A-Fib Patient Story #63

Active 64-Year-Old with Family History of A-Fib Gets a CryoBalloon Ablation by Dr. Mazzei Eight Weeks after First A-Fib Attack―Bad Reaction to Diltiazem and Multaq

By Pat Truesdale, Camden, SC, 2013

First A-Fib Attack

Pat Truesdale, Camden, SC

It was the second week in September, 2012, when I had my first A-Fibs. I felt a very scary fast heart rate booming inside my chest. I knew there was something wrong with my heart, but I didn’t know what it was.

I called my primary doctor and got an appointment for Friday, September 17 at 4 pm. The next two days went pretty well, and I was wondering if my call to my doctor was a mistake. But when Friday arrived, my A-Fib symptoms were back. And I was glad I had made that doctor appointment.

I told the nurse what I was feeling, and she immediately ordered an EKG. Soon afterwards, my faithful doctor of decades of care came rushing in with a horrible look on her face and said I was in A-Fib! She knew I lived a healthy life style with plenty of exercise. My routine blood works were always great. She ordered some blood work there in her office, and then she called the local cardiologist to try to squeeze me in for an appointment. But it was too late for afternoon appointments. She prescribed a calcium-channel blocker, Diltiazem, and told me to take 325 mg of aspirin each night. (I was already taking the 81 mg as prevention.) She said Coumadin will be required to help prevent any stroke risks.

Dizzy from Diltiazem, Finding the book “Beat Your A-Fib”

My first weekend was scary, but the A-Fibs did calm down some. After taking Diltiazem, I was having dizzy spells but did not know at this time it was the result of my new medicine. Monday couldn’t come fast enough! I was very scared and didn’t know what I was facing. You can bet I spent hours on the internet searching for answers. This is when I discovered the book “Beat Your A-Fib.” I downloaded it immediately [eBook version]. I quickly discovered this is a fantastic book! I started reading and soaking in all the information l could.

Cardiologist Appointment

My appointment was with a local cardiologist who also had been my parent’s cardiologist during their aging years. I knew him well since I took my parents to him on a regular basis. (I was my parent’s care keeper for the last six years of their lives.) I already knew I would love him as a doctor! His office’s EKG result also showed that I had A-Fib. He ordered several more tests, sent me home with a heart monitor on my body and set up another appointment. He also knew about my healthy life style since his nurse happened to be a good friend of mine whom I played tennis with. She already told him about my active life style of biking, hiking, playing tennis, etc.

I had the heart echo, the nuclear stress test the next week and was back in the Cardiologist’s office. My heart rate monitor showed I had the A-Fibs at a large volume. He said that he knew my parent’s heart history well and said it looked like I had inherited their genes for A-Fib. Since I lived a healthy life style, and all my blood work and the heart tests showed I had a very healthy heart, he thought I had Lone A-Fib. Though he couldn’t be sure. He prescribed that dreadful word, Coumadin. He did discuss an alternative to Coumadin, the newer anticoagulant dabigatran. But together he and I decided on the warfarin medicine, since in case of an accident the anticlotting effects of dabigatran currently can’t be easily reversed.

Dr. Mazzei and CryoBalloon Ablation

Next he told me about Dr. Mazzei from Columbia, S.C. who is now doing CyroBalloon ablation. An appointment was made. I told my cardiologist that I wanted it done tomorrow if he could get it arranged. The quicker, the better! He laughed and said he loved my attitude, that this condition will be fixed but it was a process! They wanted me to be on Coumadin for a few weeks before the ablation.

During the next week, I found myself experiencing dizzy spells which I hated. I had to give up road biking and did more walking.

When I met Dr. Mazzei the first time, I was not too impressed with his personality. But I always made a rule of thumb to not to judge a person by my first impression. In his office I felt an A-Fib attack and let him know. He listened to my heart, looked at me and just said,” Yes, you are.”  I told him about the Diltiazem giving me dizzy spells which he said was a possible side effect. He prescribed Multaq to see if that would help. He was very helpful and considerate. He personally walked with me to get a free sample of the new medicine.

Multaq—Lighting Bolts Shooting Down my Feet!

After lunch, I took the new medicine, Multaq. Within minutes, I felt lightning bolts shooting down my feet! Very scary! These symptoms soon passed, and I thought, “What was that?”  Then within the next 30 minutes, I had an A-Fib attack—a bad one!

The next day I called Dr Mazzei’s  office to tell them of my reactions of this horrible medicine. The nurse told me to take one more dose since it may take a few days for it to be effective. After that third dose, I made a radical decision and stopped taking Multaq! Within 24 hours, all dizziness and all A-Fibs stopped.

The only medicine I took was the Coumadin. I understood the perils of not taking a blood thinner! Strokes!

A-Fib Diary

Within the next few weeks I began to learn what activated my A-Fibs and what helped during my episodes. This was a real discovery about me! I learned that ice drinks, full meals, and caffeine all triggered my A-Fibs. I started a diary to record all my symptoms. lt was really fascinating to discover that my mother’s symptoms were so similar to mine! She would never drink cold water. And when she ate, she ate small meals or took an hour to finish her meal. I never understood all those little things she did. Now I do!

With Steve’s [Ryan] (author of Beat Your A-Fib) suggestion and my local cardiologist’s, I now know I have Vagal Lone A-Fib. This means certain conditions can trigger my A-Fib attacks. This is what I learned triggers my A-Fib:

• Iced Drinks
• Caffeine
• Heavy meals
• Quiet times relaxing
• Sleep time at night
• Medicines
• Blood pressure going up
• Low pulse
• MVP diagnosis when younger? Not proven to be a factor….but who knows?

Here are some symptoms I discovered that are indications an A-Fib is coming!

• High blood pressure
• Belching
• Heartburn
• Frequent need to pee (also ISH symptom—Isolated Systolic Hypertension)
• Low pulse while exercising (A-Fibs never happened during exercise)
• Flutters or skipped heart beats
• Light headache (BP is higher)

Here are some things that help me during my A-Fibs.

• They never attacked me while exercising. But after exercising while I am resting, the A-Fib would occur. But I can’t exercise 24-7!
• Take a tablespoon of Mylanta
• Yoga Breathing
• lf ice water brings it on, ice water sometimes reverts it!
• Drink plenty of water all day
• Blowing into a straw lowers the pulse rate, but does not stop the A-Fib
• Don’t Panic – Have a “This Too Shall Pass” attitude
• Walk around, but don’t exercise since my pulse is too high already
• Take 200 mg of magnesium 3X a day
• Take a B complex vitamin every day

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Ablation Day

November 9, 2012 was my “Ablation” date. I was diagnosed on September 14, 2012, and had to suffer through eight full weeks of my fear factors, of “What ifs.” I tried to get two second opinions before my appointment with Dr. Mazzei. I couldn’t find Dr. Mazzei listed on the Heart Rhythm Society site, though he was listed on Steve’s list at A-Fib.com.  l found that Dr. Mazzei has only been doing these procedures for less than four years. Also, Columbia Heart was a new heart hospital which is only four years old. Neither of the other two specialists (one in Greenville and one in Charleston, SC) could see me before my November19 ablation date. I wanted to get this procedure over quickly. I wanted to start feeling like a normal human being again! So, I trusted my local cardiologist’s choice and had the procedure.

Unfortunately, I am not a very good patient. I hate needles. Since I am vagal, I have a tendency to pass out when a needle is inserted into me. My sister came to be with me this day. I was so grateful to have her support!

A TEE is done the day of the procedure before the ablation to determine if I had any blood clots. If they would have found any clots, they’d either postpone the procedure or put me on blood thinners to get rid of the clots. The TEE was scheduled at 8am, and the procedure was right on schedule. I was scared of this one since it sounded pretty tough on the internet. I assumed I would be put to sleep and would wake up after the ablation was complete. Wrong! Actually, the TEE went very smooth without any anesthesia. I handled this procedure very well! “OK,” I said to myself. “That was easy, so the ablation will be too!”

The hospital scheduled me to be the 4th patient for Dr. Mazzei. My ablation would be around 12:30pm. lf you know anything about being vagal, this postponement is not a good thing. I always knew lots of water helped me to avoid passing out during blood work. Well, this day, I had neither water nor food to eat. I was unconscious during the ablation. The last thing I remember was sitting up in a frigid surgery room while they were putting large patches all over my body. They told me to lie down—and I was out.

Successful Ablation—But Afterwards Blood Pressure Drops

I woke up in my new room after 5pm. The ablation took about four hours. Dr. Mazzei came in and said he got both my flutters and my A-Fibs. Wow! I did not know they could fix flutters! I knew I had them too!

But later that afternoon, things took a turn for the worse. My right groin area showed signs of excessive bleeding. They applied pressure to stop the bleeding. But also my blood pressure got very low. They brought in more needles for blood work. My sister knows about me being vagal and my need for fluids. She requested the fluid be started up again (they stopped the lV right after the procedure). For some reason my blood pressure would not return to normal. My recent blood work showed  my hemoglobin had dropped indicating I was bleeding internally somewhere. Tests, scans and monitoring went on all night long. Neither my sister nor I had a wink of sleep. And my blood pressure stayed very low during the whole night.

Tuesday morning, my very caring Dr. Mazzei reported to me about the low hemoglobin and said he needed to keep me another night. My INR was way up also. Happily the tests and scans showed that all was normal and that there was no internal bleeding. Dr. Mazzei decided to keep me under observation for one more night to make sure I was OK.

Wednesday morning I had more blood work done. When Dr. Mazzei came in, he reported that my hemoglobin and INR were back to normal. He said the lab must have used the wrong blood! There was no way my INR could jump over night like that. I could now go home!

Recovery

Recovery was more a shock to me than I thought. I was worn out! Dr. Mazzei said it would take about a week. No tennis or weight lifting for 5 days. Walking will be fine! My first walk was about a block. The breathing hurt in my chest. I now understand what the symptom “short of breath” means to a heart attack victim. It’s not a pleasant experience. This uncomfortable pain stayed with me over a week. I was getting panicky, but one of my support pals e-mailed me and said that his chest discomfort lasted over 2 weeks.

( I believe support groups are very important. The support I received gave me a sense of belief that I would be OK and could be fixed! I send many thanks to all those who shared their experiences with me either by e-mail or their stories in Steve’s book.)

Day: 14 Recovery: l feel like I got “Me” back again. I am walking 2.5 miles every day and back to playing tennis! I do not have any “shortness of breath” or chest pains from the ablation now! I still have to take the Coumadin while I am under the three months of the ablation healing. I still wear my personal heart monitor to check my pulse once in a while, since I still have the small fear – “ls it back?” But, thank heavens, it is not! I do have a few skipped beats, some flutters, but none of those scary fast heart rate beats.

Message

Just want to say to all those A-Fibbers out there! Steve is right! There is a cure! Find yourself a great doctor and get it fixed! The enjoyment of living a fearless life with no A-Fibs is a miracle in itself!

Pat Truesdale
Camden, SC, USA
Email: truesdps(at)yahoo.com

Editor’s Comments:

Pat probably has set a record for getting cured of A-Fib in the shortest time. She was cured after only eight weeks of being in A-Fib! But she was very symptomatic and could not tolerate different meds.

Not so long ago it was common practice for doctors to require patients to have tried and failed two antiarrhythmic drugs before they could have an ablation. Happily those days are over. No longer does someone in A-Fib have to spend months in agony, discomfort and fear. Current guidelines recognize catheter ablation as a first line therapy for treating A-Fib. 

Pat’s diary of her A-Fib triggers is not unusual, especially for people with Vagal A-Fib, though not everyone will be affected by the same triggers. But the symptoms she describes as predicting or forewarning of an A-Fib attack are new and very insightful. They may be very helpful to other A-Fib patients. (Thanks, Pat.) Her list of things that helped her get through A-Fib episodes may also be very helpful to others.

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Last updated: Monday, May 25, 2015