Yet Another Cycling Forum
General Category => The Knowledge => Health & Fitness => Topic started by: Regulator on 27 March, 2023, 09:27:34 am
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I've had atrial fibrillation for a while now (it came on after I had Covid but there is also a familial history on the female side) and it's been decided that I'm a good candidate for cardiac ablation, with a good chance if will cure the fibrillation and allow me to come off the long term meds. The ablation is booked for 13 June at Papworth.
Anyone else had it done? What was your experience?
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I've had the other treatment for AF in about 1997 - cardioversion - which didn't work (I just got two large scorch marks on my chest and back!)
I believe Basil OTP has had the ablation treatment.
Three people I know have had successful ablation treatment, one probably 25 years ago and he's still going strong with no obvious signs of AF.
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Definitely worth it, but a permanent fix is not guaranteed.
Had the procedure c20 years ago and it worked very well.
However, in the last 6 or 7 years AF slowly came back and I'm now more or less back where I started.
I'm sure everyone has a different experience, and I hope yours will be longer lasting.
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Junior the Elder had this done when he was 15, some 10 years ago now.
He had an arrhythmia issue where upon exercising, his heart rate would suddenly jump up to 200+, and stay there for an alarming time.
This was caused by some kind of electrical short-circuit in the heart, where it would go into an uncontrolled feedback loop.
They burned a short section of short-circuiting material away, and it was a 100% cure.
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[I'm a long-time lurker here, but have almost never posted before]
I was diagnosed with persistent AF in 2016 IIRC. Had a cardioversion, which stopped the AF but it returned after a few days. Then had an ablation which again stopped AF but it returned again after a few weeks. Second ablation - same effect. Third ablation (Feb 2019) - AF went away again, but returned as paroxysmic rather than persistent AF, which I still have - anywhere from nothing in a day to all day, average around 20% of the time. Ablations were around a year apart from each other owing to waiting list. All were done in St Bart's in London. I'm now in my early 70s.
General notes:
- The actual procedure isn't too bad; if it got a bit painful they just increased the amout of opiates they infused into me. They used diamorphine i.e. medical-grade heroin which I found very euphoric; I can understand how folk get hooked.
- Procedure takes c.1-2 hours
- They kept me in overnight each time, just for observation
- I was distinctly weak and shaky for 2-3 days after each procedure, and for a couple of weeks had occasional mild faint/dizzy spells (not bad enought to be dangerous for driving etc.)
- After 3rd ablation I was put on Amiodarone which is an anti-arrhythmia drug with possible nasty side effects. I seemed to tolerate it well for about 16 months, then suddenly came down with very unpleaseant symptoms of over-active thyroid (had missed regular blood test because of Covid lockdowns).
- Now on Sotalol (beta-blocker) instead of Amiodarone, which I have no problems with, though I know many don't like beta-blockers. Also on blood-thinner (Apixaban).
- NICE guidance is apparently to try up to 3 ablations. Last time I saw cardiologist, early 2020, he said he'd push for one more attempt, but I've heard nothing since - I haven't chased it up as I'm not really convinced it would fix things.
- Since my last ablation I've kept a daily diary of symptoms (% of time I experience AF each day, and anything else which seems relevant). I find this useful, and so do any doctors I've spoken to. Takes about 20 seconds per day, using a spreadsheet.
I'd say it's worth giving it a go - it clearly does work well for many people. No major downsides apart from the slight risks associated with any cardiac procedure.
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He had an arrhythmia issue where upon exercising, his heart rate would suddenly jump up to 200+, and stay there for an alarming time.
My team mate had this last year/couple of years ago. So far the ablation has cured it.
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Thanks for the responses.
My AF is paroxysmal (seems to be triggered when I've got an infection). The NHS offered cardioversion - which isn't much used when your AF is paroxysmal. Luckily, I have health insurance through work. So I've managed to see two consultants and get a treatment plan quite quickly.
The consultant says that the fact it is paroxysmal increases the chance that the ablation will fix it... and, if I don't get anything done then it'll only get worse over time.
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As a doctor Regulator I am sure you will have chosen your cardiologist carefully and all will go smoothly.
However
My brother-in-law (66) had an ablation 10 days ago. Sent home the next day. Severe chest pain. Rushed back in about a week ago. 2litres of fluid drained from chest, followed by 3-4 days of ongoing drainage. A week in CCU. Now on ordinary cardiology ward.
I am presuming either a response to ablation or severe LVF due to some faulty wiring.
https://academic.oup.com/europace/article/18/4/521/2467118 (https://academic.oup.com/europace/article/18/4/521/2467118) interestingly high incidence of Heart Failure after ablation but mainly after persistent AF rather than paroxysmal. I hope it helps the decision making. I can see that taking drugs for a paroxysmal event is untidy and probably not helpful
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As a doctor Regulator I am sure you will have chosen your cardiologist carefully and all will go smoothly.
However
My brother-in-law (66) had an ablation 10 days ago. Sent home the next day. Severe chest pain. Rushed back in about a week ago. 2litres of fluid drained from chest, followed by 3-4 days of ongoing drainage. A week in CCU. Now on ordinary cardiology ward.
I am presuming either a response to ablation or severe LVF due to some faulty wiring.
https://academic.oup.com/europace/article/18/4/521/2467118 (https://academic.oup.com/europace/article/18/4/521/2467118) interestingly high incidence of Heart Failure after ablation but mainly after persistent AF rather than paroxysmal. I hope it helps the decision making. I can see that taking drugs for a paroxysmal event is untidy and probably not helpful
I’ve only read the abstract, but that’s a staggeringly high complication rate taken at face value. Do we know if the heart failure describes is persistent or if the situation typically improves over time post procedure?
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As a doctor Regulator I am sure you will have chosen your cardiologist carefully and all will go smoothly.
However
My brother-in-law (66) had an ablation 10 days ago. Sent home the next day. Severe chest pain. Rushed back in about a week ago. 2litres of fluid drained from chest, followed by 3-4 days of ongoing drainage. A week in CCU. Now on ordinary cardiology ward.
I am presuming either a response to ablation or severe LVF due to some faulty wiring.
https://academic.oup.com/europace/article/18/4/521/2467118 (https://academic.oup.com/europace/article/18/4/521/2467118) interestingly high incidence of Heart Failure after ablation but mainly after persistent AF rather than paroxysmal. I hope it helps the decision making. I can see that taking drugs for a paroxysmal event is untidy and probably not helpful
I'm not a doctor - my other half is.
Have yet to be seen by an NHS cardiologist (despite three AF related trips to A&E)... My initial (private) cardiologist was Sarah Clarke (https://en.wikipedia.org/wiki/Sarah_Clarke_(doctor)). I'm now seeing one of her colleagues at the Royal Papworth, Simon Fynn. From what I can see both are considered experts in their field.
I know there are risks with ablation, but it's a risk I'm willing to take - particularly if it mean I can reduce/stop the long term meds.
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Well, I had the ablation today. Two and half hours in theatre, most of which I don’t remember thanks to some very good sedation.
Great team of nurses and HCAs looked after me.
Jon was able to drop me to Papworth on his way to work and pick me up when he finished.
I’ve now got the rest of the week off to recover.
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:thumbsup:
Hope all goes well.
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I hope the recovery goes well.
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Hope your recovery goes smoothly and swiftly, Regulator
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Best wishes for a quick recovery .
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Same from me too.
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Best wishes from me too.
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(https://i.imgur.com/RFQQm47.jpg)
And from me, too.
Can you believe the last forum rides we were on together were 15-20 years ago?
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Al the best Reg.
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How are you feeling today, matey?
Like road-runner, it's been many years. At first, I thought the Reggicide ride to Ely, but thinking about it, it was probably the forum camp at Gordon Taylor's place.
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Wishing you well, Reg!
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Whereas I first met Reg last month.
All the best for the recovery.
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Good luck with recovery and hope it’s effective.
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Thanks all!
I’m feeling a lot better, although I do have some very spectacular bruising in my groin, which is continuing to develop (apparently it can take a week or more). I’m not allowed to do any heavy lifting or vigorous exercise at the moment, but I have been out with the dog a few times and have a short walk (about 2.5 miles) planned for this afternoon.
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Please, no pictures :hand:
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Well, now the the exercise ban is over, I had a 6.30 a.m. class at a local gym (as part of a trial week).
It's on a small, local trading estate and is run by two local lads in their early 20s. They were very welcoming and supportive to a fat old thing like me. The class only had three people this morning (apparently 6 is the most they're ever had for a morning class), which meant that the trainer had plenty of time to correct my form on various things.
I've got a tester 'weights and plates' class booked for Thursday. Then we're on holiday for two week... but I intend to sign up when we get back.
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I managed to miss all of this entirely. Sounds like your recovery has gone well. Good luck with the fitness regaining!
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Well, I'm now in the gym five mornings a week (for a 6.30 am class). No AF issues so far. :thumbsup:
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Woot ! Good news. :thumbsup:
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Well done, Reg.
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Yay, glad it is sorted.
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Well done you, keep it up! :thumbsup:
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:thumbsup:
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:thumbsup:
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:thumbsup:
I've been in the hospital all day with an arrythmia (again - it happened in 2021) but there is nothing wrong with the ECG shape or any blood tests - just lots and lots of ectopic beats. Felt very unwell this morning with pulse of 100 and BP of 165/85 although these gradually dropped back to a more usual 54 and 124/70 by the time I got home (I think I may have a virus, and we decided to walk 3 miles home, which helped shift it).
Does AF show on an ECG? I never get any issue when exercising - it's only ever when still. Seems to be triggered by stress and seasonal allergy.
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When I went to A & E with AF in ... 2020 (? Can't remember now) the oximeter said my pulse was about 50, but the display showed a main strong beat and a couple of wibbles. I spoke to someone at 111 and when I described the symptoms (a sort of light feeling in my chest) I was told to go straight to A & E.
Their machine registered my pulse as 170. It seemed to measure each wibble as a heartbeat. I was injected with some sort of drug and within minutes that brought my pulse down to between 60 and 70. Ever since then, I've been on beta blockers (bisoprolol) and edoxaban blood thinner. I've not had a repeat of the exercise - at least, that I've noticed - so haven't been back in.
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:thumbsup:
I've been in the hospital all day with an arrythmia (again - it happened in 2021) but there is nothing wrong with the ECG shape or any blood tests - just lots and lots of ectopic beats. Felt very unwell this morning with pulse of 100 and BP of 165/85 although these gradually dropped back to a more usual 54 and 124/70 by the time I got home (I think I may have a virus, and we decided to walk 3 miles home, which helped shift it).
Does AF show on an ECG? I never get any issue when exercising - it's only ever when still. Seems to be triggered by stress and seasonal allergy.
You'll need a 24hour heart monitor to see AF as it's normally so random . . . it's a bit like an ECG with 5 or 6 stickers on your torso connected to a gadget about as big as a walkman that does the recording (you hook it on your belt during the day and it lies in bed when you're asleep) - they then extract an ECG type print-out to see any AF blips and then prescribe accordingly - most likely a top and bottom BP controller and Edoxaban (was Warfarin in days gone by) to thin blood and reduce potential for blood clots which could cause a stroke.
I've been medication for AF for about 30 years - had a cardioversion about 25 years ago which didn't work . . it just left 2 scorch marks on my back and chest!!
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They did the monitor 18 months ago but it only picked up six ectopic beats in 24h, which is completely normal (this was four months after the symptoms, so the monitoring was pointless). The odd beats seem to be triggered by seasonal asthma in Jul/Aug, which happens only in wet summers. Nov 21 was the only time it happened at another time of year. Asthma treatment may be more useful as I don't currently have any.
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Rogerzilla, best wishes. And maybe you should avoid any threads discussing the Orange one.
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I hope you can shift that soon, it sounds unpleasant, although I suppose that might not get to the cause.
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Good luck, Roger. AF should show up on an ECG as a sort-of saw-tooth base pattern punctuated by irregular sharp peaks.
You can get watches that allow you to monitor for Afib. I have a Withings (https://www.withings.com/fr/en/watches) one that was recommended by my cardiologist, but you can get equivalent Chinesium ones for a tenth of the price.
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The ECG is completely normal except for the ectopic beats, so they don't think it's AF. I'm going to see the asthma nurse later as I think that is triggering the odd beats. Had it 20 years ago, same time of year, and the GP then reckoned it was a seasonal allergy. It went away on holiday in the Alps this summer.
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Maybe the NHS might fund a cure in Chamonix.
Actually, you'd have a good chance of our lot saying OK to that.
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I got a copy of the bill for my surgery. £22k :o most of which was single use disposable instrumentation.
I can see why NHS tariff is so high for this procedure.
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The consultant fees are usually a small part of it. My eyes were about £5000 each. The consultant got about £800 and the anaesthetist £500. The hospital got the rest.
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:thumbsup:
I've been in the hospital all day with an arrythmia (again - it happened in 2021) but there is nothing wrong with the ECG shape or any blood tests - just lots and lots of ectopic beats. Felt very unwell this morning with pulse of 100 and BP of 165/85 although these gradually dropped back to a more usual 54 and 124/70 by the time I got home (I think I may have a virus, and we decided to walk 3 miles home, which helped shift it).
Does AF show on an ECG? I never get any issue when exercising - it's only ever when still. Seems to be triggered by stress and seasonal allergy.
AF only showed once on the ECG done at the hospital... that was an episode that lasted about 30 hours and necessitated an admission.
The other two times, I arrived there in AF but by the time I was seen and given an ECG it had subsided. However, my Apple Watch had recorded the episodes so they had something to go on.
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The consultant fees are usually a small part of it. My eyes were about £5000 each. The consultant got about £800 and the anaesthetist £500. The hospital got the rest.
The consultant's bill arrived today - £1,450, which I thought wasn't too bad (but then I'm not paying it ;D )
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How Sean Yates deals with his health from about 54:45 in
https://www.youtube.com/watch?v=D9lWu2376To
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The consultant fees are usually a small part of it. My eyes were about £5000 each. The consultant got about £800 and the anaesthetist £500. The hospital got the rest.
The consultant's bill arrived today - £1,450, which I thought wasn't too bad (but then I'm not paying it ;D )
We spent more on the late, lamented Big Tom in October...
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The consultant fees are usually a small part of it. My eyes were about £5000 each. The consultant got about £800 and the anaesthetist £500. The hospital got the rest.
The consultant's bill arrived today - £1,450, which I thought wasn't too bad (but then I'm not paying it ;D )
The joys of private health care insurance.