Kropotkinskaya is a candidate for ablation to deal with atrial fibrillation. Anyone here with knowledge or experience of the procedure, how to prep, what to expect, after-surgery care? Anything else related to a fib and ablation?
Thanks.
I don’t know too much of the specifics you’re asking about, but my father has had two ablations for his Afib - one about five years ago, and again last year. They were effective in getting him off the medicine he had been on, and the cardiologist was rather surprised he would end up needing a second procedure - but then, he’s 86 years old. He bounced back fairly quickly from the first time, less so from the next - he may have had a TIA while recovering from the second. Still quite worth it.
Best wishes to you and Kropotkinskaya.
I have permanent, persistant atrial fibrilation, or afib. I just thought everyone’s heart beat like that until a few years ago when I went into the hospital for something unrelated. Sometimes they want to shock your heart with the paddles like you are having a heart attack and it may restart in the normal rhythm, they declined to do so because they feared the heart might not start back up, so I live with it. Like I said, it seems perfectly normal to me. I have to warn people when they give me an EKG that no, I am not having a heart attack. I just have extra heartbeats sometimes.
Ablation is where they run a wire into your heart and burn/kill a few nerve endings that may be causing your irregular heart beats, it has not been offered as a cure for me. It seems like stone-knives-and-bear-skins type of health care to go in and kill some of the nerves in my heart and hope that fixes things. It works for many, many, people, but you should understand what the are doing. Burning a few nerves in your heart.
I am on a beta blocker called Metoprolol that seems to help with Afib, they will probably put you on that, they may want you on a blood thinner because your heart may be slow to move all the blood through it and we don’t want blood sitting around and turning into a clot that may lead to a stroke.
Listen to your cardiologist, not me. Good luck.
Kropotkinskaya has twice had “cardioversion,” or the heart zap. I may have injured our relationship as a result. The doctors and nurses said I might not want to watch, explaining the patient has a fairly vigorous convulsion with the shock. I said, within Kropotkinskaya’s earshot, “Can I push the button?” They burst out laughing; K, not so much.
They have been adjusting and changing the various medications to control heart rate and blood pressure and to thin the blood, but the side effects have been profound. Thus the suggestion of ablation. Thanks for your thoughts and good wishes.
Four years ago, I had cardiac ablation for Supraventricular tachycardia. Considering it is a major procedure done on your heart, it was pretty straightforward, no pain, I don’t want to say easy, but it wasn’t difficult. Since mine was ventricular, they went up through a vein and not an artery. I was given Versed about an hour before the procedure, wheeled into the procedure room, and anesthesiologist did his thing. Apparently I take a little bit more anesthesia than the normal person because I did kind of wake up in the middle of it. I remember asking are we done yet, are the wires out, then the happy juice was upped and I was out again. Prior to the ablation I had three cardioversions in the ER. One of the ER doctors was lovely and told me about her ablation and that she went through it without anesthesia because she wanted to watch it on the monitors. She said the worst pain was that she felt like she had a really really bad case of heartburn, which is what I felt when I kind of woke up during the procedure.
The worst part was having to be flat on my back for four hours after. When I say flat I mean flat. I could not even lift my head to have a drink of water. I had wonderful nurses in the recovery room. They monitored my vitals every 10 minutes, etc. They were just wonderful. I went home that evening. Took it easy for a couple of days and then it was back to normal activity.
I have improved the heart rhythms of many people, but your cardiologist would give you the best advice.
After the AFFIRM trial came out, there was evidence controlling the heart rate was more important than having perfect rhythm. This made medicating atrial arrhythmias easier. But they don’t always work. And rhythm irregularities really annoy some patients.
Sometimes patients have seen electrophysiologists and have a very detailed picture of which cells need ablation. They’d sedate you prior to the procedure. Follow their instructions for prep - usually no solid food for eight hours before the procedure, and possibly holding some medications. I don’t think recovery is especially onerous. What did they say?
Cardioversion is also sometimes performed; a controlled shock for new irregularities presenting within 48 hours. If it is done for older arrhythmias, sometimes anti coagulation or echo is recommended.
Several years ago I was diagnosed with tachycardia and Afib, and ablation is one of the procedures they did. They also put me on Eliquis (blood thinner) but since I also have anemia they had to take me off it. As an an alternative they installed a Watchman in my heart, which is supposed to intended to prevent blood clots and eliminate the need for blood thinners.
They had also put me on metoprolol; at one point they increased the dosage, but with the recent health issues I’ve been having one of the medication changes they made was to reduce the metoprolol dosage to below the original amount. I last saw my cardiologist in February, and according to my EKG my heart is doing fine. He said I don’t need to see him again until August.
I have had AFib for maybe 25 years and no one ever suggested any treatment but a blood thinner. For years it was coumadin (aka rat poison) and I had to have the clotting tested every 6 weeks and the dose adjusted. Now eliquis, no testing needed. But I unaware of any irregularity; I think that chamber just doesn’t beat. Also my pulse rate started dropping about 18 years ago and when it dropped into the low 30s they installed a pacemaker and now I beat at a steady 60. The original lasted nearly 15 years and three years ago, it was replaced.
Please forgive the aside…
I love it when people use a derivative of their user name to describe other members of their family. Am I correct that this is a reference to your spouse, and not a child?
Ah, yes, Kropotkin is a Russian name, and although my female spouse uses her original family name, the female derivative would, I thought, amuse some Dopers.
I underwent four ablation procedures in 2016. They had to try four times because they needed to locate the exact spots in my heart where the electrical impulses were too strong, causing arrhythmias. Three of the ablations were performed under anesthesia; the last one was done without anesthesia. This was very interesting; I could watch on a large screen as the catheter moved up the artery and slowly crept across my heart. The electrophysiologist used stimulation to locate the overactive areas and deactivated them with heat, a bit like stubbing out a cigarette in one spot. The same process also works with cold (cryoablation). Another cardiologist sat at a computer and provided the coordinates the electrophysiologist needed to locate. It took four hours before the most important points were finally found. The whole procedure was painless; the only discomfort came from the very hard surface and the cold in the operating room.
Afterward, I had to lie completely flat on my back for six hours and wasn’t allowed to move; that wasn’t particularly pleasant, but it wasn’t terrible either. After that, I was able to go home; I was told to take it easy, but I was able to go back to work the next day.
To the best of my knowledge, ablation is recommended for paroxysmal, i.e., episodic, arrhythmias that haven’t occurred too frequently yet. Each of these episodes increases the likelihood of recurrence, so you shouldn’t wait too long to undergo ablation. If the arrhythmias are permanent, ablation is no longer effective. Cardioversion is an electric shock that restores the heart to its normal rhythm. It is intended to resolve a specific crisis; it is not a curative treatment.
I haven’t had any arrhythmias since then, but I take a low-dose beta-blocker and Eliquis. In general, arrhythmias are not curable; anyone who has had them once must expect that they could return even after many years. The usual health recommendations apply: avoiding alcohol, smoking, and a stressful lifestyle.
Ablations are quite expensive procedures; doctors may not recommend them if insurance does not cover the cost or if the patient suffers from other conditions, such as diabetes, obesity, etc.
I am not familiar with the situation in the U.S., but I was advised to have the procedure performed at a large hospital, as the surgeon needs great dexterity to guide the catheter into and through the heart; the success of the procedure depends on this dexterity. In smaller clinics, ablation is not performed as frequently, and the doctors are not as experienced.
I wish Kropotkaya all the best; she shouldn’t worry—she’ll be fine again after the ablation!
I’ve had paroxysmal Afib for 20 years. They put me on Flecainide Acetate and low dose aspirin and that sorted it out for a couple years. When it came back they added a low dose of bisoprolol fumarate to the mix which again sorted it out for a couple years. Then after that when the afib came back they would up the dose of bisoprolol until it got to the max recommended. Then had an ablation in 2018. The procedure took longer than expected and since I’d been under for so long they kept me hospital overnight. I was still a bit wobbly the next day and the bruising on my inner thigh was epic. I’m still on medication and still have episodes of afib. I’ve got a call with my cardiologist next week and I’m guessing I’ll be having another ablation. Whenever I have an episode of afib I use a Kardia Mobile device to record it.
I have a friend who has done it twice. The first time he bounced back quickly and seemed good as new. He’s still recovering from the second one. Or maybe, the second one was less effective and he’s still suffering a bit from the underlying condition. But he’s basically fine, just doesn’t have the stamina he used to have.
I’ve had afib for over 20 years now, and was going to have the what I think of heart reboot procedure, but the drug the cardiologist put me on before it seemed to have settled things enough that he canceled it. I’m on warfarin and diltiazem. I get my INR checked every six weeks. I’d rather not take any of the new drugs, my warfarin is no co-pay. Never needed an ablation.
I have a leaky valve, but it is not getting much worse and my cardiologist doesn’t think I’ll have to do anything about it.
My blood pressure has gone up a tad, and I got a blood pressure cuff. I decided to go with the expensive one that detected afib. It did - but then refused to give me a blood pressure reading. I returned it and got the cheap one which was not so picky.
My wife can hear my heart jump around sometimes, but it has been better. Before I detected it I felt it, but thought my phone was buzzing.