Ablation Recovery: 3 Months Later
It has been almost 3 months since my cardiac ablation, and it has been one of the most obnoxiously turbulent recoveries of my life. However, my experience may not be unique, and because cardiac ablations are common and often necessary to at least semi-permanently resolve AFib, I want to discuss the recovery process and share my perspectives, research, and advice.
Given that I have cleared the prescribed 3-month recovery period for cardiac ablations, I have bridged the ablation-recovery gap and have slid into the “safe zone.” However, just because this procedure is common does not mean that it is easy to recover from or that it is permanent, because this is the second cardiac ablation I have had in an effort to manage my AFib-prone heart.
Theoretically, an ablation recovery is relatively simple and straightforward, but clearly that is not always the case. So, as someone who hit every possible problem with this recovery process, let’s discuss what happened, why, and what you can do to avoid it for yourself during your recovery journey.
Definition Of AFib And An Ablation:
Before we discuss a cardiac ablation, we need to understand what it treats and why it is necessary. The article Atrial Fibrillation by Ko et al. describes the stakes of this type of unsteady heartbeat very clearly. “In the US, approximately 10.55 million adults have atrial fibrillation (AF). AF is associated with significantly increased risk of stroke, heart failure, myocardial infarction, dementia, chronic kidney disease, and mortality” (Ko et al., 2024). Now, the symptoms, however, are wide-ranging and often can even be undetectable. These “include palpitations, dyspnea, chest pain, presyncope, exertional intolerance, and fatigue, although approximately 10% to 40% of people with AF are asymptomatic” (Ko et al., 2024). In my experience, my AFib was anything but silent, but it seems that the more unique and scarred the heart is from previous invasive procedures, the more likely it is that the patient is more impacted by it.
Now, given that it is not always detectable, how can you know? This is why it is so important to see your doctor regularly and to be honest about your symptoms. Because if it is asymptomatic, a regular physical can often detect it when one’s personal judgment cannot. The article also suggests this as well in how “AF can be detected incidentally during clinical encounters, with wearable devices, or through interrogation of cardiac implanted electronic devices. In patients presenting with ischemic stroke without diagnosed AF, an implantable loop recorder (ie, subcutaneous telemetry device) can evaluate patients for intermittent AF” (Ko et al., 2024). Once it is detected, it is categorized into a type. There are “4 stages of AF evolution: stage 1, at risk, defined as patients with AF-associated risk factors (eg, obesity, hypertension); stage 2, pre-AF, signs of atrial pathology on electrocardiogram or imaging without AF; stage 3, the presence of paroxysmal (recurrent AF episodes lasting ≤7 days) or persistent (continuous AF episode lasting >7 days) AF subtypes; and stage 4, permanent AF” (Ko et al., 2024). Personally, my AF is permanent because my heart literally does not know how to functionally beat on its own, meaning my pacemaker is a non-negotiable device in maintaining both my health and my life.
But this is not the same for everyone, and it is often a long medical road before reaching the need for an ablation. First off, “lifestyle and risk factor modification, including weight loss and exercise, to prevent AF onset, recurrence, and complications are recommended for all stages” (Ko et al., 2024). Other options include oral anticoagulants, daily aspirin, and other prescriptions to keep the heart steady and stable with minimal invasive risk to the patient. However, where an ablation comes into the treatment picture is that “catheter ablation is first-line therapy in patients with symptomatic paroxysmal AF to improve symptoms and slow progression to persistent AF. Catheter ablation is also recommended for patients with AF who have heart failure with reduced ejection fraction (HFrEF) to improve quality of life, left ventricular systolic function, and cardiovascular outcomes, such as rates of mortality and heart failure hospitalization” (Ko et al., 2024). Now, in my situation, I check all the boxes. It was needed to improve my quality of life since I was extremely symptomatic and mentally and physically compromised by it, and I am also in heart failure. So, if your doctor deems that you need a cardiac ablative procedure to manage your AF, it is best to follow their advice because the risks of not doing so are too great to ignore.
My Recovery From The Ablation:
Now, the first problem came a week after my procedure. Initially, upon waking up, I felt wonderful, but as the days went on, I had more chest pain and felt understandably horrible. At first, I thought this was just due to the wearing off of pain medication and the usual recovery process, but there was an intermittent stabbing feeling in my chest that would not relent. Now, after the procedure, I was told to rest and did my best, but life and expectations got in the way. However, this particular pain came roaring back after I was asked to help move a bunch of books in the basement. Against my better judgment and because of familial guilt about my being lazy, I participated. Not too much, but enough that I went upstairs, crying, holding my side, and begging for pain medicine.
Then, the next day I noticed that I could not sleep, was feeling weaker, could not catch a full breath, and had dark stool. Given these symptoms, I compared them to the list of symptoms to look out for after such a procedure and called my doctor, who told me to go to the ER immediately.
Apparently, the ablation is conducted with a rather large amount of water, and sometimes the water does not dissipate as easily as it should. Normally, it just flows out of the body in the days after the procedure. But, for me, the liquid from the procedure proceeded to surround my heart and lungs. So, I was prescribed diuretics for a few weeks to help manage it. This was all from late June to mid-July.
Now, something that should be noted is that over the last year, a stressful period I won't detail here caused my AFib to begin and last for 4 months, which led to AFib for 4.5 months; during this time, I gained almost 10 pounds and had trouble breathing. The doctor told me to lose weight, and my very health-focused family treated my weight as if it were due to my laziness and therefore a moral failing. However, with the diuretics, I lost 3-5 pounds per day until all the extra weight was gone. Therefore, the “weight” was not fat, but water retained by a failing heart no one even thought to consider, even though I am known by all of them to be in heart failure.
So, after taking the diuretic, it took about a week for 7 of the pounds to return and the difficulty breathing to come back. I got a call the day before I left on my trip telling me to take the diuretic “as needed” without telling me how to use it, why, or even elaborating on the purpose of this medication. This was in late July.
As one can imagine, this was a recipe for disaster. I realized that I felt better at sea level with this medicine, and due to the electrolytes being impacted, lack of medical communication on the subject, and lack of understanding of what “as needed” meant, along with getting their ok to take it daily, I slipped back into arrhythmia (AFib’s lighter, unsteady cousin) for only an hour. But it terrified me, to my very core. So the dose was lowered with the doctor’s consent, and I took it, putting me in arrhythmia for 2 whole days. This is because a side effect of diuretics, especially with a recent ablation, is to induce arrhythmias… which no one informed me about.
As such, it seems my heart failure has been upgraded to a moderate level. This means that my heart is struggling to do its job and therefore is symptomatic via fluid retention, mental fog, and fatigue, to name just a few symptoms, and, therefore, it means I need to watch my salt and fluid intake. This was distinctly not the outcome I wanted from this ablation… but it may have an unexpected silver lining.
So, yes, now that I am 3 months out from my ablation, my heart rhythm is more stable and dependable; however, this was not without a cost, because this recovery was extremely turbulent, like getting tossed around in a never-ending storm. This is why my posting schedule has been turbulent this last year: the conditions that led to the AFib, the AFib itself, and now the recovery process from the ablation.
The mental recovery process was particularly difficult. Perhaps it was partially due to the recovery from the extended period of the AFib itself, but for a long time the concept of A+B genuinely did not equal C.
By this, I mean I temporarily and functionally lost the ability to read, write, and think cohesively as a result of the impacts of untreated AFib. It was like I was floating above the words; I could see them, but could no longer discern what each individual one meant. As you can imagine, as someone who recently got my master’s with distinguished grades, it was horribly disturbing and genuinely terrifying. Losing my writing, especially, and watching it suffer was horrifying. The thing is, I have always used reading and writing as a way to escape my heart condition, and to lose both because of my heart condition was something I could not accept and arguably one of the most isolating experiences of my life. Words were my adaptation to my arguably abnormal circumstance. So, after my ablation, I gauged my recovery by my ability to read and learn. In the mental training program I made for myself, I practiced chess and read anything I could get my hands on. Be it children's books and YA novels all the way up to “The Ides of March” and Plutarch. And now, some days it is still difficult, but I am almost completely back to my old self.
Physically, I feel remarkably better, but that is only when my heart failure is managed with the prescribed liquid and food protocol. And it is because of this that I am mentally far clearer-headed than I have been in a year… perhaps over a few decades.
What I mean is that there is a silver lining to this entire situation. Now, in early September, this situation with AFib, diuretics, and heart failure highlighted a problem I have had for decades.
I have had difficulty breathing since my early teens and have been feeling more and more “underwater,” like I was mildly drowning, over the years. But what I often do is just accept it, press onward, and be secure in the hope that “this too shall pass.” Granted, this might not be the wisest way to handle this situation, but at the time, and for all these years, it was all I could do because everyone around me accepted the condition as “fine,” “normal,” and “just Blair being Blair.” This is because my friends and family just assumed that it was the natural, tragic progression of my illness.
It was not. I only know that now because of my persistence and my faith that I was a bright, intelligent person being held down by something I could not name. Despite being constantly dismissed and treated like a fool because of my illness, I was thrilled to finally learn, after all these years, that I was right all along.
But as a result of this chaos, it has been theorized that instead, my symptoms may not have been caused by just generic “asthma” but rather “cardiac asthma.” This explains why, with lower altitude, cleaner air, and less liquid and salt in my body, my body has essentially dried out, and I can breathe and think more clearly than I have in decades. Granted, it is still something of a difficult slope to manage, and trial and error is definitely a factor. But my ablation, while definitely not straightforward, may have created an unexpected upside after all… something that could have been discovered decades ago if anyone had listened to me, a cardiac patient, when I began to have trouble breathing years ago.
This is why my upcoming article will discuss “Who Is To Blame? Medical Negligence Or Patient Nonadherence With CVD.” Check out next week for more on that topic.
But for now, it seems I will have smooth sailing in my future as long as I manage the protocol that keeps me healthy.
General Recovery From Ablation:
However, while my experience recovering from this procedure was not straightforward, this in no way means that I would not get an ablation again if it were ever needed, nor that anyone should fear either ablations or their doctors.
According to the article, Recovery From Left Ventricular Dysfunction After Ablation Of Frequent Premature Ventricular Complexes by Yokokawa et al., “in patients with frequent PVCs and cardiomyopathy, the ejection fraction improves or normalizes within a period of 4 months postablation in most patients. Even if not entirely normal by 6 months postablation, the ejection fraction may still continue to improve and eventually normalize” (Yokokawa et al., 2013). This means that recovery from ablation takes time. For me, I was told it was three months, but given the mental and physical strain my body went through to get me into that situation, it might take up to 4 or even 6 months to completely recover.
Advice For Ablation Recovery:
Talk to your doctor, keep your medical appointments, and take your medicine as prescribed.
Yes, this seems counterintuitive after my experiences, but despite all of it, a medical professional is your best line of defense against heart problems and AFib. They are not infallible, but ignoring their advice is not an option, and your health will lose the battle if you do.
Rest. No matter what.
Seriously. It's important to move about and not stay in bed too long, but if you have an ablation, it is wise to take it at your own pace. Do not let others push you into doing things your body isn’t ready for.
Be patient.
Be patient with yourself, your doctor, and those around you. Recovery from an ablation is a long road. As someone who lacks patience, I understand how frustrating this is, but losing faith in yourself and patience with the process won’t help anyone, especially yourself. Just remember, “This too shall pass.” This situation, like all others, is temporary and will, in all likelihood, get better if given the chance.
Be vigilant.
If you feel something is wrong after an ablation, do not ignore it under any circumstances. I did ignore my breathing concern and chest pain for days primarily because I was told I was being dramatic, and I wish I hadn’t. So, trust your gut, and if you have concerns, trust your doctor.
An ablation is a tool, not a miracle.
I mean this kindly as someone who has had two ablations. It works as well as it is maintained, and it can save your quality of life if you do the same for yourself. Lifestyle changes may need to be made, and medicine may need to be taken regularly, but whatever sacrifices need to be made are worth it to see the next day.
Now, even though my second ablation and the recovery from it were abnormal, this does not mean that I do not recommend the procedure. The dangers that come from untreated AFib can have permanent and dire consequences. My goal with sharing my research, experience, and advice is to hopefully provide context and hope for others. CVD is one of the hardest long-term medical issues to face, and the procedures are part of that. But if you stay the course and trust your heart and your medical team, you can weather the storm and hopefully come out stronger on the other side.
What do you think? Can you relate?
Comment below.
Tune in next Monday and Friday for more! I will be writing more now that I'm finally feeling better, so I'm getting a new, more frequent schedule.
Keep ticking, everybody!
P.S. Are there any aspects of CVD health or pacemakers you’d like to know more about?
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Reference List:
Ko, D., Chung, M.K., Evans, P.T., Benjamin, E.J. and Helm, R.H. (2024). Atrial fibrillation. JAMA, [online] 333(4). doi:10.1001/jama.2024.22451.
Yokokawa, M., Good, E., Crawford, T., Chugh, A., Pelosi, F., Latchamsetty, R., Jongnarangsin, K., Armstrong, W., Ghanbari, H., Oral, H., Morady, F. and Bogun, F. (2013). Recovery From Left Ventricular Dysfunction After Ablation Of Frequent Premature Ventricular Complexes. Heart Rhythm, 10(2), pp.172–175. doi:10.1016/j.hrthm.2012.10.011.
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