07:50PM |
Registered: 8 years ago Posts: 1,102 |
|
Re: My Afibbers Journey March 28, 2017 09:57AM |
Registered: 8 years ago Posts: 105 |
|
Re: My Afibbers Journey March 28, 2017 12:30PM |
Registered: 7 years ago Posts: 21 |
|
Re: My Afibbers Journey March 28, 2017 12:33PM |
Registered: 7 years ago Posts: 21 |
Thanks, Clay! You were one of those who encouraged me to keep trying to get Natale. I heard you're procedure was smooth. Congrats! What medicine are you taking post-procedure? I would like to dump the Cardizem and just take the Eliquis until (I HOPE!) I'm cleared to stop the blood thinner.
Glad you're doing well!
K
Glad you're doing well!
K
|
Re: My Afibbers Journey March 28, 2017 08:18PM |
Registered: 8 years ago Posts: 105 |
Kevin -
Rythmol and Eliquis. Apparently its their standard protocol to keep you on any anti arrhythmic drugs you were on for a number of weeks to let things heal in a calm environment. I was a little bummed to hear that too but then when I think about it, it makes sense. They said the objective is to get you off all drugs, but I guess they try to do it gradually and if they see that things are holding steady.
If taking Rythmol for a few more weeks is the worst of this, I can handle it. Glad you're doing well too!
C
Rythmol and Eliquis. Apparently its their standard protocol to keep you on any anti arrhythmic drugs you were on for a number of weeks to let things heal in a calm environment. I was a little bummed to hear that too but then when I think about it, it makes sense. They said the objective is to get you off all drugs, but I guess they try to do it gradually and if they see that things are holding steady.
If taking Rythmol for a few more weeks is the worst of this, I can handle it. Glad you're doing well too!
C
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