Post-ablation ordeal

Well, afibbers, to say this has been an eventful couple of weeks for me is an understatement. This is going to be a long post, but hopefully it will be of interest to some of you on this forum.

Background:
Twelve years ago I was diagnosed with paroxysmal atrial fibrillation. In the beginning, episodes were quite infrequent. However, because of my worsening condition (this year I have been in Afib about 65% of the time), I decided it was time to have an ablation. I had done considerable research seeking an EP that met my criteria for skill and experience and number of ablations done. The best of the best, as everyone on this forum knows, is Dr Natale, followed by the team in Bourdeaux. Either choice would have been financially prohibitive. I live in Ottawa, Ontario, Canada. However, in December last year I found an EP in Ontario who had trained under the maestro and who came recommended by Shannon. So I asked my GP to refer me to Dr Atul Verma at Southlake Regional Health Centre in Newmarket, Ontario. Newmarket is a 5-hour drive from Ottawa.

It took 8 months to get the ablation booked and, finally, on Thursday, August 15 I had the procedure done. It was preceded by a TEE. I happened to be in NSR that day but Dr Verma said it was not a problem, and actually was better. I was put under general anesthetic for both procedures. Everything went well. Dr Verma ablated around the pulmonary veins and the posterior wall. I was discharged early the next morning still in sinus rhythm and was prescribed Flecainide 50 mg BID to take for the 3 month blanking period. This was in addition to Eliquis 5 mg BID I had been taking for the month previous to the ablation and Pantaloc 40 mg BID I had started one week before.

My husband and I went back to the hotel and had breakfast. The original plan was to hang around Newwmarket for another day to make sure everything was okay, but I was feeling pretty good so we decided to head back home (mistake #1).

On the drive home, I started feeling very weary and had a tension headache. We arrived home late afternoon, had dinner. I’m very symptomatic and know when things are changing with my heart beat. At 7pm I noticed some ectopic beats which was not a good sign because they generally lead into Afib for me, which they did around 11 pm. I was disappointed at this turn of event, but not discouraged, because I knew this can happen during the blanking period.

Friday 16th:
However, the next morning, my heart rate was 120 and I was experiencing several long bouts of intense wooziness. This was very unusual for me. Pre-ablation, when I was in Afib my heart rate rarely went above 90 and I would have only short, mild lightheadedness from time to time. Discharge instructions said if I went into Afib within the first 24 hours of the procedure I was to get cardioverted. I went into at 30 hours and wasn’t sure what to do. It was the weekend and difficult to contact Dr Verma or anyone on this team, so I reached out to the forum for advice. Shannon was not immediately available, but Carey responded and recommended I get to the ER because of the wooziness and high HR. Thinking that it was simply a matter of getting a cardioversion and all would be good, I decided to go to the Ottawa Heart Institute instead of heading back to Newmarket (mistake #2).

Now the adventure begins.

Saturday 17th:
We arrived at the ER around 12:30, I was triaged quite quickly, had an ECG and into an ER bed about 2:00. Then they hooked me up to their monitors. Heart rate now was fluctuating between 130-150 and I was having numerous bouts of wooziness, which I learned later was being caused by long pauses when the heart was trying to convert to NSR. At one point, while in the bathroom, I passed out. An instant later I found myself lying on the floor staring at the base of the toilet wondering what the hell happened. Fortunately, no serious injury, just some bruising.

Two unsuccessful cardioversion attempts were made at 4:45. I did not ask how many joules were used. By this time, I had a fever (above 38C), chest pain and a dry cough. Thus began a multitude of tests: chest x-ray, CT scan, blood cultures, bloodwork, echocardiogram. Because of the high fever and the high HR, I was admitted into the Ottawa Heart Institute that evening. And I was given colchicine to treat pericarditis. They wanted to administer in combination with aspirin, but I refused the aspirin, fearing it would interfere with the Eliquis. It’s now Sunday. I’m in the CCU being closely monitored by both machine and humans. It’s the weekend, so no EP around.

Monday 19th:
Chest pain has subsided, cough persists. Stop order placed on the Flecainide. No one seems to know why. I’m still in Afib and HR remains high 120-160 with lots of long pauses but no significant wooziness. Finally see the EP who informs me that I have a sinus node dysfunction and that’s why they took me off the Flecainide. He says it can slow down or stop your heart from beating and that’s not good with the long pauses I’m experiencing. Then this is when I’m slammed with the news that I need a pacemaker! Wow! Right out of left field. If I wasn’t already extremely stressed and highly emotional, this certainly did the trick. I was basically told that this was the only option. They said I couldn’t stay at this high HR for a long time without doing damage to the heart. Of course, the unknown was when/if I might self-convert to NSR or at the very least the HR might lower. I was told to think about it and let him know what I wanted to do. When I asked about trying another cardioversion, he said they couldn’t do that. By the way, that was the first and last time I saw the EP; after that it was someone on his cardiac team, a revolving door of three.

I was given cefltriaxone, an antibiotic, for the fever. And a magnesium IV plus potassium pills because of low levels. There were no pauses in the heart beat that afternoon, a few short ones around midnight, and one lasting 6 seconds.

Tuesday 20th:
No pauses. Still on antibiotic, magnesium and potassium. By now I’m feeling slightly pressured by the doctors and my family to proceed with the pacemaker. But I’m definitely not there yet and I’m thinking I want to take a wait and watch approach. My husband, while supportive of whatever decision I make, is expressing great concern about a wait and watch approach and feels he will need to be around me 24/7 in case I black out again and fall and hurt myself.

By now the cardiac resident has been able to reach Dr Verma who suggests to them that they wait another 24 hours to allow the inflammation to go down and then try another cardioversion. But I’m not comfortable being under this hospital’s care anymore. I want to go back to Dr Verma in Newmarket. Highly emotional and not knowing what to do next, I reach out to Shannon. Bless his heart, he managed to calm me down and assured me that he would contact Dr Verma and ask him to call me directly.

Wednesday 21st:
Dr Verma calls me early morning and I tell him that I want to be back under his care. He concurs and says he will make the arrangements. I tell the medical staff the news. A hospital-to-hospital transfer is arranged (non-ambulatory) for the next morning. Had I known then it was non-ambulatory, I would have had my husband drive me to Newmarket. I could have gotten there that night instead of having to wait till the next morning.

Thursday 22nd:
Arrive at the hospital in Newmarket around 1:00 pm, feeling immensely relieved. I’m back under the care of Dr Verma, the EP I have trust and faith in. Chest x-ray and more bloodwork. Dr Terracabras, a cardiologist on fellowship with Dr Verma, comes to see me. She is joined at the hip to Dr Verma and I trust her completely. They will attempt another cardioversion tomorrow as the inflammation and fever have subsided. HR is still running high. Dr Terracabras reassures me that we are nowhere near thinking about a pacemaker. She says that’s the last thing they do, not the first. I’m so glad to be back here.

Friday 23rd:
More bloodwork and ECG. At 10:30 am two unsuccessful cardioversion attempts, one at 240 joules and the other at 300. I’m given Amiodarone IV for about 30 minutes. Then another unsuccessful cardioversion attempt at 360 joules, a high dose that leaves some red marks on chest and back. Disappointing, yes, but I’m told not to be discouraged. Good news is that there were no pauses and my HR has dropped down, now fluctuating between 120-130. Another echo done following the CVN.

Dr Verma and Dr Terracabras visit me in the afternoon. My husband is with me. We are told that while my situation isn’t common, it does occur and we are not to worry. The HR has come down a bit. My heart is in good shape, no remodeling and the ejection fraction is good. It’s gone through a lot though. So the plan now is to wait a week for any residual inflammation to dissipate and attempt another cardioversion. I was discharged in the afternoon. We spent the night in Newmarket, and drove back to Ottawa the next day.

Saturday 24th – Wednesday 28th:
Feeling okay, all things considered, but weak and tired, still in Afib with HR fluctuating between 80-133. On Wednesday we drive back to Newmarket.

Thursday 29th:
Cardioversion is a success. Oh joy, oh joy! I’m told I was shocked with 360 joules of energy and a hand-held paddle was pressed to my sternum to increase the current flow. We leave the hospital and head back to the hotel. This time I’m hanging around for another day just in case. I’ve been prescribed Amiodarone (ugh!) 100 mg BID to take for one month. It’s a drug I vowed I would never take, but I trust Dr Verma on this and it’s for only one month, so I agreed.

Friday 30th:
Still in NSR and feeling tired but good. We head back to Ottawa. Two hours along the way I sense something wrong. Checking my pulse, it feels like ectopics but about a half hour later they are gone. Breath a sigh of relief. We get home and have dinner. Shortly after, I am back in Afib with a heart rate of 136. Damn!

Saturday 31st:
Still in Afib with heart rate now fluctuating between 110-122. It’s the long holiday weekend here so I have to wait till Tuesday to contact Dr Verma in Newmarket. Hoping I’ll stay stable until then (or possibly even self-convert, wouldn’t that be lovely!).

Sunday Sept 1st:
Woke up feeling considerable soreness in my chest, particularly when taking a deep breath. Don’t know if it’s something to be concerned about. Wondering if it’s due to the pronounced pressure on the sternum from the paddles. Still in Afib with HR reading 122.The good news in all this is that at least I’m not experiencing any wooziness like before, so I’m thankful for that.

So that’s the saga so far, folks! It’s been, and continues to be, a roller-coaster ride that is physically and emotionally exhausting.

Many, many thanks to Shannon for all your help and encouragement throughout this ordeal. We afibbers are blessed to have you, Carey, and many others on this forum so willing and able to provide so much support and give so much of your time and energy. Thank you from the bottom of my heart.

Questions:
1. Has anyone experienced anything like what I have/am going through?
2. Any idea why my HR skyrocketed in Afib after the ablation? Pre-ablation, when in Afib, it never went above 100. Response I got from Dr Verma was just that this sometimes happens.
3. Any words of wisdom or advice or comments appreciated.


BREAKING NEWS! ...
A couple hours ago I experienced a bit of lightheadedness. Ten minutes later I self-converted. And I’m still in NSR at this writing with BP of 127/69 and HR of 71. YAHOO! Fingers and toes crossed it holds.

Lorraine

Hi Lorraine!

It has been just shy of a week since we last spoke and Im happy as a clam that your latest ECV last Thursday was successful! And wow again ... Atul Verma and team aren’t shy at all about zapping folks with a big gun cardioversion ... 360 joules after the 350 joule last week is not messin’ around by any means. The most I ever had during my 16 total ECVs during my gratefully now former AFIB history, was around 250joules! And150 joules to 170 joules was the norm for the vast majority of my ECV’s, with a handful at 200 joules and the one at 250joules.

I’m not surprised that you report a bit more elevated soreness in the chest area after such a jolt on Thursday. A big jolt north of 250 joules would likely leave a calling card like that. But rest-assured it will all subside very soon, just take it one day at a time and listen to your body after the rollercoaster ride you have had this first 12 days post ablation.

That was quite something on that Monday night, going on now two weeks ago from tomorrow night (Monday Sept 2) I think it was. when I had called you around 5 pm from my favorite organic fish taco joint near the little hotel Magdalena and I often stay at when we are down in Phoenix/Scottsdale doing errands etc. from our home in Sedona, a 2 hrs drive north from the big city.

I was there this time for a follow-up appointment with my hand specialist the following day to check on my own procedure progress from six weeks prior.

I called from the restaurant assuming, for sure, that this would be a very short phone call as you would just update me on the fact that all was well after your index ABL
with Dr. Verma while I was awaiting my fish tacos!

Imagine my surprise when I heard your rather desperate sounding voice telling me that for the past four days since your ablation at Southlake, you had been in a Cardiac ICU at an Ottawa Heart Center hospital some 5 hrs drive south from Dr Verma’s Southlake Medical Center!

To make matters worse, my Iphone battery went dead at the exact moment my tacos arrived! Leaving you ...and me... stranded in mid-sentence recounting your increasing gedoe! I then wolfed the tacos down as I walked quickly back to the hotel several blocks away to reconnect with you from my hotel room phone while charging my cell.

When we reconnected and I heard your voice again Lorraine, it was clear the well-meaning cardiac docs at the Ottawa hospital were pressuring you to agree to have a pacemaker installed immediately, which seemed to me to be a rather drastic step that I felt sure Dr. Verma would want to have his input on before any such thing was done! I believe you had failed two cardioversions in the Ottawa Hospital at that point ... or was it three?

In any event, it was clear that you needed to hear directly from Dr Verma right away. Unfortunately, Dr Verma had left Canada very shortly after he finished your ablation the prior Thursday and, ironically, he had flown directly to Kansas City for the (KC Heart Rhythm Society Conference being held there that weekend).

Dr. Verma was attending this conference, in large part to be one of several prominent prior protégés of Dr. Natale who came to Kansas City to help celebrate with their mentor Dr. Natale’s well-deserved life-time achievement award as a leading light in Electrophysiology that he was being honored with that weekend.

Im not sure who, if anyone, back in Southlake even knew Dr Verma had left the country for the short weekend?

Feeling pressed myself at this point to try to contact Dr Verma on your behalf, I checked first with his office records I that I had in my Iphone from the other Canucks I’ve referred to him over the years. But I only had his office and Fax numbers.

Being Monday night, it was clear that the KC conference had ended the day before so I called Dr. Natale that night who was at Scripps La Jolla doing cases for a few days. Just to see if Dr Natale perhaps had Dr Verma’s direct cell number?

Alas, Dr Natale only had the same two office numbers I had for Dr Verna. But as luck would have it, I did find Dr Verna’s private email he had once given me, and I dashed off an immediate update and for him to please call Lorraine’s cell number as soon as he could. Dr Natale had confirmed to me that Dr Verma would not likely be in favor of Lorraine getting a pacemaker as the next phase of her ablation process!

After signing off with Lorraine that night, I awakened the next morning to the very good news of a reply email to me from Dr Verma saying he had already contacted Lorraine, and had reassured the Ottawa Heart docs that she did not need a pacer at this time and that he was arranging for her to be transported back to his care at Southlake!

Lorraine has done a great job of recounting the rest of her very unusual post ablation adventure in her Afibber’s Forum thread. And I want to say how very proud I was of how steady and collected Lorraine remained during this whole ordeal! Obviously, it was a very stressful experience for her, especially during those four plus days she was on her own in the Ottawa Heart hospital with no real AFIB ablation experts!

Lorraine remained focused and clear and always with a positive attitude of making the best of a challenging situation during this entire process. I’m so glad it’s all settling down now, Lorraine, into a more typical blanking period story.

Best wishes to you and your trooper husband too!

Cheers!
Shannon



Edited 1 time(s). Last edit at 09/04/2019 03:23AM by Shannon.

Hi, Lorraine. Sorry for your ordeal and wishing you the best for the future.
The first cardioversion I had, after about 15h in afib, went well but I was back in afib some days later.
The same EP, while trying to ablate my RA flutter a couple months later, tried to cardiovert me to stop the afib that had started in the beginning of the procedure. In vain. I had 4 shocks : 200, then 3* 300 J. I awoke in afib with red marks on my chest and painful breathing. I thought I had some broken ribs! I self converted the next morning.
Two days after my first afib ablation (other EP, elsewhere), I was so bad I went to the ER. Of course, it was a mistake. Happily, I self converted before they try to make it themselves.
We learn from our mistakes. Now, I avoid ER, electric cardioversions, rhythm drugs, unexperienced EPs and dehydration.
I hope you'll be fine very soon, Lorraine. I've no advice to give, many people here are more competent than me to do. My answer was to tell ablation is not an easy journey for everyone.
Cheers from Belgium.



Edited 1 time(s). Last edit at 09/02/2019 08:16AM by Pompon.

Wow that's a helluva journey you've been on this last couple of weeks Lorraine!

Massive respect to you for your positive attitude throughout!

And what fantastic support from Shannon and Carey too.

Fingers crossed that things settle down for you from here.

Best regards,

Mike F.

Lorainne,

So sorry to hear of your traumatic experience, but happy to know it seems to be resolving. Yahoo, indeed! It's wonderful that Shannon was able to get in touch with Drs. Natale and Verma for you.

I remember when I was first in afib, I was sent to a cardiologist at UC San Diego. She was a specialist in pacemakers. Guess what her recommendation was? Right, a pacemaker, which had to be done immediately because she was leaving for an extended residency in Europe. Thanks but no thanks. I switched to a cardiologist at the Scripps Center for Integrative Medicine who told me that a pacemaker was certainly not necessary. I found this forum and eventually had a Natale ablation with excellent results.

Force be with you!

--Lance

Thanks for your comments. Appreciate everyone's input.

As of this writing, I'm still in NSR with HR of 64. Yeah! I’m cautiously optimistic, although I know to expect that I may go in and out of Afib over the course of the next 8-12 weeks as the heart heals.

Of concern at the moment though is the considerable chest soreness I’ve been experiencing three days after the CVN. The first three days I felt some soreness, but it's gotten worse since yesterday morning. I don’t know if it’s due to the 360 joules of energy and the pronounced pressure on the sternum from the paddle during the electrical cardioversion. I understand that sometimes this can cause a sternum fracture, in which case there’s probably nothing to do but let it heal on its own. On the other hand, it might be pericarditis, which can be serious and would need to be treated. I had it while in the Ottawa hospital two weeks ago, so it might be a recurrence.

Of course, it’s a holiday today so I’ll not be able to contact anyone until tomorrow. Following the CVN last Thursday, I was told to expect some chest pain and instructed to take Tylenol 500 mg if required and have been doing so TID for five days now, which is another concern. I don't like taking it for so long but I need it to help alleviate the discomfort. [sigh]

So, I'm still on the roller coaster but, hopefully, getting nearer to the end of the ride!

Lorraine

Wow.
What a scary time. I admire your calmness.
Did the ablation itself cause this?

Quote
katesshadow
Wow.
What a scary time. I admire your calmness.
Did the ablation itself cause this?

I may sound calm now, but believe me I was quite anxious and stressed out during the worst of it. Thank goodness I had Shannon for support.

No idea if the ablation caused this, but I suspect so. Dr Verma said it can happen sometimes.

Lorraine

I have many ECV's, but never over 200J. I have felt some pain, especially while taking a deep breath afterward for several days. Did they put the Paddles right over the Sternum in the middle of your chest? I have noticed more pain when done this way, although putting the Paddle there, is probably the best placement configuration. I have also had a broken Sternum, they did nothing for it.

Wow, Lorraine, thank you for sharing this with all of us. We sure have some heroes on this forum, don't we?!!!
Sending you hugs, but I'm hugging you very gently, like an air hug (((((Lorraine))))).
Sue

Quote
Lorraine

Wow.
What a scary time. I admire your calmness.
Did the ablation itself cause this?

I may sound calm now, but believe me I was quite anxious and stressed out during the worst of it. Thank goodness I had Shannon for support.

No idea if the ablation caused this, but I suspect so. Dr Verma said it can happen sometimes.

Lorraine

Well, I'm hoping that it's smooth sailing for you and that the ablation brings you many years of freedom from Afib. I've only had the one episode in Nov. 2018, but my middle name is "anxiety."

Yes, Shannon is a godsend, along with Carey and many others on this forum who give so selflessly of their time and knowledge.

Quote
The Anti-Fib
Did they put the Paddles right over the Sternum in the middle of your chest? I have noticed more pain when done this way, although putting the Paddle there, is probably the best placement configuration. I have also had a broken Sternum, they did nothing for it.

Somebody placed a pad on your sternum? That's not only not the best placement; it's downright wrong. There are two ways to position pads: the anterior-posterior placement (AP) or anterior-anterior placement (AA).

AP placement has one pad on the upper-right chest and the other on the left side of the back under the scapula. The AA placement has one pad on the upper-right chest as with the AP placement, and the other on the ribs of lower-left side. There are some diagrams here.

I assume the broken sternum was unrelated to the cardioversion, but still, that's just all the more reason not to put a pad there. No wonder your chest hurt. The muscle contractions caused by a cardioversion are very powerful and would probably make a broken sternum hurt like hell.



Edited 1 time(s). Last edit at 09/03/2019 03:14PM by Carey.

Quote
The Anti-Fib

Did they put the Paddles right over the Sternum in the middle of your chest? I have noticed more pain when done this way, although putting the Paddle there, is probably the best placement configuration. I have also had a broken Sternum, they did nothing for it.

I was mistaken about the use of a paddle. Following the CVN, I was told that pressure was exerted on the pads during the shock to optimize the current flow. Thinking that there's no way the doc would be putting her hands directly on the pads, I assumed that they must have used a paddle. WRONG! I have now learned that she used only hand pressure with a towel or something in between. So my apologies for the misinformation. I obviously didn't have the correct facts.

Lorraine

Quote
Carey

Did they put the Paddles right over the Sternum in the middle of your chest? I have noticed more pain when done this way, although putting the Paddle there, is probably the best placement configuration. I have also had a broken Sternum, they did nothing for it.

Somebody placed a pad on your sternum? That's not only not the best placement; it's downright wrong. There are two ways to position pads: the anterior-posterior placement (AP) or anterior-anterior placement (AA).

AP placement has one pad on the upper-right chest and the other on the left side of the back under the scapula. The AA placement has one pad on the upper-right chest as with the AP placement, and the other on the ribs of lower-left side. There are some diagrams here.

I assume the broken sternum was unrelated to the cardioversion, but still, that's just all the more reason not to put a pad there. No wonder your chest hurt. The muscle contractions caused by a cardioversion are very powerful and would probably make a broken sternum hurt like hell.

Yes you correct about the 2 main placement configurations. There are other variations though, and my last ECV had a Pad placed directly over the Sternum. This was done by a very experienced EP. It is an observation of mine that there is no consensus as how to Cardiovert. Dr.'s or Nurses tend to have there own ideas. For example in my last 5 ECV's, the Pads have been placed slightly differently every time. What is essential is that the 2 Pads are placed in such a way that the Current goes through the Heart, preferably through the Atria, to resolve Atrial Fibrillation.
Placing one Pad directly over the Sternum allows for Current to flow directly through the Atria, if the other Pad is placed low under the left shoulder blade. The idea is to hit both the Atria, but also have current go through the Ventricals, in case they induced VF as a result of the ECV process (a rare event), and the Pad would already be in place to Shock a patient out of VF. On second thought though, you are right it may not be the the best configuration, but I was trying comfort the OP, that nothing was necessarily done wrong during her ECV at 360J.



Edited 2 time(s). Last edit at 09/03/2019 04:52PM by The Anti-Fib.

After 2 days of heavenly NSR, I went back into Afib a few hours ago and my HR has shot back up fluctuating between 109-136 on last 3 readings. Systolic BP is high too at 150. Damn! The only good news today is that the chest soreness has subsided a bit. I've talked to someone on Verma's team in Newmarket. Instructions are to increase the amiordarone from 100 mg BID to 200 mg BID for 2 weeks. And if I haven't self-converted by Thursday morning, I'm to go and get a CVN here in Ottawa which will be facilitated by Newmarket.

This is a disappointing turn of events, my spirits are low, and it's a challenge maintaining a positive outlook. I've been through a lot the last 2 weeks. I want off this roller coaster!

Lorraine

Quote
The Anti-Fib
Yes you correct about the 2 main placement configurations. There are other variations though, and my last ECV had a Pad placed directly over the Sternum.

Yeah, I've seen several variations, but directly over the sternum is a new one. Was the other pad in the usual AP position on the back or the AA position on your left ribs?

Quote
Lorraine
After 2 days of heavenly NSR, I went back into Afib a few hours ago and my HR has shot back up fluctuating between 109-136 on last 3 readings. Systolic BP is high too at 150. Damn! The only good news today is that the chest soreness has subsided a bit. I've talked to someone on Verma's team in Newmarket. Instructions are to increase the amiordarone from 100 mg BID to 200 mg BID for 2 weeks. And if I haven't self-converted by Thursday morning, I'm to go and get a CVN here in Ottawa which will be facilitated by Newmarket.

This is a disappointing turn of events, my spirits are low, and it's a challenge maintaining a positive outlook. I've been through a lot the last 2 weeks. I want off this roller coaster!

Lorraine

If it was me, and I could get my HR down under 90, I would just stay in AFIB for several weeks, maybe converting on my own, and take a break from overtly trying. Despite all of the Cardioversions, the fact remains that you are still too early in your recovery period, to judge a long-term outcome. Evidently they are having trouble getting your HR down to more livable levels. Hopefully the increased dosage of Amio will help with this.



Edited 1 time(s). Last edit at 09/04/2019 01:42AM by The Anti-Fib.

Quote
Carey

Yes you correct about the 2 main placement configurations. There are other variations though, and my last ECV had a Pad placed directly over the Sternum.

Yeah, I've seen several variations, but directly over the sternum is a new one. Was the other pad in the usual AP position on the back or the AA position on your left ribs?

Here is a Paper that has the Standard AP and AA configuration you mention, and also has an additional variation for each of these.
[onlinelibrary.wiley.com]

The Placement in question is not shown. Also I am seeing what is described as AA Anterior-Anterior is basically the same thing as AL Anterior-Lateral.

On my last ECV, the Front Pad was directly over the Sternum, and the other was where standard AA position is, but moved about 4-5 inches towards the back.

Finally I am seeing direct placement of Pads over the Sternum for children.[www.google.com]



Edited 2 time(s). Last edit at 09/04/2019 06:01AM by The Anti-Fib.

Wow Lorraine,

Your ordeal makes what I went through last year seam small. Hope things continue in a more positive way for you.

Lorraine,
What a hard journey. Any one with symptomatic afib identifies with what you are going through. You are good to take the time and detail out your experience so far So helpful to have Shannon and Carey in your corner.

Joe Hare.

how often can one get converted? I usually get 50 joules. I was converted Monday and past Thursday. I am sure the ER won't do it every other day until I get my ablation.

I kept asking everyone...is it safe to be converted often? I don't get any complications at my local Er...only once at Cedars when the cowboy gave me a cocktail of etomidate, fentanyl [25mg by vein!, and ondansetron as a sedative for the conversion. It put me in the cardiac ICU for three days.

curious to your reply

I am scheduled in two weeks for an ablation. My gosh...what happened to you that made poor Lorraine's ordeal small ?

They're not something to be relied upon as routine treatment, but there's no known limit on how many you can have. I've had 15+ myself, but I'm not even close to being a record holder. They cause no known long-term harm.