to ablate or do some meds first?

Hi,

I was to start propafenone this past weekend after getting home from a trip. Unfortunately, though my trip was great I can't seem to handle the stress of moving & packing every 2 days & all the noise (deaf in one ear) & new faces. I am thyroidless & my adrenals get stressed easily. Travel home was abominable as I have experienced many times before with canceled & missed flights & constant re-routings. Add to all this, I developed a sinus infection the day my travel home started. I had 4 afib episodes in the last week. I had fever & chills (still sick of course as these last a while) the night I got home & after a hot bath I had afib for the next 24 hr (through sleep, but would check it when I woke & once pulse was 168).

Well, I was to start propafenone the next morning Saturday, but since I have a little fever & a sinus infection, I am going to have to wait until I get well.

I have noticed I have started to have foot/calf cramps since starting Xarelto & that disturbs me. All this medicine juggling is just getting to be too much, as my endocrinologist & I keep trying different thyroid doses to see if things will calm down. For 10 years, I have been on totally natural dessicated thyroid (no synthetic) & since having to change that, I keep lowering my synthetic/natural combo, until today I am to start only synthetic of 75 mcg - which I might add is a dose my sister, who has a thyroid, takes. I wonder how can a person who has no thyroid take the same dose as a person who has one. The whole heart thing has messed up my thyroid balance & I have been experimenting on myself for a year between thyroid changes, beta blocker changes, now blood thinners, & soon anti-arrhythmics. I do not have high blood pressure & the beta blockers were just for my AF.

I am wondering if ablation by Dr. Natale might be a simpler route for me so that I could possibly not have so many meds & even get back to my natural thyroid instead of synthetic. I would of course be at lower doses, but the natural thyroid just takes care of so much that synthetic does not.

I am trying to decide about the risk/benefit ratio of going ahead with ablation, but first perhaps when I get well, starting the propafenone temporarily because I do not know how long it takes to get an appointment with Dr. Natale. I will say I just saw some of the topics here & the stuff about post ablation possible GI problems, accelerated heart rate - no matter what route you take it seems a gamble.

Does this sound good - to take a shot with the propafenone trial for a while (once not sick), but begin trying to book an ablation with Dr. Natale in the meanwhile? Austin is a direct flight for me & it might not be so hard to go through all that. I would hate to wait too long & then find out he has either moved or retired. So, beginning today my endocrinologist has lowered my thyroid dose again to totally kick out the natural (as it has the direct T3 in it), to do this for a month while watching my afib & get new thyroid labs. I will have to call the cardiologist & tell him of these plans. How can I watch how the thyroid med change is affecting my afib if at the same time, we start propafenone? I have been on thyroid support groups off & on for about 19 yrs & I know about changing just one thing at a time if you want to see what is causing what.

Until this trip I had not really seen stress in relation to my afib, usually it was just happening after meals in evening, but not as much stress as I felt being around so many new people & circumstances & changes as last week. But now I see that definitely added to my afib even though I was still having it after meals & in the evening I can always do exercise & day stuff very well.

To start planning for ablation soon, to do propafenone until then? And how does one go about telling their local doctor that they choose to use Dr. Natale instead of the EP in their clinic?

Thanks.

I think you're an excellent candidate for an ablation since you're not tolerating the meds well and your afib burden is pretty hefty. I really can't think of a good reason to delay such a choice. A successful ablation will eliminate the antiarrhythmics and beta blockers from your life, and possibly the anticoagulant as well (that will depend mostly on your CHADS-Vasc score). It usually takes a couple of months to get an ablation with Natale, so I'd go ahead and start the propafenone as soon as you can.

As for telling your doctor, I told my EP by saying, "I decided to have an ablation with Dr. Natale." Your heart, your life, you don't owe anybody an explanation or apology. They should have absolutely no problem with your decision. Alternatively, you don't have to tell them anything if you don't want to.

Hi Madeline,

I agree with Carey, you’re situation will best be served by eliminating AFIB from your life all together! The issues of moderate temporary heart rate elevation post ablation and even less likely but also temporary potential GI issues post ablation are not that common and almost always tend to be self limited as well.

And please don’t let an exagerrated fear of such potential ‘transient’ issues derail your plans to free yourself from a lifetime of what otherwise will most often become steadily progressive AFIB!

If you wish Madaline, please PM me your cell and time zone and we can discuss the overall process and perhaps maybe able to expedite things a bit.

Cheers!
Shannon

Quote
Shannon
Hi Madeline,

I agree with Carey, you’re situation will best be served by eliminating AFIB from your life all together! The issues of moderate temporary heart rate elevation post ablation and even less likely but also temporary potential GI issues post ablation are not that common and almost always tend to be self limited as well.

And please don’t let an exagerrated fear of such potential ‘transient’ issues derail your plans to free yourself from a lifetime of what otherwise will most often become steadily progressive AFIB!

If you wish Madaline, please PM me your cell and time zone and we can discuss the overall process and perhaps maybe able to expedite things a bit.

Cheers!
Shannon

Thank you Shannon & Carey,

I will be in touch & could use some help setting up my ablation. I am barely over my last travel & still sick & trying to get going again, so step by step, but will take you up on help. Thank you to this group who explains everything so well that drs do not have time to go into with us! I can follow orders much better when I understand the reasons behind them more. I wish I had time to be on here every day reading, but I also wish I could be out there living instead of always studying my health!!!