Recent flutter ablation and dual lead pacemaker

Two weeks ago I had aflutter ablation and implant of a dual lead pacemaker. I still have discomfort from the pm surgery but also since surgery have had more irregular and rapid heartbeats than before the surgeries. My doctors and nurses say this is totally normal following these procedures and will last for 1-3 months after. They are now saying I should have the "big" ablation on the other side. I also have COPD. Would appreciate any comments. Thank you!

5 Comments

Hi Ian

by bobandbj - 2014-06-25 06:06:57

Thanks for getting back to me. Yes, I was told it was normal to have these for a month or two following the procedures while the heart heals. I guess that makes sense, but it doesn't feel right -- at all! The doctor, did however, tell my husband that I will probably have to have the ventricle side done as well or as he refers to it as the "big" ablation" for the a fib. Even though prior to my surgery my doctor said the flutter ablation and pacemaker will help me. As you know it is so hard going through this and having to rely on doctors and nurses for information. I have found with my COPD there nothing like people like me going thru this to know really what is normal and what is not. I have so much strength and comfort in "my own kind", if you will, for truth. And I thank you so much for getting back to me..I feel much less alone with this mess:)

Hi bobandbj

by IAN MC - 2014-06-25 11:06:29

I was surprised to read what your Drs and nurses told you !

I too had an aflutter ablation followed by an implant of a dual lead pacemaker and I was fortunate in that the ablation completely cured my atrial flutter.

When they told me of possible consequences prior to ablation ( such as possibly needing a PM ) at no time did they warn me that it is "totally normal" to end up with more irregular and rapid heartbeats. My EP claims a 95% cure-rate for atrial flutter after a single ablation.

It sounds to me that the ablation may have failed, or there was more to your heart condition than you have described

I look forward to reading other comments on this

Ian

Why the pacer?

by golden_snitch - 2014-06-26 03:06:36

Hi!

I don't get why you need a pacemaker after a flutter ablation. I had a flutter ablation, too, and the circuit that they ablate (isthmus ablation) is really not that close to the AV-node, let alone the sinus node, so what is the pacer for? Usually, atrial flutter ablations are an easy fix, taking not long, successful in more than 95% of all cases. If neither your sinus node nor your AV-node are slow or blocking, then you do not need the pacemaker, and it might just interfere with your own rhythm, which can in turn cause arrhythmias.

The "big" ablation your doctor is referring to is most likely an AV-node ablation. Don't think I have ever heard of that being done for atrial flutter. It is usually the last resort therapy for atrial fibrillation patients in whom numerous drugs, cardioversions, and ablations (pulmonary vein isolations, PVI) have failed. But, of course, a "big ablation" could also be a pulmonary vein isolation in the left atrium.

I know a lot of patients who complained about an increase in extra beats (PVCs) after an ablation, or about an increased resting heart rate. Personally, I have never had this, and I have had 8 ablations. But my EPs have always warned me that, after an ablation the heart might be a little irritated and "huffy", and that it would be normal to have more extra beats. So, since your ablation was just two weeks ago, I'd probably give it at least two more weeks. If you still experience arrhythmias then, ask for a holter monitor.

Best wishes

Inga

Hi Inga

by IAN MC - 2014-06-26 04:06:08

I was interested in your " Why a pacer ? " question
We are all different and my situation is an example of this.

I had a successful flutter ablation but within 3 weeks I had to have a PM fitted. This puzzled the Drs because my ablation pathway was nowhere near the AV node,

BUT I had been having occasional symptoms of transient bradycardias ( pre-syncope feelings ) for a few years prior to having the ablation. So it seems that I had 2 separate conditions, atrial flutter with all the usual symptoms, and a slowly worsening bradycardia. Unknown to me I was a potential PM patient just waiting to happen !

I had my first faint a couple of weeks after the ablation.

The interesting question is; did the ablation, for whatever reason, accelerate my need for the PM ? This certainly seemed to be the case but the Drs couldn't explain why !

Ian

Flutter Ablation and Dual Lead Pacemaker Implant

by bobandbj - 2014-07-07 01:07:22

Hi again! Well, I had my Aflutter ablation and Pacemaker implant 4 weeks ago today and I am still experiencing daily irregular beats as well as periods of 100+ heart rate at times even while just sitting. I've phoned my doctors more times than they seem to like so 2 weeks ago I just quit calling to complain and question if all this is normal. They continued to tell me I will experience these kinds of things for up to 3 months and it's normal! It was also mentioned he will see me in 3 months and check out my situation then and it's a possibility I will need the "big" ablation as he calls it. I've experienced Afib in the past - diagnosed 3 years ago as Paroxsymal Afib and have had about 4-5 episodes in that time period. I have severe COPD and even if I get a hang nail my COPD is blamed! So the doctors are using this as the reason for everything; however I've had the disease for 16 years and have remained stable with it and have progress only slightly. I did go on oxygen 5 years ago so low Oxygen Saturation is rarely an issue with me.
Sorry to go on, but I am wondering if this recovery process I'm going thru is normal. I always find it best to hear things from the real experts -- people like us. Thank you for listening.

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As for my pacemaker (almost 7 years old) I like to think of it in the terms of the old Timex commercial - takes a licking and keeps on ticking.