2 months post PFA ablation

I had my ablation mid-March and have not had Afib since the procedure. However I am quite fatigued and lightheaded and have not been able to get back to my pre-ablation exercise routine due to this fatigue. Is this part of the blanking period? Also I have noticed when I do activities my heart rate climbs rather quickly, and then drops back to normal quickly. I have spoken with the Dr who did the procedure, who is out of state, and he told me to follow up with my primary as it’s not related to the ablation. My local cardiology team told me to follow up with my primary as well. Is there some reason my local EP can’t address this and keeps referring me to others?
Thanks!

Are you on any meds? Prolonged fatigue is not a normal expectation of an ablation.

Just Xarelto. I did find an interesting study about prolonged fatigue post ablation.

[www.ncbi.nlm.nih.gov]

Nice find, Dini. The study doesn't show much, if anything, different from my own particular case. I see that ablation for SVT or VT is substantially different than for AF when it comes to recovery. Patients with AF ablation take considerably more time to approach 'normalcy'. The study agrees with the others that insist AF is progressive, debilitating, and that anxiety and fear play a large role in the motivation to have the AF mediated mechanically (with scarring via ablation of the PV ostia and antrum). Also, that a large motivation for ablation is so that patients can get off of DOACs.

I am happy that the suggestion is to include more formal education to patients so that they can help themselves to manage their own recovery, knowing what to expect and how to deal with symptoms and mood. but also that there really is such a thing as a blanking period where AF ablations will not necessarily preclude some ectopy, including AF; it should be anticipated as a normal event after an ablation.

I thought this part to be of interest:

Building on the work of Lee et al. (2014), we propose that recovery from AF ablation is more like recovery from surgical procedures than it is like recovery from other types of ablation. The experience of prolonged fatigue after AF ablation limits the speed with which patients are able to return to their desired level of physical activity or working full time. To mitigate or at least minimize discrepancies between what people expect and what they experience, it would be useful to change AF ablation patient education so it is more congruent with education used for postoperative surgical procedures.

While some jump right back to pre-ablation activity levels, what you describe is not at all uncommon. It took me three plus months to get anywhere near my pre-ablation activity/exercise levels, including atypical heart rate changes like you describe. It could be the insult to the heart, deconditioning, anesthesia, age, change of meds, or some combination.

We all react and heal differently to operative procedures like ablation. Unfortunately, ep's and cardiologists seem more engaged before rather than after and GP's often don't have a clue. Listen to your body and try to slowly build up your stamina with an easy to calibrate progressive exercise program like walking and above all, be patient. I found Dr. Phil Maffetone's heart rate formula (look it up online or get the book, Maffetone Method) very helpful.

Jim

Yes, recovery times from Afib ablation can vary a lot. I had other things going on, like Dysautonomia, and I had to travel out-of-state for the ablation. It took over a month for me to feel fully recovered. All the medications given during the ablation were part of the story in my longer-than-average recovery, but it wasn’t unexpected for me and I knew I would recover eventually, and it was certainly worth it!

I completely agree, the ablation was worth it!

Quote
mjamesone
While some jump right back to pre-ablation activity levels, what you describe is not at all uncommon. It took me three plus months to get anywhere near my pre-ablation activity/exercise levels, including atypical heart rate changes like you describe. It could be the insult to the heart, deconditioning, anesthesia, age, change of meds, or some combination.

We all react and heal differently to operative procedures like ablation. Unfortunately, ep's and cardiologists seem more engaged before rather than after and GP's often don't have a clue. (...)

Jim

I agree, for what you describe sticks to my on experience.