“Pill-In-the-Pocket” for Five Years, then Catheter Ablation for a Cure
by Marilyn Shook, 2008, Updated July 2015
My first bout of Atrial Fib was in 2002. I consulted with Dr. Fred Morady, a renowned University of Michigan Cardiologist/Electrophysiologist. He recommended a Pulmonary Vein Ablation. The procedure was in its infancy, and I would not consider it. He suggested I carry medication with me and take it when A-Fib occurred. Each time I went into A-Fib and/or A-Flutter, I could really feel it.
My Meds and How I Used Them
The medications I was on: Inderal, 20 mg; Rythmol, 300 mg at onset of A-Fib. Repeat Inderal in 3 hours if A-Fib persists. Wait 3 hours and repeat Inderal and Rythmol.
About 2 years later, I went to see another Cardiologist/ Electrophysiologist, Dr. David Haines, at William Beaumont Hospital in Royal Oak, Michigan. He came to Beaumont Hospital from the University of Virginia, and his specialty is Atrial Fib. He also suggested a Pulmonary Vein Ablation. I felt my “Pills-In-The-Pocket” were working, and there was no pressure from Dr. Haines to proceed with the ablation.
The A-Fib episodes, however, were happening more and more frequently and lasting longer. Also, I am 67 years old; and all the literature says someone my age should be on Coumadin (a blood thinner), since Atrial Fib predisposes you to strokes. I really resisted that.
After Five Years the Pills Did Not Work
This past September when we were traveling in the Southwest, the pills did not work. I ended up in the E.R. in Bullhead City, AZ. During the doctor’s admitting assessment, he said I went into a normal rhythm; and I was discharged with a copy of my EKG. At my next appointment with Dr. Haines, I presented the discharge EKG to him. He asked me if I was extremely tired during this trip, as the discharge EKG showed a subtle Atrial Flutter. I knew then I needed to proceed with the Pulmonary Vein Ablation. The “Pill-In-The-Pocket” served me well for five years; however, it was time to go for the cure.
Opted for Pulmonary Vein Ablation (PVI)
I had a Pulmonary Vein Ablation performed by Dr. Haines on November 26th, 2007. I am six months post procedure, and it looks like it was successful. I wore an events monitor the month of February, and there were no bouts of A-Fib or A-Flutter recorded. I had a Pulmonary Vein C.T. scan performed about 2 weeks ago looking for narrowing of the pulmonary arteries, and there was none. I just had a total knee replacement with NO A-FIB!!
The Pulmonary Vein Ablation procedure was about five hours, and general anesthesia was used. I spent the night in the hospital and went home the next day. I felt extremely tired after the procedure; however, I think it was the anesthesia. I am not a fan of general anesthesia. I obtained a copy of the Pulmonary Vein Ablation dictated report and now understand how important it was to use the anesthesia―to have the patient comfortable and to be able to control all movements. There were no limitations post procedure, and I was on Coumadin for three months. I am presently on no medication except for a daily aspirin.
My Advice to Others with A-Fib
If you decide to go for a Pulmonary Vein Ablation, make certain you pick a Cardiologist/Electrophysiologist who has performed many Pulmonary Vein Ablations. Ask many questions—first and foremost “How many Pulmonary Vein Ablations have you performed (the key words here are PULMONARY VEIN ABLATIONS)? What is your success rate? Have you had any complications? How long will this take?” Make a list. I also strongly suggest you pick a Cardiologist/Electrophysiologist from the list provided on this A-Fib site.
If you have any questions or would like additional information, please contact me.
AUGUST 2014 Update:
Our own A-Fib Support Volunteer, Marilyn, just had a Medtronic Reveal LINQ ICM (Insertable Cardiac Monitoring System) implanted to help identify a weird intermittent irregular heartbeat she has been experiencing. (She has been A-Fib-free since her ablation in 2008.) Every time she went to a doctor, she would be in normal sinus rhythm (many of us have had that same frustrating experience). Even a three week monitor only picked up PACs.
Medtronic’s new Reveal LINQ ICM (Insertable Cardiac Monitoring System) is a little over a one-inch long, about 4mm think and about ¼” wide, and is the smallest heart monitor on the market. It’s placed just under the skin of your chest in a simple outpatient procedure and is not visible in most patients. The LINQ ICM automatically detects and records abnormal heart rhythm for up to 3 years. It’s designed to help doctors quickly identify, diagnose and treat irregular heartbeats.
She promises to keep us informed about what the LINQ reveals. “If it is A-Fib, I would not hesitate to undergo the pulmonary vein ablation again.” Good luck, Marilyn.
Marilyn was A-Fib free for 7 years after her pulmonary vein ablation. But she occasionally felt a weird irregular heartbeat that never showed up in the doctor’s office or with short duration monitors.
She had a Medtronic Reveal LINQ ICM (Insertable Cardiac Monitor) installed August 2014 to identify these arrhythmias. The Reveal monitor did document 2 or 3 episodes of A-Fib. She opted to have a repeat PVA.
“It’s been 9 months since my repeat PVA, and there is no evidence of A-Fib. I have not felt that arrhythmia, and my implanted cardiac monitor has been negative for A-Fib. I no longer take Xarelto or any cardiac medications. I do take a daily 325mg Aspirin. I am optimistic that the repeat PVA will be effective, and I will continue to be A-Fib free.”
We are most grateful to Marilyn for sharing with us how effective the Reveal monitor was in identifying very intermittent irregular heartbeats that probably never would have been documented otherwise. Not everyone would have been as aggressive as Marilyn. But she knew how relatively safe a second PVI would be, and she had confidence in her EP, Dr. David Haines, at William Beaumont Hospital in Royal Oak, Michigan.
February 2016 Update:
“I am still A-Fib free since my 2nd PVA in October 2014. My Linq monitor detected a 2 minute run of A-Fib this past July 2015. The following week, I had surgery to remove the two adenoma-filled parathyroid glands. Maybe, just maybe, those parathyroid glands contributed to my A-Fib returning 7 years after my first PVA?? My Linq monitor is interrogated every month and there is no A-Fib detected since my parathyroid surgery . Dr. Haines was not at all concerned about the 2 minute episode of A-Fib detected prior to my parathyroid surgery. I am hopeful!”