Post-Ablation Concerns: Managing Atrial Fibrillation Recurrence

Electrocautery-related issues?

Hello, Director.
I would like to ask for your advice.
I am a patient with atrial fibrillation.
On the 15th of this month, I underwent catheter ablation surgery at Taipei Veterans General Hospital.
The doctor informed me after the surgery that it was very successful, but the day after I was discharged, I started to experience recurrence.
Since last night, my heart rate has been around 150 beats per minute and has not returned to normal! The medication is not helping! In fact, my heart rate seems to have become even more irregular after the ablation! I would like to know if this is a normal postoperative phenomenon.
What should I do now? Should I go to the emergency room? I have a small child at home and I am feeling anxious! Thank you for your response.

Xiao Zhang, 40~49 year old female. Ask Date: 2021/09/18

Dr. He Dongjin reply Cardiology

Hello, there is no need to go to the emergency room.
It seems to be a minor issue that is not related to your current condition.
Try not to worry too much; it is likely just a recurrence similar to before.
I recommend following up with your original physician for monitoring.
Take care from Changhua Hospital.

Reply Date: 2021/09/18

More Info

Post-ablation concerns, particularly regarding atrial fibrillation (AF) recurrence, are common among patients who have undergone catheter ablation procedures. It is important to understand that while catheter ablation can be effective in treating AF, it does not guarantee that the arrhythmia will not recur. In fact, some patients may experience a return of AF shortly after the procedure, which can be distressing.

In your case, experiencing a recurrence of AF just one day after the procedure is not entirely uncommon. It is important to note that the heart may take some time to heal after the ablation, and during this healing process, it is possible for arrhythmias to occur. The fact that you are experiencing a heart rate of around 150 beats per minute is concerning, especially if it is persistent and accompanied by symptoms such as palpitations, dizziness, or shortness of breath.

Here are some steps you can take to manage your situation:
1. Contact Your Healthcare Provider: It is crucial to reach out to your cardiologist or electrophysiologist as soon as possible. They can provide guidance based on your specific situation and may want to evaluate you further.

2. Monitor Symptoms: Keep track of any additional symptoms you may be experiencing, such as chest pain, shortness of breath, or extreme fatigue. This information will be helpful for your healthcare provider.

3. Consider Emergency Care: If your heart rate remains elevated and you are experiencing significant discomfort or any concerning symptoms, it may be appropriate to seek emergency medical attention. Rapid heart rates can lead to complications, and it is better to err on the side of caution.

4. Medication Management: If you have been prescribed antiarrhythmic medications or anticoagulants, ensure that you are taking them as directed. If you feel that the medications are not effective, discuss this with your doctor.

5. Lifestyle Modifications: While you are recovering, consider lifestyle changes that may help manage your AF. This includes avoiding stimulants (like caffeine), managing stress, and maintaining a healthy diet.

6. Follow-Up Appointments: Ensure that you attend all follow-up appointments with your healthcare provider. They may perform an electrocardiogram (ECG) or other tests to assess your heart rhythm and determine the best course of action.

7. Educate Yourself: Understanding atrial fibrillation and its management can help reduce anxiety. There are many resources available that provide information on AF, including support groups and educational materials from reputable medical organizations.

In summary, while some recurrence of atrial fibrillation after ablation can be expected, persistent rapid heart rates warrant prompt medical evaluation. Your healthcare provider will be best positioned to assess your condition and recommend appropriate interventions. Remember, it is essential to communicate openly with your medical team about your symptoms and concerns.

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