1st Ablation Scheduled

Hi, All:

I have been on this forum for well over a year and recently decided to have my 1st cryoablation. I am actually part of a clinical trial with Synaptic Medical Corporation as recommended to me by my EP for participation in the study. I have paroxysmal Afib. I have been addressing my Afib, first with a change in my thyroid medication to lower the strength due to treatment for hypothyroidism that transitioned to subclinical hyperthyroidism. I am now low thyroid where I should be but the Afib persisted so I am having the ablation. (It was believed the over medication for my low thyroid symptoms was the culprit for me developing Afib). I have had several echos, stress tests and previously was taking a heart rate controlling medication. I am taking Xarelto as prescribed by my doctor as well as I was recently prescribed 120 mg of Diltiazem. I have to say I am not feeling any side effects from taking Diltiazem. I. have been an active exercise enthusiast for years but would never consider myself among the elite group of athletes. I just enjoyed running outdoors for many years and participated in several 1/2 marathons but am now more of a recreational exercise participant. Afib, of course, changed my trajectory. For those with similar experiences, I would like to hear what you have to say regarding what to expect post ablation and its impact on exercise. In other words, no one has given me any professional advice on how to resume exercise. I mostly do fast-pace walking and some light jogging to mix in but refrain from letting my heart rate get too high to the "threshold level."' I currently stay within aerobic capacity or lower but am not sure if after the ablation even that low level of intensity is "too much." Again, I don't have any guidelines. If you are like me, any suggestions would be very much appreciated.
Thank you.

My cardiologist denied that I ought to feel less energetic, or less capable of performing when he saw me for the second time, about two years after confirming an ER diagnosis of paroxysmal AF. He immediately put me on 12.5 mg of Metoprolol BID, 5 mg Eliquis BID, and 20 mg of Atorvastatin PO. He felt that my BP was a bit too close to being hypertensive, and explained that the Metoprolol would have two beneficial effects: slow my heart when I was in AF, but also make my heart less forceful when beating, which would lower my BP some. The statin was because he assumed I had ischemia.

I have been a competitive runner since about 1979...or was...until my first run-in with AF subsided and I gained confidence and attempted to resume running. I wasn't ever very successful. I found that I could run-walk, and took to running in sunny places, and walking in shady places. This might sound odd, but my thinking was to generally keep my sun exposure to a minimum during the months when the sun is highest overhead (May through August), and that meant dashing between tree shade, wherever it lay. It kept my daily exercise 'interesting' because I had to be present, if you will, and remember to break into a run when I broke into direct sunshine again. But, I could never sustain my running for more than a few minutes, and this was at a training pace for a 68 year-old. With a goofy heart. I just couldn't get my mojo back.

The question, though, is was it the metoprolol, the statin, or just me being a wimp? That question remains unanswered to this day.

My cardiologist said flatly he didn't want me to lose any cardiac fitness, so, I tried. When I told him I just wasn't able to muster the zip I used to have, he said I couldn't blame metoprolol or the statin for that. I'm not so sure.

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gloaming
When I told him I just wasn't able to muster the zip I used to have, he said I couldn't blame metoprolol or the statin for that. I'm not so sure.

Oh man, one of my pet peeves: Doctors who wave off the effects of drugs they've never taken. I'm pretty sure you can blame the metoprolol. Tell your cardiologist to take the dose of metoprolol you're taking for a week and get back to you. I think aspiring cardiologists should have to experience beta blockers before being allowed to prescribe them. Metoprolol and most other beta blockers absolutely, positively suck the life right out of me. It makes walking up a modest hill feel like climbing a mountain. It caps my heart rate at about 115, which makes riding my bike at more than about 12 mph impossible for more than a minute or two. Normally, I can do 15-20 mph for an hour straight.

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Carey

When I told him I just wasn't able to muster the zip I used to have, he said I couldn't blame metoprolol or the statin for that. I'm not so sure.

Oh man, one of my pet peeves: Doctors who wave off the effects of drugs they've never taken. I'm pretty sure you can blame the metoprolol. Tell your cardiologist to take the dose of metoprolol you're taking for a week and get back to you. I think aspiring cardiologists should have to experience beta blockers before being allowed to prescribe them. Metoprolol and most other beta blockers absolutely, positively suck the life right out of me. It makes walking up a modest hill feel like climbing a mountain. It caps my heart rate at about 115, which makes riding my bike at more than about 12 mph impossible for more than a minute or two. Normally, I can do 15-20 mph for an hour straight.

well said the cardiologist does not have your body.

There's no reason you won't be able to resume your stated pre-ablation exercise levels post ablation. The question is when.

I was told I could resume full exercise 10 days post my cryo ablation, with is consistent with what is posted on web sites like Cleveland Clinic and Mayo.

Personally-- and from what I've read in multiple afib forums -- I find those recommendations much too generic and don't take into account the healing process which can significantly vary person to person. For example, I had post procedural pericarditis, which is not that uncommon. That slowed my recovery and limited my exercise to slow walking at the most for the first month and it was three months before I was back near pre-ablation exercise levels.

I would suggest listen to your body and do a little less than you feel like. If that's brisk walking after a week or ten days, fine. If it's just walking around the house, that's also fine. Don't push things and work up to your pre-ablation exercise level gradually.

Jim

Your advice is sensible in my estimation, Jim. I could barely walk and talk, both slowly, when I went out for an evening stroll the day I was allowed to leave the city where I had my index ablation. So, night #2. My heart rate was climbing up into AF territory by the time I had walked 300 meters.

I think the handouts given to patients for their edification and guidance should reflect first that each individual will experience a unique post-op recovery of both their physical capacities and their mood and mental acumen. From there, each patient is responsible to self-assess, self-monitor, and to commence a return to normal activities slowly and only as they gain confidence and a sense of well-being again. There is no prescription that applies to every patient. Instead, each patient must take their time and strive for normalcy when they think they feel well enough to do so.

Thank you, All. I believe a common sense approach is best but after dealing with the erratic way my heart would beat given my constant need to check my heart rate on my Garmin and then think I was within normal range for the intensity of the exercise, my heart rate would suddenly "shoot up" as if coming from almost nowhere. Mystifying. I would find myself resuming back to a slower pace of walking, even slower than brisk walking or light jogging. I read a very good book entitled, The Haywire Heart, and that really summed it up for me. So post-ablation concerns are will I encounter the same issues as my body's pre-ablation status regarding the control of my heart rate when confronted with Afib, or will I find myself comfortable enough both pre-ablation and pre Afib status to feel comfortable to at least do some jogging and mixing it in with walking without returning back to Afib and having to confront all of the modifications I have had to deal with since the Afib diagnosis. The only thing I read in the paperwork from the doctor I was given is I should not lift anything more than 10lbs the first week after the procedure. Nothing else regarding restrictions for the level or type of activity other than no driving the first 3 days due to the incision made at the groin area. And, yes, doctors don't know unless they themselves take the drugs to know why patients complain and want to get off from them. I wonder how many EP's themselves have or had Afib???
Thanks, again, for your support. This forum has been a real life-saver for me when I had questions and did not know where to turn, even with the use of the information available on the internet. Your responses to my concerns really made/make a difference as I navigate through this!
Diana