[Closed] Irregular hear rhythm - ablation experience to share?

One of my riding buddies had an ablation done a month or two ago due to irregular bouts of tachycardia during exercise. He seems to be recovering well and will be out on road rides in the next couple of weeks.

I 'suffer' from AF but it's drug-controlled at the moment, symptoms sound very much like yours OP. Was offered an ablation but the cardiologist suggested to save that option until the condition worsened. From experience, the husband of a family member had an ablation in his early 20s and he says he hasn't had a single episode since - he's knocking on the door of 50 now.

Also it sounds a bit 'new-agey alternative medicine' but there's a practising doctor that wrote a cookbook after suffering from AF - Rupy Aujla, The Doctor's Kitchen - I've got the book and between that and the drugs I've been pretty much symptom-free for coming up to 4 years

Sounds quite similar to me with the PVCs, athletic heart, no structural issues. In the absence of other obvious stuff (and with zero calcium score in my arteries) I've been put down as having micro-vascular heart disease, but possible electrical issues.

Been tried on a range of beta a blocker type things and statins (cholesterol is ok) but I can't tolerate any of them.

After last round of treadmill test and holter monitor he said there is definitely an issue, possibly electrical too, but to go in and do any invasive investigation and ablation could make a small (in the scheme of things) issue worse. Advice was not to worry, get on with life and don't do anything that makes it worse. Otherwise I'm signed off from him.

For various reasons including this last year I've massive backed off the volume and intensity of my rides and the symptoms seemed to have gone away. Recently though, I've been building back up to long road rides (did hilly 170km) at the weekend and they are coming back. Toward the end of the ride I was getting a dry cough when we stopped, and the last couple of days since then a bit of left side chest ache and breathless/dry cough on exertion from any sustained walking.

So, for me, it seems I've just got to manage it by not doing 'excessive' duration and intensity. Maybe just a couple of hours rides, not all day.

I have a work colleague who had an ablation may be 5 years ago for tachycardia, he exercises and is a retained firefighter, so that option worked for him.

Hope you get clearer guidance from your consultant.

Didn't @ton have something like this?

I developed AF in 2015 (aged 44). Had both electrical and pharmacological cardioversions to get me back into sinus rhythm. Had my first ablation in Aug '15. Went in via the groin. I had no haematomas which I hear can be an issue in recovery. I was back on a bike within 2 weeks and was symptom free for approx 18 months. I did find that my RHR went up and got many more ectopic beats but it didn't affect my cycling and I rode 12k km in 2016. Symptoms began to return in 2017 and I ended up having another ablation in May '18. Again no issues with the op and recovery was swift. No symptoms since then and I cycle a lot. I have, however, decided to stay on beta blockers (Bisoprolol) to minimise the likelihood on the AF returning - although I'm now beginning to think about coming off them as I'm a less capable cyclist on them and they also make me feel cold!

My ops were in Charing Cross hospital which has a fairly cutting edge electrocardiology set up. I'd had another ablation willingly if necessary. I did have a scary experience on flecainide/beta blockers and needed to be resuscitated but was in a cardiac ward at the time so had plenty of attention - wouldn't recommend that experience...

Good luck in your choices!

I did have a scary experience on flecainide/beta blockers

Sorry to thread hijack but that's my current treatment. What was the issue?

Watching this thread. Have had similar symptoms with premature contractions but no ill effects beyond that. I've found that diet soft drinks are really bad for it. And taking magnesium has stopped issues whilst exercising.

Should get booked into the cardiologist but I'm not sure I could trigger it on a treadmill unless I sank four espressos beforehand.

I went through something similar a couple of years ago after a single (6hr) AF incident, plus then evidence of short (10-20s) issues that I found in my riding HR records, Garmin connect being really handy for this.

Similar to many above, I was advised to avoid an ablation if possible - apparently they are rarely a permanent fix.

I gave up booze, which seems to have sorted it for the time being - at least delayed it, as age is the other major factor.

Thanks for thoughts all @molgrips sorry forgot to mention I have also been supplementing magnesium and potassium, which may have been partially responsible for the improvements in my symptoms.

In terms of recovery time from the ablation, what was the advice you got?

After losing so much time out of riding this spring in m not keen to lose even more this summer, especially given I'm now much improved. Maybe I will sit on it and think until the autumn/winter.

Yup, had Paroxsysmal Atrial Fibrilation for a while and got RF ablation for it in about 2008 (maybe). It gave me back a lot of things, gave me a lot of fitness and really, really reduced the number of episodes I had of AF.

The procedure itself is relatively easy... Small hole in Right femoral vein, shove probe up vein to heart, make a small hole in the heart wall between atria and then make small burns around the pulmonary veins. Scars do not conduct, so the rogue impulses that caused my AF don't get to make my left atrium spasm.

The whole thing took a couple of hours, leaving me with a weird scar in my groin. Downsides include having to shave "down there" and getting a huge haemotoma in your groin that was quite possibly the most painful thing I have experienced when it was pressure cleared (i.e. nurse put his fist on the haemotoma and then most of his bodyweight).

I was on blood thinners for a couple of months before the op (warfarin), other blood thinners immediately before and after the op, then warfarin again for a month or something afterwards. I think I was off work for two weeks. I can't remember how long I was not exercising for.

@TheFlyingOx - the combination was used to cardiovert me and I crashed after I left A&E and came to the cardiac ward. When I passed out by BP was 22/17 and falling as was my HR at 25bpm. According to my wife people ran out of the ICU and injected me with various drugs. I did recover very quickly. My understanding is that a small minority of people can't tolerate the combination.

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I had atrial flutter and atrial fibrillation, and not just episodes but permanently. I had to have ablation 3 times to eventually resolve it, but IMO is a much better path to take than medication which was next to useless. I also had cardioversion multiple times, and normal rhythm never lasted more than a couple of days.

For me it took too long to sort because my local specialist was ****ing useless and I had to take matters into my own hands and bypass him and go further afield.

But as above ablations gave me back so much more than trying to control the situation with medication. The medication route just left me feeling exhausted, barely able to live and just waiting to die young.

And apparently cyclists have a higher tendency towards heart rhythm problems, but they don't know why.

@howarthp that might have been a reaction to the medication used to put you out for the cardioversion, rather than the actual procedure. They delighted in telling me that it was the drug that killed Michael Jackson (assuming they used the same on you).

Is that the opiate-based one? The one that they joke about making you forget things?

Is that the opiate-based one? The one that they joke about making you forget things?

Could be, I can't remember.

I won't bore you with my story. I took 5 years to get sorted. 3 failed ablation.
I the end I had to have open heart surgery to sort my problem.
Fingers crossed it keeps fixed.

And good luck with your problems mate. Hope you get sorted

Thanks for thoughts all.

And apparently cyclists have a higher tendency towards heart rhythm problems, but they don’t know why.

I bought the book 'haywire heart' which is a bit of an eye opener regarding long term endurance sport and links to heart rhythm issues.

Amazingly common in otherwise fit and healthy people this!
My AF is drug controlled, anti-coagulant, betablockers, etc. Was never offered ablation, but I don't get flutters or palpitations. Just gotta be on these drugs (same as my 82 year old mum!) forever.
Slowed me down a good bit.

A lot of the decisions are risk-based. If the AF is not bad, then the risk of injury during ablation is greater than the benefit of a successful procedure. When I first got my diagnosis, I was given Flecainide and sent on my way. It was only a few year after that that a friend found out about RF Ablation and I could get referred to a specialist in the field. Even then, with the drugs helping, the technology was immature enough that the risks to a relatively young, relatively fit(-ish) male were higher than the benefit.

Roll forward to 2008 and the team at Papworth had five years more experience of doing the procedure and the tools and techniques had all progressed. The risk/reward balance had changed and I got the op. The last I heard, they has started using fibre optics and lasers for the procedure I got as it was more accurate and gave better results.

The big thing is to keep pushing for regular reviews. Stuff changes.

And apparently cyclists have a higher tendency towards heart rhythm problems, but they don’t know why.

It's a well-established thing, there have been large cohort studies showing higher levels of AF in Nordic skiers (who do lots of long duration high intensity exercise), for example. As you say, it's not particularly clear why this happens. It's probably to do with left atrial pressure (and thus stretching), which increases during exercise (but also with age and other chronic health issues like obesity and hypertension).

Interestingly, exercise is beneficial on your risk of AF up to a point, beyond which rates of AF increase only with very extreme exercise. I suspect that most people on here are not exercising to that level yet probably report it more frequently. Anecdotally, we see plenty of keen cyclists / runners with AF, but I suspect a large proportion of them are people who exercise regularly (but not excessively) and are more in tune with their body's performance than more sedentary people would be. It's also far more bothersome for them so they seek help.

I'm not going to comment on the OP's issues specifically because it's too much of a minefield and too many unknowns to make any useful comments. I will say that RVOT ablation (for the type of ectopy OP describes) is technically quite different from an AF ablation - probably lower risk and almost certainly higher success rates. You'd have to talk an electrophysiology doctor to get a proper idea of your own risks/benefits. Ablation has also improved massively in the last 10-15 years.

I had my ablation 2 years ago at Papworth. Similar story to most of the above really low resting heart rate around 38bpm, doctor said that either I was a super fit athlete (I am not) or there was something wrong. He monitored it for a couple of years then I started to get bouts of AF and dizziness.

Booked in for a few tests with a specialist who recommended the ablation. In and out of Papworth in half a day. All done under sedation rather than a general anaesthetic. They struggled a little to get my blood pressure up in the immediate aftermath of the Op but I was still discharged within 3 hours. I did have pretty extensive bruising on my thigh afterwards. But the procedure has been a success so far (they do warn that it is not a permanent fix). Resting HR is now around 48 which the specialist is happy with.

Thanks for the replies everyone, really appreciate it

Late forties here. I've had two ablations due to paroxysmal AF both in UHW, Cardiff. First was a cryoablation in 2018, which helped a lot but did not completely solve the issue. Second was a RF ablation in 2021, just 5 weeks ago. Neither procedure was particularly bad, just a bit uncomfortable for a few hours.

For me, the worst thing is the recovery period. Right now my heart is a bit unpredictable; a lot worse than before the op. Most days are fine, but some days it's in arrhythmia for several hours. As it settles over time it is is improving (the inflamation takes a while to diminish). Last time I was fairly normal after a couple of months, but it probably took 6 months for me to fully recover.

After my last op I started cycling again after a couple of months. The ablation didn't hold me back at all on the bike. I was in very good shape until my current lay-off, doing pretty decent sized rides in South Wales twice a week.

I would refer you to the web-site healthunlocked.com where there is an AF forum. Lots of pretty useful info there.

From what you've said regarding a pretty specific diagnosis and a high chance of likely success, based on my experience, I'd probably go for it. Just not in peak mtb season, as not being able to make use of dry trails is a real bummer!

Good luck whatever you decide.

I had cryo ablation for AF 3 years ago. No issues since although my cycling as dropped right off due to having young kids. Was indoor riding 3 weeks after. The main issue was the insertion wound which was infected. 5 months after the ablation I did my longest ever ride at 180 miles. Every 100 before that had involve AF.
The procedure is uncomfortable but not painful. Be careful when reading sites like healthunlocked as many AF sufferers are not athletes (not that I am but I'm not 60+ and totally sedentary) so very cautious. Much more so than my cardiologist.

Both the guys I mentioned in the other thread have had ablations and it has stopped the issues they were having with irregular rhythms.
They are both much happier with no issues since, no longer waiting for an episode to happen.
They have passed the cardio monitor on to a woman in the village who 'MAY' be also suffering from a similar irregular beat and is gathering evidence to see if that is the case.
Good luck which ever route you decide to take.

About 20 years ago I started having SVT attacks after playing squash and got to a point I stopped playing. I then had an attack while sitting in the garden in the sun after a stressful day. My wife called the doc who called an ambulance and I was taken into A&E where I was shocked back into a normal heart rate. I was advised to have the ablation and from that day of the op I’ve never had an issue. Just had to let the access in the groin heal for a few days and all was good.
Good luck in what ever route you take.

I don't have or know much detail, but my bro (now 58) had one just before lockdown and it has worked out well.