I didn't post that third day off the carvedilol, because there wasn't anything on board at that point to control the arrhythmia(s) or heart rate. It was rough, and it was making me tired. I was SO sure that being OFF the stuff would make me feel better, but... I really hadn't considered or factored in my heart being out of rhythm so much. So there wasn't anything left in me that allowed for sitting at the computer to post.. or to do anything else, for that matter.
The night before the procedure I took my BP, which would normally show a low reading. Now, remember that any form of cardiac arrhythmia will screw with your BP readings... the readings, which isn't necessarily the ACTUAL blood pressure. The danger here is not knowing if it's actual BP or.. a skewed reading since BP monitors use your HR to get/calculate the readings. Now, the night before the procedure I'd been of carvedilol, which both lowers your BP a little and controls HR, and I had blinding headache (that had come and gone over the past several days), so.. my BP showing that night may have been accurate. However, and thankfully, it was most likely caused by my heart acting up and went back down to low/normal once it went into normal sinus rhythm again.
The pics below show the high reading the night before the procedure, and the very LOW reading the morning of. Both have the little heart symbol (white square with the 'echo' lines), which means my heart's rhythm deviated by at least 25% during the reading. Makes sense, and isn't surprising.
This is what was happening pre-ablation:
After ablation... well, it's been near impossible to actually GET a reading. That's another talk show. I have to continue on the medications: Beta-Blocker, ACE Inhibitor, and blood thinner (Eliquis, the blood thinner, I will be on the rest of my life due to the TIA I had in 2013).
My HR has been.. odd, about 80 BPM, which is strange, but I'm not sure what that's about, except that if my BP is dropping too much.. my heart is compensating. And if my BP is too low, the BP monitor won't get a reading (home monitors aren't as sensitive as the ones at Dr's offices).
At the hospital - Ablation Day
The waiting was long, which is usually the case. Blood work has to be done, and another T.E.E. (transesophageal echocardiogram) to make sure there are no blood clots in the atria. A blot clot in the atria during an ablation could mean it dislodging, resulting in stroke, during the procedure.
The ablation took about 4 hours. I was out of it, of course, but do recall waking momentarily when they removed the catheters and applied pressure to the entrance wounds (DAMN THAT HURT!!). The pain woke me, but I went right back under once they got the bandage on me.
Dr. Osario came in a bit later and spoke with me about the procedure, what he did, and what he found.
"All I had to do was breathe on you and your heart would go out of rhythm. I'm surprised you didn't come and see me sooner!" He said.
I told him I didn't have insurance, and I honestly didn't know that what was going on was really that serious. I really didn't know. But since last year... a little voice inside was whispering ... something isn't right!!! It got my attention, especially since I moved to Montgomery and things continued to worsen. Even then, I blamed my symptoms on almost everything but my heart.
Dr. Osario went on to tell me that the ablation took care of my SVT (supra ventricular tachacardia) which I'd had since I was a teenager, and the atrial fibrillation as well. The difference, briefly, between the two is that SVT is an incredibly fast HR (160-200+ BPM) with a regular rhythm, and AF is an incredibly fast HR (150-200+ BPM) with an irregular rhythm. What they have in common is that both originate in the atria. AF... the ablation, for PAF (which is technically what I have) happens at the pulmonary veins (see pic below).
The image below shows an extremely overly simplified version of what happened during the procedure, and yes... they had to go through the wall of my heart to reach the pulmonary veins. This is showing the treated areas for AF/PAF. Discussing....SVT we will worry about another time, though they did treat that as well. The AF was the most dangerous issue here, but it may have been a factor in causing my AF.
It was an incredibly invasive procedure with great risk, but the benefits outweighed the risks, plain and simple. Oh... and the wire with the loop is the mapping catheter, which is used to "map" the area to be cauterized so that the catheters can be 'guided' later, like a GPS system, by huge magnets... and the doctors skillful hands. Pretty cool stuff.
The ablation for AF/PAF is always the same, especially PAF. But the EP (Dr. Osario in this case) 'triggers' the arrhythmia using medication injected into the IV. Apparently, in my case, this took very little effort. lol Funny, really, because this little froggy wouldn't dance for anyone before (but for an audience of one.. ME!), but I guess he saw this as his last chance and gave the performance of a lifetime...and went out in a blaze of glory! lol Hence, Dr. Osario's comment. But this was a good thing, because it made mapping easy, and the procedure easy, and I was in the OR for 4 hours... instead of 6!
Once the ablation is done, the EP (electrophysiologist) attempts to trigger the arrhythmia using the same medications. If he cannot trigger the arrhythmia, the procedure is considered a success.
After.....
Bed rest, have to lay on your back in a semi-sitting or laying position for 4 hours. :/ Ugh. NOT easy. Couldn't even go to the bathroom! Nevermind that (oh the huge manatee!!). Once I could avoid the doggone bedpan 4 hours later... walking the few feet to the bathroom felt like I was climbing a mountain. Wow.... was my heart tired and achy! And painful. Chest pain from hell, pressure in my throat, tired beyond anything I'd felt before. And back on the meds.
Doctor's orders....
No strenuous activity or exercise. No heavy lifting, nothing 5 lbs or over. No bending, stooping, squatting, blah.. blah.. blah. Like I could! .... for a week. Have to take it easy for a week, but have to continue taking it somewhat easy for a couple of months.
It takes about 2 1/2 to 3 months to be certain of how successful the ablation was, so I have a follow up with Dr. Osorio then, and a follow up with my cardiologist August 24. My cardiologist is different now, as Dr. Diwan made a career move out of state. So bummed about that. Hopefully my new cardio doc is as good. We will see.
4 days later....
Still very tired, but... at least I can sit here at the computer without massive chest pain. Some chest pain, but getting better. I can tell when my BP plummets, but... it's worse in the morning. Not sure what the deal is with the 80 bpm HR, but.. just keeping an eye on that for now. Feels like it's more around 70 or so at the moment (wow! more like normal, instead of in the 40's or racing!!!!). Coolness!
The future....
The big, fat wait. Only time will tell how successful an ablation is. Some people have to have do-overs (1, 2, some even 3 times), while others have great success the first time. Some continue having issues right out of the OR, while others find that their AF finds another pathway into their heart within a year or two (or shorter). There's no 100% guarantee. But the good news is that for PAF... your success rate is better. :)
You see, even after an ablation AF is still there! What the EP did is cauterize the areas so that the crazy electrical signals are isolated so they can't reach your heart! I still have AF... it's just not affecting my heart. Weird concept, I know, but that's how it works.
Pulmonary issues?? I have no idea if I have resulting pulmonary issues due to the back pressure from AF and resulting periods of spiking high BP. I have moderate mitral valve regurgitation which causes some back pressure into the lungs, so that may be causing some problems.
Early last year I had an echocardiogram which showed mild pulmonary hypertension. It wasn't of any concern to anyone, so it was just left 'as is.' The pressure then was 36. I had another echo done a few months ago which showed the pressure at 46. This could have been caused by BP spikes, AF... but.. that has to be looked at now, too. It's often connected, so... I have to see the pulmonary doc this Thursday.
I'm pooped out. Took forever to write this, and... I'm done.
Til next time....
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