my wife had this issue—prevented her from training and racing. Three months ago she had the ablation procedure. Since then no Affib at all. She was on a monitoring device that confirmed no problem. This result is much better than usual—I attribute it to the skill of the Doc here in Tampa—Dr bengt Herwig
How are you now 6 weeks later?
What kind of ablation did you undergo? PVI or something more advanced?
I’ve been battling Afib for about 5 years—used to be a episodic occurrence monthly, which I could control via fleccainaide & atenol, but since resuming serious training about 6 months ago it has become a serious PITA. I’ve tried all the meds, including the newest, Multaq, and they all suck. At best they make afib livable but with little chance of serious AnThr type training. Just completed a 6 week schedule on Multaq & my avg HR was down over 25 beats vs previous months, and power dropped about 15% as well. High suck-age factor.
I’m scheduled for ablation on November 11 with Dr. Koonlawee Nademanee—supposedly one of the top 2 guys for ablation in the U.S., and the one who invented/perfected the whole Complex Fractionated Atrial Electrograms system (basically a 3-D mapping of your heart). I looked at PVI & most of the other 2D surgeries, but the results were so-so at best. Nademanee supposedly has a 90%+ success rate after 2-3 procedures (and almost 80% after 1), so am crossing my fingers.
Would be interested to know from the other posters on this topic what kind of ablation you underwent, what the recovery times are like, and what your end result is?
Follow up to my previous post:
I am now 15 weeks post procedure and all is going well. No issues since the single post procedure cardioversion. Was taken off Wafarin week 13, Toporol week 14 and only take 81 mg. aspirin daily. Jury is still out regarding what improvement I will experience training until I have adjusted to training without the drugs. I have slowly increased mileage and pace and have not yet reached pre-procedure performance levels. That has a lot to do with my conservative approach and this being the off season. I am gaining confidence and will consider the procedure a success if I pass the 9 month anniversary with no new episodes.
I’m very happy with those who are now sinus and drug free!
I was diagnosed AFib in 2003 when I was 36, but I’m not sure when I actually had it. I’ve been on warfarin and digoxin since then.
Last year I had my first pulmonary vein ablation and it converted me to sinus, but it only lasted for 24 hours. My doctor did a cardioversion the next day, it didn’t convert.
On Jan 25, 2010 (few days ago) I had my 2nd ablation, it failed again. My doctor performed 3 cardioversions before I woke up. Failed. So I was put with amiodarone for 2 days and went on 3 more cardioversions. They all failed.
It might sound painful to you to have all these done within 3 days, I wouldn’t mind if they brought me back to sinus. Now I’m on amiodarone watch for 30 days, will it convert me to sinus?
Is here anyone has similar situation like me?
I’m not sure if ablation is not working on me or I need the 3rd or 4th attempt. My doctor told me my case is rarer then some patients. I’m about to turn 44.
I really hope to be drug free for the rest of my life, if anyone knows an alternative please share with me.
Thanks,
EW
PS–I’m concerned about amiodarone since it has side effects and it meant for life threatening patients, am I wrong?
I’ve had to deal with intermittent A Fib for 5-6yrs. My regiment now is
low dose asa daily and propafenone 300mg 2 as needed for A Fib.
It is a med not without side effects but it works for me and converts
to sinus within 3hrs. As with your experience my cardiologist feels
ablation is not perfected well enough for me to try(and he does the proceedure)
I’ve done some w/o’s in A Fib but have not been when starting a race
although I did go into A Fib about 5min into the swim at Clearwater and had to
back off to finish.
May I know how your ablation went? (you can find my earlier post)
My ablation was a huge success after I battled intermittent a-fib for years. Two failed electro cardioversions and several failed chemical conversion regimes led me to the catheter ablation. The ablation literally changed my life. My training/racing and job have finally settled down. Recovery was quick. Doc said do anything I want to the next day but I still took it easy for a week or so. Biggest concern were the stitches from the groin insertions. My a-fib would only appear when I was racing or training hard so I couldn’t wait to run a fast 5k and see if the ablation really worked, which it did. This was about 10 days after the surgery.
Had only a few pvc’s after my surgery and resting heart rate went from 45 to 68, where it has remained for the last 14 months. I believe quitting the beta-blocker I was taking prior to the surgery is mostly responsible for the rise in rhr.
As far as side effects: the prostititus I got from the Foley tube was a real buzzkill.
Anyone considering doing this -find the best Dr. you can. This surgery was a bigger deal than I thought it was going to be and I doubt I would want to go through it again if it didnt work the first time.
Good Luck!
Congratulations!
Coming up on 2 months post surgery & I have nothing but the highest recs for Dr. Koonlawee Nadamanee. Surgery is really, really cool—basically the operating room is like something out of Star Trek—about as high-tech as you can get. Procedure lasted 4 hours. Dr Wee does NOT recommend just a simple PV procedure—do a bit of research & the results of his mapping technique vs PV speak for themselves.
First day after I was a bit sore, and ginger as had some bruising/swelling where the catheters went in on my groin. Had intermittent & frequent Afib for about 1 week after—historically my Afib would die out after 12-18 hours–these were going away after 10-60min—however they were pretty frequent–2-3x a day. I was told this was normal. After 2 weeks I wasn’t experiencing Afib anymore, and was cleared to begin gentle exercise. Of course I went for a 2 hour ride day 1 & scared the crap out of myself–60 minutes in went into the highest Vtach I’ve ever had–300+ HR for about 20 min—just couldn’t shake it. Really not a good feeling. Off the bike for another week. Then I started slowly again. Total mileage in November was 110 miles. Post Vtach episode, went into Afib once more—day after Thanksgiving (due to caffeine, travel, lots of wine, and lots of pumpkin pie & holiday sweets). Self corrected after 6 hours. Took myself off Coumadin on December 1, as didn’t want to risk riding & crashing while on it. Doc was fine when I told him 2 weeks later as my chance of stroke from clotting from Afib was extremely low.
December was very good—slowly built the bike riding up, and got in 2 runs. 450 miles in December, including some very high efforts. Only went into Afib once—day after xmas, eating lots of left-over xmas chocolate after heavy wine drinking on xmas day. Self-corrected after 30 min. January has been very good—almost 1k miles on the bike, and only went into Afib once—day before yesterday after digging myself a serious hole with 4 straight days of high intensity riding/racing, and 200+ miles (with one big night of wine drinking the day before I went into Afib). This episode last 20 min, but then came back in the middle of the night for about 4 hours. However I was absolutely exhausted by the miles/effort on the bike + the usual triggers (for me) of alcohol + caffeine + sugar.
The difference between before & after is night & day. Pre surgery I was going into Afib 3-4x a week, with each epsiode lasting 12-18 hours. ANY hard efforts on the bike would trigger it mid-ride–and was starting to experience some scary Vtach episodes (watching your HR on a anerobic climb skyrocket from 180 to 250+ is not a good feeling).
They say the total healing time is up to 6 months. Maybe with PV. I’m at about 90% of where I was fitness-wise pre surgery. The rest in November was good for my body, however I gained 8lbs, and am having a heck of a time dropping them so far in January.
There was an article that just came out that said that if meds don’t work, you should have the surgery. I don’t know anyone for who the meds work enough to let you train at a high level. The surgery is great, and Dr. Wee is one of the 2 Docs in the US I would have trusted (the other is in San Fran/Austin). Make sure you have good PPO insurance though, as the surgery is REALLY expensive.
Perhaps you didn’t read my post meds have controled my A Fib
for around 7yr and only taken as needed
.
sorry to hear your story. Ablation seems to work best on those who have not been in a fib that long. I was always able recognize when I went into the abnormal rhythm and insisted on immediate cardioversion. I never wanted to be in a fib for any longer than a few hours.
I did have one recurrance in November after a drank a beer (alcohol was my main trigger). I got cardioverted right away and it hasn’t been back since.
Good Luck.
Whats your definition of occasional afib? I was going into it 2-4x per week. My Dr’s experience is that for some, especially bigger guys + ex-swimmers, once you start down the afib road it is only going to get worse & most meds aren’t really effective (yes they help control it, but certainly don’t prevent it or give you that much of a better quality of life).
I’ve had 2-3/wk but that is not the rule. Last year I didn’t have an episode
from Dec 2008 until early July 2009 and then seemed like I was having
at least one/per wk or 2. Always controled with propafenone 600mg taken
when I noticed the A Fib(in some cases after I would have to fight off the
denial demon) I thought for a while my triggers were alcohol and/or caffene
but I have challenged with them on several occasions with no A Fib occuring.
The only things I can relate are perhaps hydration and electrolytes but because
of the sporatic nature I may never know for sure. The propafenone converts me
to sinus within 3hrs. I’ve had episodes that occur while running and resolve
within 5min on it’s own. I think I have only gone into A Fib once while in a race
and that was Clearwater. Had to back off to finish and once I got back to the hotel
converted within 20min of taking med which probably means it spontaniously
converted because that was a little quick for the med to have worked.
i’ll chime in here, too if that’s ok.
i started with a-fib about seven years ago. was sporadic (maybe once a month) but for some reason this past summer i would go into a-fib after (or during) almost every workout.
went with the cardiac ablation in October. like another poster noted, my dr. advised that i had no limitations once the incisions in the groin area were healed. interestingly, the incisions were so small that they did not require stitches. got in the pool a week after the ablation and was running/biking full speed within ten days.
talk about a modern-day miracle. i can’t get my HR up as high as i used to but being able to sleep through the night and finish a swim/ride/run without having to stare at my HR monitor is truly a blessing.
as others have said, ablation is very common. they were doing 39 at my facility the day i was in there. but, most of those are done by a handful of specialists. that’s who you want to see.
I completely agree re modern miracle. 100% difference after vs before. As to HR—I actually seem to be able to go higher—hit 189 3x on my Saturday group ride—highest I’ve seen in years. Part of it is my fitness is finally coming around, but also I also now have confidence in my body that I’m not going to spontaneously combust into Vtach, or worse.
I would venture to guess, based on the success ratios + the # of Dr.'s who are becoming proficient at it, that within 5 years ablation is pretty common & the first line of attack vs years of trying meds.
If you don’t mind saying how old are ya"ll
I’m 65
just curious
Mike
.
- looking California but feeling Minnesota.
My post isn’t about ablation (yet), but I might get there eventually, plus I think it could be useful to keep our a-fib posts consolidated. If this gets ignored or any of you ablation folks object to my post here, I’ll start a separate thread.
I had my introduction to a-fib this weekend at age 44 during the run portion of a hard bike/run workout. I didn’t recognize what was going on (just felt…bad), so I didn’t get to the ER until the next morning. After a couple of hours of IV treatment, I returned to a normal sinus rhythm without the need to resort to the paddles for an electroshock.
For now, the doctor and I agreed on 81 g of aspirin per day plus 1 dose of metoprolol per day. I just went for my first post a-fib jog, and I have to say the results were a bit depressing. My HR was about 25 beats per minute lower than normal for the pace, and my RPE was a little higher. Some or all of the RPE might have been due to heat and humidity, but I don’t think all of it was, especially when you add in that I hadn’t exercised in close to 72 hours (in fact, I was in the hospital a lot of that time).
Have I basically just installed a governor on the system that will prevent me from going as fast as I could 3 days ago? My “math” is: I used to need 180 beats per minute to run a 6 minute mile, but now I’m only going to able to get to 160 beats per minute. The volume of blood pushed by my heart in each pump is unchanged, and so fewer beats = less blood = less oxygen = less speed. So, is this what I’m look at with the metoprolol or am reading too much into 1 workout?
Maybe I’m willing to live with that scenario if it’s correct, but I want to gather information to figure that out. I have a follow up with my cardiologist in 1 month, and I will solicit his input also, but my guess is that slowtwitch may have more experience with attempting to train with a-fib than the doc.
Everyone is different, and how they react to the various treatments/meds is different as well, so take all the advice with a grain of salt. Speaking for myself, I couldn’t train/race at a high level on the meds/pre surgery. On the meds my power was down about 20%, and my top end just wasn’t there—at 160 bpm heavy fatigue would set it. This was while I was on Multaq, Atenol, and 2-3 other different/similar anti-arrythmia medications. At best they helped me convert to NSR quicker (4-6 hours) than no meds (12-18 hours), but they certainly didn’t help me stay out of arrythmia. For me the final straw was that the meds just weren’t working—my arrythmia was progressing to the point that I was having Vtac episodes almost weekly/EVERY hard cycling race, and a massive heart attack was becoming a very real possibility.
6 months out post surgery I’m experiencing arrythmia about 2x a month—always after digging a huge hole for myself on training rides/races in the middle of 16-20 hour training weeks. Onset is usually in the middle of the night following a huge training day, and I always convert within 6 hours or so. Totally liveable, but we’ll see if it gets worse this summer----if so I’ll do a followup surgery this fall. However please keep in mind a few things:
- I’m destroying myself on the bike—it takes a 4-5 hour ride w/8-10k climbing for me to dig myself a big enough hole to become symptomatic.
- My diet/recovery program sucks. I drink alot of wine, and 90% of my post-surgery arrythmia episodes are after drinking moderate to heavy amounts of alcohol as part of my own unique personal recovery program. I also eat WAY too much simple cargs/sweets, and the simple sugars + alcohol + electrolyte imbalance/dehydration all combine to create a personal arrythmia tsunami for me.
- IF I were to cut out two of the three contributing factors listed above I’m sure I would rarely, if every experience it.
Plenty of elite athletes can race/train thru afib using medication to govern the occurrences. Personally I couldn’t, but also because I refused to eliminate some of the contributing factors from my lifestyle.
I have intermittent A Fib Current regiment low dose asa 1 daily
and Propafenone 300mg 2 as needed for A Fib
When first treated was on beta blocker(class Atenolol
metoprolol etc) and had a TIA also tried me on coumadin which
I didn’t like because of what we do. They couldn’t get that regulated
so they gave up (thank god) I can w/o and race in A Fib but performance
suffers. Did Clearwater 07 and noticed I was in A Fib about 6-8 miles in bike
backed off and finished. When I downloaded my HRM at home I actually
started about 5min in the swim.
My cardiologist feels ablation has not developed enough to get consistant
results
Good Luck in your quest
Mike