Thinking over... no response required.

Two years ago I had a PM implanted. A month after that I had a  cardioversion to reset my heart rhythm. Six weeks ago I had a series of ablations. I can see the mistakes that I've made that caused my heart to get worse. Throughout my life doctors would mention that I had an irregular or a premature heartbeat, etc. Than the docs would go on and talk about my sore knee or injured foot. Only once, after a high altitude run and a nagging (first) wife did I have follow up on my heart. I was in my 20s and sent home after 3 days in a CCU. However, I never followed up on doctors mentioning that I had issues with my heart. Some said, "oh you will deal with it when you are older." It was a big mistake because I did not ask questions or get a referral to a cardiologist. Anyway, years later, when I was 58, I had a bad spell of something going on in my heart. I tried to run...and every 20 feet I had to stop. I was barely able to breathe. Eventually, a friend told me I should go to an ER.. I went. All hell broke out. I was, for 3 hours, in atrial flutter. Docs caught it on the EKG. Everyone wanted me to go to surgery and have ablations. I held off until I saw the attending. I did not get to see him until the next day. He reviewed my case and said because I did not have any of the risk factors (smoke, overweight, drink alcohol or do drugs, under 60 and I was not female) I can elect to have ablations when when it interferes with my lifestyle. So, I put surgery off for 5 years. I felt what was going on in my chest everyday but I continued to avoid getting anything done. Until it got worse. I mean really bad. I went into urgent care, expecting to hear doctors say I needed an ablation. I was wrong. My lower chamber was now slowing down. I needed a pacemaker. My heart, before surgery, slowed to 25 beats a minute and dropping. The implant was successfully completed. However, I did not know that the pm did not control my atrial flutter... so a month later I had the cardioversion. It worked... for 2 or 3 months... but again... I waited to see my doc whom I did not see until the annual checkup... and now I had atrial flutter and atrial fibrillation. Back into my favorite place, the operating room, and I had an ablation in one chamber and about 16 in the other. I don't know how much damage I did to my heart by putting off all of those interventions for so long. Maybe when I was first diagnosed with atrial flutter and had the ablation could have avoided a need for a pacemaker and cardioversion and even such an extensive series of ablations. Or maybe no matter what, I would have ended up needing those things because it's in my genes. Anyway 6 weeks after surgery and I had no episodes of flutter or afib. That is positive. On the stupid side of life, I was looking at my cell phone when I walked into a log and trip/flipped over and landed on my heart. I re-positioned my PM. I blackened my chest with a bruised that matched the bruised from puncturing the femoral vein when they went in through my groin. Over a few weeks gravity got the PM back in place. I did not yank any leads from my heart.. I'm still running and dance.. and now I nap. 


1 Comments

Afib/Aflutter and ablation

by AgentX86 - 2022-05-19 18:07:44

This one of those things that there is no answer except in hindsight. These are progressive diseases and the earlier they're treated (ablation) the higher the probability of success. OTOH, the symptoms may never get so bad enough that it's worth worrying about.

Most flutter can be abated relatively simply with excellent outcomes. Afib is entirely different. It often takes two, or more tries, even with the best (and I mean top 10) EPs. Afib can seek through years after an ablation, requiring more.

I highly doubt that not having an ablation caused SSS. It is likely that they have the same root cause (fibrosis). Certainly cardioversion is used to get the heart back into normal sinus rhythm, - to terminate AF/AFL. It's only a temporary measure, though my first was good for seven years (the second more like seven minutes, then less than that). It's simple an might even work.

FWIW, I was 54 when I was diagnosed with AF and was actually in HF, at the time.

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