My cardiac ablation procedure last Friday morning was successful. I think I now have a normal sinus rhythm again without all the early beats or fast heart rate sequences I had for recent months. That’s what the doctor told my wife when he visited her while I was in recovery. At least I’m not constantly aware of irregular heart rhythms like I was before, so it seems like it’s getting back to a regular pattern where you usually don’t notice your heart most of the time.
Early Morning
I was scheduled at 7:30 am as the first patient of the day in the Texas Cardiac Arrythmia Institute at St. David’s Medical Center main hospital in Austin. We had to arrive at 5:15 am, and it’s almost an hour’s drive from our home, so we needed to wake up at 3:45 am. At least there’s not much traffic at that time. My wife came with me since I was allowed only one guest. I had received a negative COVID-19 test just 2 days before my outpatient procedure.
Extended Time
It took somewhat longer than they expected because some of the areas they need to zap were very close to the main electrical pathway through the heart, so they had to be especially careful not to affect that at all. It actually took about 3 1/2 hours, when they initially thought it might be 1 1/2 to 2 hours. However, I’m glad they took the more time to be extra careful and get it done right; I was out during that part of the procedure anyway.
Adrenaline
Initially, they weren’t seeing many PVCs (early ventricular beats), like I usually had when I was wearing the Zio monitor (about 13%), but there were tons of PAC (early atrial beats) happening in triplets (3 in a row). They gave me adrenaline through my IV line to get my heart revved up so it would be easier to catch them and identify the spots that needs to be fixed.
Super-Jittery
My doctor had warned me that at times my heart would be racing with somebody else driving. He said it might feel like having 3 cups of coffee all at once, and I felt more and more jittery until it felt like I was actually bouncing off the table. It really got going, at least 115 bpm that I remembered hearing them tell me. I was awake throughout the electrical mapping part of the procedure before they put me out during the ablation phase when fixing the problem spots.
Access Site
To perform this heart procedure, they needed to insert electrode catheters via the large femoral thigh vein in my groin up inside my heart to do the electrical mapping for the electrophysiology study and ablation to disable the misbehaving heart cells that triggered the arrhymias. They used an Abbott Perclose ProGlide suture-mediated closure (SMC) system to seal it off and stop any bleeding with a quicker recovery time so I was able to go home that afternoon.
Fever
That evening I noticed that I had a fever of 101, and the discharge instructions said to contact the doctor is it was over 100. I talked to the on-call electrophysiologist, and he thought it was probably just a “stress reaction” and to take 2 Tylenol, which did the trick and brought it down.
Glucose Spike
Also my blood glucose kept going up, until it was over 600. which is my meter’s measurement limit. That’s getting in the scary-high range, so I contacted the on-call endocrinologist to get some advice. Besides drinking lots of water to help dilute and flush my blood, she had me take a correction insulin dose to get it down. I then checked it periodically throughout the night to make sure it was going down, which it did (slowly).
Dexcom CGM
I had disconnected my Dexcom G6 CGM before my procedure because I was concerned that the electro-magnets, X-ray imaging, etc. might affect my transmitter. I put it back on Saturday with a new sensor, but primarily relied on fingersticks over the weekend while it was calibrated to get back on track.
Feeling Good
I was tired over the weekend, but I’m feeling good now. I am very glad to have this procedure done and behind me, and that it worked out well. I’ve gone for walks the past several days, and everything seems to be healing nicely (with the expected bruising near the access site).
Follow-up
I understand that it’s normal to still have some irregular rhythms for several weeks while healing from the heart irritation and inflammation; several small spots in my heart were actually damaged (on purpose) to eliminate the arrhythmias from those locations. I have a follow-up visit at the end of this month to get all the details about the electrophysiology study and ablation procedure, as well as check my ECG at that time.
Glad to read you are well and on the mend, Doug.
I appreciate you writing this. And your attention to details is excellent. I am in the process of deciding upon and having a cardiac ablation in the next month or so. I met with the doctor this morning and some of the scary possibilities like damage to the esophagus came up and that’s a little freaky for me. Did you have any issues with that? He said that there is a thermometer in the esophagus to measure if the heat level gets too much because they are burning Directly behind the esophagus at times and you can get hot and damaged and even perforated in the worst case scenario. Or it can have damage after the fact as as it builds up in there. He said he would put me on something to control the acid to help prevent any problems like that afterwards
With my cardiac ablation, they inserted the electrode catheters through an incision in my thigh/groin area and threaded them up into my heart. I don’t know what you are talking about regarding the esophagus, but I had no issues there other than my throat being a little sore for a few days from the anesthesia. My procedure was done with the very latest technology in an advanced world-class facility that is dedicated just to cardiac arrhythmias.
By the way, I have not had the follow-up with my electrophysiologist yet, which will be a month after my procedure. So I don’t have all the details about what he found and/or corrected yet. However, I am still having some arrhythmias after the ablation, unless that’s related to the healing/recovery process.
Hey again. I did not mean to confuse you about the esophageal situation. My EP who is supposed to be one of the best here in Charlotte NC were talking about things that can go wrong from having the ablation which does indeed go up through the groin. Not the esophagus.
He just mentioned that he puts a thermometer of some type in the tube that’s already in the esophagus and therefore keeps an eye on the heat level from the procedure so that the esophagus does not get overheated and damaged. He also give the patient meds like protonix and sulfulcate afterwards as a precaution to ward off potential acid reflux damage and promote healing that might be necessary. (If they see that the temperature goes to high they stop the procedure and let things cool off to protect the esophagus.) Hope that clears it up. I hope you do really well and your arrhythmia is gone very soon.
I had my ablation on Monday 12/7. I’m back in the hospital currently being checked out for extreme fatigue, dizziness, chest pressure, heavy tingling cold arms. Jury is still out. Will have Echo this morning as my bloodwork numbers are high re heart damage. Hopefully that is due to ablation “damage” on purpose but they want to rule out an event. Head CT and chest X-ray are fine. I stopped the Carafate I was on to protect the esophagus as I sensed it might be causing my fatigue and dizziness. Sure enough all that is gone. We shall see.
I hope you feel better soon. I think it might take several months for recovery, and additional arrhythmias are normal during that time.