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Life continues to throw me curveballs
Posted by Lorraine
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Life continues to throw me curveballs July 12, 2020 07:30PM |
The saga begins for this Canadian gal in August 2019 when I had my index ablation done in Newmarket, Ontario. Long story short, it was not successful. You can read about my post-ablation ordeal here.
Over the next five miserable months, I was in and out of Afib constantly with high HR. A few days before my scheduled Jan 27 redo ablation, I was hit with a viral infection. Started with chest discomfort, then a dry cough and shortness of breath. A visit to my family physician resulted in a referral to ER to rule out any cardiac event. I was also in AF at the time.
Testing indicated the heart was fine. No elevated levels of troponin. A chest x-ray ruled out pneumonia. The conclusion was probably a viral infection. My heart rate was quite elevated during my stay (150-175) and the attending physician was reluctant to send me home without an attempt to bring it down. Metoprolol 25 mg IV was administered three times. It brought it into the range of 112-125 temporarily. Two attempts at an ECV were unsuccessful. I was also given a couple of antibiotics as I had some fever. I was sent home with an Rx for Metoprolol. I don’t do well on this drug as I have low blood pressure to begin with and this drug brings it down even further.
Of course, the scheduled Jan 27 ablation had to be cancelled as I was in pretty bad shape, coughing like crazy, very weak and tired, with chest discomfort and considerable shortness of breath. It didn’t help that I was in AFib for 10+ solid days, the longest ever, at heart rates ranging from 130-175.
I recovered after about 10 days and with a lot of pulling strings and moving mountains, I didn’t have to wait very long to get the ablation rescheduled.
February 7, 2020 – ablation #2. OR report says there was reconnection in the anterior portion of the LSPV and LIPV, the posterior LIPV, and the anterior mitral line. They were re-isolated. All four pulmonary venous antra were re-isolated. Plus, some additional ablation along the anterior wall to eliminate residual potentials.
It was a successful procedure. And for the next four months, I was in blissful NSR… until I wasn’t!
Post-ablation, I was prescribed Metoprolol 12.5 mg b.i.d. and Eliquis 5 mg b.i.d. Following a consult with my EP in early June, I was told I could stop taking the Metoprolol, weaning off over 2 weeks. In doing so, I noticed that my heart rate was starting to inch up into the high 70s and low 80s and then into the 90s. During May it had been mostly in the high 60s and low 70s.
Now comes a couple of medical events that may have triggered the beast (and its cousin) to rear its ugly head.
Two days after stopping Metoprolol, I had laser eye surgery. That night and the next morning, tachy readings of 101 and 109. Over the next four days, HR now in the 90s consistently.
Six days after the laser eye surgery, I had dental implant surgery. Dentist’s protocol was I had to stop the Eliquis for three days. During the procedure my HR was mostly in the 120s with one spike to 144. That evening it was 83, which was surprising given all the stress of the event.
Over the next two days, lots of tachy in the low 100s and some “unclassified” Kardia readings in the 140s. Then on the third day post-surgery, all hell broke loose. And for the past 15 days I have been in either Afib or A/flutter. I need to be cardioverted. The problem is the interruption in Eliquis. My EP says I have to be 3 weeks without any interruption before they will do the ECV. So, I have to wait it out. I’m scheduled for an ECV in Newmarket on July 17.
In the meantime, my EP put me back on Metoprolol and increased the dosage to 25 mg b.i.d. Unfortunately, it has had no effect on bringing my heart rate down. HR remains in the 140s. What it is doing, however, is lowering my normally low blood pressure even lower. Yesterday morning it was 78/62 and remained there all day. I could not function. I spent the entire day in a recliner.
The high HR combined with very low BP is taking its toll on me. I cannot live like this. So, I took it upon myself to cut back the Metoprolol to 12.5 mg b.i.d. beginning with last evening’s dose. And, today, there is already significant improvement in my BP. While the HR is still way up there at 141, BP this morning was 91/60 and a reading a few minutes ago 93/65. This is getting closer to my normal of around 98/65. And today I had at least some energy to move about and do some things. I gotta tell you, though, living with this racing heart is not fun. I have no energy and can barely function. Minimal movement and I’m exhausted.
This is so very disappointing and discouraging. Everything was going so well. Now this. The Afib is bad enough, but now there’s flutter too. Never had flutter before. I don’t know which is worse.
I’m hoping that the ECV will be successful, but, even if it is, I know there’s no guarantee that it will last. I’m wondering what to expect going forward. Given that I am experiencing this arrhythmia outside of the 3-month blanking period and for such an extended length of time, and given that flutter is in the picture now which I never had before, I'm thinking that I'm probably going to need another ablation.
[Canadian female, 76 years old, paroxysmal AF since 2007, index ablation Aug 2019 unsuccessful, second ablation Feb 2020 unsuccessful]
Over the next five miserable months, I was in and out of Afib constantly with high HR. A few days before my scheduled Jan 27 redo ablation, I was hit with a viral infection. Started with chest discomfort, then a dry cough and shortness of breath. A visit to my family physician resulted in a referral to ER to rule out any cardiac event. I was also in AF at the time.
Testing indicated the heart was fine. No elevated levels of troponin. A chest x-ray ruled out pneumonia. The conclusion was probably a viral infection. My heart rate was quite elevated during my stay (150-175) and the attending physician was reluctant to send me home without an attempt to bring it down. Metoprolol 25 mg IV was administered three times. It brought it into the range of 112-125 temporarily. Two attempts at an ECV were unsuccessful. I was also given a couple of antibiotics as I had some fever. I was sent home with an Rx for Metoprolol. I don’t do well on this drug as I have low blood pressure to begin with and this drug brings it down even further.
Of course, the scheduled Jan 27 ablation had to be cancelled as I was in pretty bad shape, coughing like crazy, very weak and tired, with chest discomfort and considerable shortness of breath. It didn’t help that I was in AFib for 10+ solid days, the longest ever, at heart rates ranging from 130-175.
I recovered after about 10 days and with a lot of pulling strings and moving mountains, I didn’t have to wait very long to get the ablation rescheduled.
February 7, 2020 – ablation #2. OR report says there was reconnection in the anterior portion of the LSPV and LIPV, the posterior LIPV, and the anterior mitral line. They were re-isolated. All four pulmonary venous antra were re-isolated. Plus, some additional ablation along the anterior wall to eliminate residual potentials.
It was a successful procedure. And for the next four months, I was in blissful NSR… until I wasn’t!
Post-ablation, I was prescribed Metoprolol 12.5 mg b.i.d. and Eliquis 5 mg b.i.d. Following a consult with my EP in early June, I was told I could stop taking the Metoprolol, weaning off over 2 weeks. In doing so, I noticed that my heart rate was starting to inch up into the high 70s and low 80s and then into the 90s. During May it had been mostly in the high 60s and low 70s.
Now comes a couple of medical events that may have triggered the beast (and its cousin) to rear its ugly head.
Two days after stopping Metoprolol, I had laser eye surgery. That night and the next morning, tachy readings of 101 and 109. Over the next four days, HR now in the 90s consistently.
Six days after the laser eye surgery, I had dental implant surgery. Dentist’s protocol was I had to stop the Eliquis for three days. During the procedure my HR was mostly in the 120s with one spike to 144. That evening it was 83, which was surprising given all the stress of the event.
Over the next two days, lots of tachy in the low 100s and some “unclassified” Kardia readings in the 140s. Then on the third day post-surgery, all hell broke loose. And for the past 15 days I have been in either Afib or A/flutter. I need to be cardioverted. The problem is the interruption in Eliquis. My EP says I have to be 3 weeks without any interruption before they will do the ECV. So, I have to wait it out. I’m scheduled for an ECV in Newmarket on July 17.
In the meantime, my EP put me back on Metoprolol and increased the dosage to 25 mg b.i.d. Unfortunately, it has had no effect on bringing my heart rate down. HR remains in the 140s. What it is doing, however, is lowering my normally low blood pressure even lower. Yesterday morning it was 78/62 and remained there all day. I could not function. I spent the entire day in a recliner.
The high HR combined with very low BP is taking its toll on me. I cannot live like this. So, I took it upon myself to cut back the Metoprolol to 12.5 mg b.i.d. beginning with last evening’s dose. And, today, there is already significant improvement in my BP. While the HR is still way up there at 141, BP this morning was 91/60 and a reading a few minutes ago 93/65. This is getting closer to my normal of around 98/65. And today I had at least some energy to move about and do some things. I gotta tell you, though, living with this racing heart is not fun. I have no energy and can barely function. Minimal movement and I’m exhausted.
This is so very disappointing and discouraging. Everything was going so well. Now this. The Afib is bad enough, but now there’s flutter too. Never had flutter before. I don’t know which is worse.
I’m hoping that the ECV will be successful, but, even if it is, I know there’s no guarantee that it will last. I’m wondering what to expect going forward. Given that I am experiencing this arrhythmia outside of the 3-month blanking period and for such an extended length of time, and given that flutter is in the picture now which I never had before, I'm thinking that I'm probably going to need another ablation.
[Canadian female, 76 years old, paroxysmal AF since 2007, index ablation Aug 2019 unsuccessful, second ablation Feb 2020 unsuccessful]
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