CryoCor Ablation, Then RF Ablation. Sleep Apnea Diagnosed and Treated: No More A-Fib
By Ted Shurman, 2008, Update 2011
I am a 44 year old male who has been managing A-Fib for 4 years via Sotalol and Coumadin. Some doctors have told me that Coumadin is not necessary since my heart is otherwise healthy. However, I chose to play it safe, since my father died from A-Fib at age 66. It was his first known episode. He came back early from traveling through Europe because “he didn’t feel like himself”. He saw a doctor who prescribed drugs including Coumadin. He suffered a stroke that evening.
Max Dose of Sotalol Reached Seeks Ablation
In recent years, my episodes have become more frequent, occurring every two months on average and lasting between half a day and 9 days. I have always been able to return to normal sinus rhythm on my own. I reached a max dose of Sotalol (240 mg twice a day), so it was now time to pursue a fix.
FDA Clinical Trial: CryoCor Ablation
I chose CryoCor because I think it is safer and should be as effective. I feel I owe it to my wife and three young children to take the safest route. I live near Albany NY and regularly travel 3 & 1/2 hours to the University of Rochester, NY to participate in the FDA Clinical Trial. I was very comfortable meeting Dr. Daubert. I was randomly placed in the “control” group and had to wait to “cross over” into treatment.
After 7 months, I qualified to cross over and I had my CryoCor ablation on 10/8/07. The procedure lasted 6 hours. Unfortunately, I had a complication at the very end and I had to be admitted for a few days. Somehow, a small hole formed that allowed blood to leave the heart and fill the sack that surrounds the heart (tamponade). Fortunately, they were able to remove the blood from the sack before the sack became completely full and stopped the heart. The hole healed on its own.
I continued antibiotics for 14 days to ensure that an infection did not occur. While recovering from the complication, I slipped into A-Fib and was not able to restart Coumadin for 2 weeks to ensure that the hole was fully healed. My QTc was longer than desired, so no Sotalol was prescribed, just Toprol. This was a very stressful time, being in A-Fib without Coumadin.
(The QT interval represents points on the EKG signal. The “c” stands for “corrected,” which means it is adjusted for heart rate. The QT interval is affected by the heart rate. For more see our article: Understanding the EKG Signal.)
A week after restarting the Coumadin and going back on a low dosage (120 mg twice a day) of Sotalol, I went back into NSR. It had been a very difficult three weeks, but life was now good again!
I have been in NSR since then (4 months now). We have decreased the Sotalol dosage to 80 mg twice a day for the last month. Today is my last day of Sotalol. Hopefully I will be able to maintain NSR without any Sotalol. If I can’t, I’ll be going back to Dr. Daubert for Round 2 [second ablation]. Despite the complication, I am very happy with the wonderful care I received from Dr. Daubert and Strong Memorial Hospital. I have no regrets. Eventually, I will be cured of A-Fib and off of Sotalol and Coumadin.
Good luck to everyone and a special thanks to Steve and his website for helping so many.
Update June 9, 2008
Twice I have stopped the low dosage of sotalol but I had flutter and fib problems so I am back on it. Although I am vastly improved, I am not fully cured. I will have a second CryoCor ablation in August.
Updated April 12, 2011
Second Ablation in 2008
In August 2008 I had a second ablation. CryoCor had been bought-out and the study stopped, so I had an RF ablation. This time everything went well, and the AF was gone. After about a year, I started having infrequent brief moments of arrhythmia. After 6 months it was becoming more frequent, so I needed to see a doctor—I saw a new doctor George A. Vassolas in Schenectady, NY. During my first meeting with him he asked me about sleep apnea. I told him that I have never been diagnosed but I know I have it (for 20 years or so).
Sleep Apnea Diagnosed and Treated: No More A-Fib
He strongly suggested I get the apnea diagnosed and treated first—then he would treat the new arrhythmia (PSVT-a milder arrhythmia than A-Fib), if still needed. I did so and was diagnosed with severe sleep apnea (60 apnea events per hour).
Since 2010, I have been sleeping with a mask (now for 1 year) and I feel great – rested and no more arrhythmias. It took me a few months to get used to the mask, but it is worth it!