Breakthrough after four years - Ugh

Hey all,

Well, had my afib ablation in December 2019 and had been afib free (not one single episode) for four year. But almost to the day last month I started getting curious runs of missed beats. Almost rhythmic misses actually. Like five or six ectopics in a row. It all settled down after a couple hours, but yesterday it happened again and drifted into afib. Not quite as noticeable as in the past. Usually I could feel it throughout my body and my face would get hot. I had to check my pulse a couple times to confirm but definitely was in it. I popped 50 mg of flec, waited a couple hours and then did 40 pushups. Getting my heart rate up sometimes pops me out of it. It worked. Years ago I would have to wait around 20 hours to have a successful push-up intervention, but I was able to do it sooner this time. I feel totally fine today. No blips or anything. Felt totally fine right after I popped out of it actually. Hopefully this isn’t a monthly event now, leading to weekly events and then an eventual touch up procedure. Let’s hope.

It's such an unfortunate development. It seems that the literature claiming that AF is a progressive disorder rings true for most of us. I am in NSR bliss for the time being, but I don't allow myself to feel confident I have this licked forever. I am quite convinced that a day will come when I'll have that dreaded and familiar sensation of AF. I'm glad my EP discharged me four months post ablation with an invitation to be referred back to him directly.

I hope for your sake, if you MUST progress into AF once again, that it is slow and manageable.

Thanks. It really is random but also somewhat cyclical. When I use to get it a lot, it would hit about three days apart. Last 20 hours and not be triggered by anything in particular. In fact I was on vacation last week, drinking and staying up late. Not sleeping like I would routinely. And didn’t have a single blip. Then it crops up two days ago when I’m hydrated, rested and eating normally. It’s a weird condition

Should they occur, it might be a good idea to capture any future events on a home ekg event monitor like the Kardia or Apple Watch - just to be 100% sure it's afib and not another arrhythmia such as aflutter, which can sometimes appear after ablation. In addition to giving you and your ep more information, treatment is different and for example you would not want to pop Flecainide while in aflutter. Sounds like you've had a very good run of normal rhythm and hopefully this event is an outlier, but as you state, afib is "weird" and very unpredictable.

Jim

Agree. I did get in on 6 lead Kardia. The tracings always have a lot of artifact says my EP but he did confirm it was sporadic afib. He suggested a holter but these episodes are so fleeting, and 15 day holter won’t likely catch it. The episodes are weeks and week apart. For now at least. I’ll re-evaluate as things change, and they always change.