Nice While It Lasted - First Afib Episode After One Year

After having persistent afib (no symptoms) for three years, Dr Natale did my 1st ablation last Aug 9th. Aside from some tachycardia in months to follow, my 6 month and 12 month (2 weeks ago) 7 day heart monitors both were relatively good. 121 SVTs, (longest 43 beats - 22 beats on 6 month), 843 PVCs with 3 morphologies and 3 couplets and overall PVC burden .1%. 4588 PSVCS with 1 morphology and 118 couplets with overall burden of .54%. No atrial fibrilation or flutter.

Then it happened. Few days ago my Kardia showed possible afib (HR at 85. 115, 154, etc). No symptoms except racing heart rate while laying in bed. Decided to take 150mg Flec and 25mg Metoprolol. 3hours later had NSR. The NSR lasted about 46 hours then a second round of possible afib on kardia at 2am (so not episodes after sleeping a bit- do have sleep apnea). Waited til 6:30 in morning with HR between 95-130. Took 250mg Flec/ 25mg Metoprolol. This time stayed in afib at least 6 hours after meds (wasn’t able to check for another 4 hours) but now NSR

SW nurse in Texas and they said I could continue to use meds as needed or start tomorrow on 100mg Flec x2 plus 25mg Metop. Also, look at schedule for touch up and doing left side and then Watchman.

Is it wishful thing to hope these were isolated events and maybe not definitely necessary to schedule followup procedure yet or is it inevitable. Still no symptoms that I can tell.

Sorry to hear this. You had a pulsed field ablation if I remember correctly? Did Dr. Natale ablate non-pulmonary areas with RF as well? If not sometime down the road a touch up might be necessary unless you are okay with staying on medication. Hope the meds get you in NSR soon though in the meanwhile.

Hi Daisy

I remember talking to you a ways back. I was in the pulse trial but did not receive the pulse technology. They wouldn’t tell me much being in the trial and they preferred that I stay blinded til the one year was up. I can now ask them for my file. At the time, Dr Natale said that I would most likely have to come back to do a touch up as well as the left atrium (I think that is correct. I was hoping being that I made it a year and my 7 day monitor was pretty good that I might get lucky.

Anyway, since I was deemed to have persistent afib, maybe I am lucky to get to this point. Time will tell.

Truly, this is a bummer. Still, you're in 'bout the best hands that money can buy, and he DID predict that you'd be back ere long. That should instill confidence in both the outcome and the fact that Dr. N could foresee it and was prepared to share the prediction with you. In a way, things are unfolding as they ought.

Still, I would not have wished this to be. Hang in there.

Geocappy - I had a similar path of Afib, persistent for almost three years until Natale ablation, which gave me a great six months of NSR. It was so "Nice While It Lasted" but then flutter and tachycardia came along and I was able to control it somewhat with flecainide. I wish I had scheduled a second ablation sooner, since it was another six months before I actually had the touch up. The good news is that the touch up took care of it completely.
Gloaming put it well, that "Dr N could foresee it and was prepared to share the prediction with you." On my very first consultation with Natale, he predicted that I would probably need a second one. Natale just knows.

~ Linda

I was also persistent (or “permanent”).

I think “one and done” is actually pretty rare. Hard to find any stats on it, though.

I’d say since your had a full year of NSR after only 1 procedure, you’re still in a pretty good position.

Hopefully a touch up will get you in NSR for even longer.

I’ve had 4 Natale ablations (5 total), I am unfortunately a hard case. But I’ve been in NSR for a couple of years now, so fingers crossed.

Unfortunately, ablations don’t “cure” afib. They only serve to try and keep the beast caged for as long as possible. You’re in the best possible hands, though.

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Mac
...total), I am unfortunately a hard case. But I’ve been in NSR for a couple of years now, so fingers crossed.

Unfortunately, ablations don’t “cure” afib. They only serve to try and keep the beast caged for as long as possible. You’re in the best possible hands, though.

I have had an argument on the Mayo Clinic 'Connection' forums...very good for info commiseration and general info and encouragement, too...about the progressive nature of AF. All reputable sites I have been to, and there's a hockey sock full, state that AF is considered to be a progressive disorder. That, to me, suggests that one is going to move through defined stages until an assumed end-state...empirically and academically. The other poster insisted that it isn't progressive...not in all cases. I suppose that he was correct technically because 1/10 cases might nub itself and remain fixed for some reason, but my point was that the rest of We-The-The-Great-Unwashed will experience unwanted progression to more persistent, and then to permanent AF, and quite certainly on to heart failure. If......untreated. So, the great advice and lesson to those new who are still young in their experience is to get on top of the disorder ASAP. Beg, borrow, or steal, but get treatment, and up your game if/when the disorder ups its game. Or, it'll win.

To address your comment..."until heart failure"

My mother's husband has been in persistent AFIB for at least 25+ years...treatment has been BB and BT...he is now 85 and doing well. And my grandmother was in persistent AFIB for 24 years until she passed away just weeks shy of her 104th birthday...not from heart disease. Message boards are dominated by people who struggle or continue to struggle. Those who have had success managing AFIB are less likely to post or comment...my two cents.

That's a worthy perspective, schca67, and not to be discounted. Thanks for adding your thoughts.