Unexpected Cardiac Ablation

I was only meant to go for a consultation but things turned and a heart ablation was on the cards.

Photo by Piron Guillaume on Unsplash. Example of operation theater.

My heart went out of rhythm 5 times last year. The first one was on 6 January 2020.

I don’t smoke, not overweight, do not misuse alcohol, and don’t have high blood pressure.

But I was born with Tetralogy of Fallot(TOF). And I have had a long heart journey.

I had 4 cardio versions last year.

All of them were for atrial fibrillation (AFIB)and I felt blessed that my heart cardioverted after the joules were administered.

Some of my cardiologist’s comments.

“Every time I cardiovert you I’m surprised to see that your heart goes back into normal sinus rhythm” Well this year it stayed in rhythm for only a few months at a time and then went back into AFIB. My longest AFIB free run this past 20 years has been 4 and a half years.

“You are a sitting duck for a stroke” Because atrial fibrillation patients are 5 x more likely to get a stroke.

By the grace of God, I’ve had a full life and actually a very blessed life.

The test.

After four cardioversions during 2020, I experienced a “strange” heartbeat in October 2020. It felt different than the previous AFIB episodes.

It started with a high average resting heart rate. Because I’m on a beta-blocker my average resting heart rate is in the ’40s, most of the time about 43–46 bpm.

Monday morning I saw my resting rate was in the ’60s. The real “test” was the one set of stairs at my office. I usually am so relieved that I’m never struggling with the stairs. The people with knee, hip, and weight problems do not moan or say anything, but I hear that they don’t enjoy it based on their heavy breathing.

I usually then say a silent prayer “Thank you Lord that I am healthy and fit despite my heart issues”.

The stairs put me into 124 bpm. Usually, this activity, which I don’t even consider as exercise, takes my heart rate no higher than 86 bpm.

Resting heart rate and a tick.

My ave. resting heart rate later that day stayed at 72 bpm. I started thinking about the causes. I was confused because I was on Arycor an anti-arrhythmic drug and bisoprolol a beta-blocker. They are supposed to keep my heart rate low.

Tick bite? I live on something like a small farm. Very small. But we have ticks and they attach to one of three cats or three dogs. We do take precautions and for the most part, the pets are “clean”.

We give them bravecto chew’s(tick repellant), “tick powder”, “flee and tick drops” and check them almost daily. But the ticks are relentless and I found one on my back. It bit me on my back (euw).

I was happy that I made a professional diagnosis and thought that I would just go to the doctor to confirm my diagnosis. She confirmed that it was not the tick bite. It was not one of the symptoms and it was too soon after the tick bite.

So what?

2020 = Covid 19.

The doctor was not sure about what the problem was. She confirmed that my heart rate was high. She suggested that we start by eliminating possible causes. Because covid-19 presented in so many different ways she suggested that we start by eliminating it.

I did not do an ECG at her office.

I went for the covid-19 test and it came back negative early the following morning.

Now what?

I figured that because I was scheduled to go to my Electrophysiologist (EP) on Thursday it would be best if my cardiologist knew about my elevated heart rate. Maybe it was something he could help with or something that he had to know.

It felt like my heart was fast but not out of rhythm. Or so I thought.

It must have been one second after the clinical technologist hooked me up to the ECG machine that he broke the words. Your out!

It’s atrial flutter! Not atrial fibrillation. But it was out.

In atrial fibrillation, the atria beat irregularly. In atrial flutter, the atria beat regularly, but faster than usual and more often than the ventricles, so you may have four atrial beats to every one ventricular beat.

I was used to atrial fibrillation(AFIB) not atrial flutter. In my personal opinion, both suck! This is the stage that my hectic began to pick up speed.

Cardioversion

Cardioversion is when they shock your heart, back into rhythm, by administrating some joules.

Luckily I already did my covid test and was scheduled to be booked into the Mediclinic in Bloemfontein (my hometown)the next day.

While I was sitting at admissions waiting to be booked in, the office of my EP in Pretoria phoned and said I must cancel. They want me as is. Out of rhythm and all.

So I had no cardioversion in Bloemfontein.

Consultation in Pretoria.

That is what I thought. The EP had other plans. He wanted to see me in Atrial Flutter because this would help him with his treatment options.

He wanted to do an ablation on me. This, I heard the day before he wanted to do it. As I later heard he had a cancelation and I was due for a tune-up of my heart-timing!

Wednesday night I had to drive the 450km (279miles) to Pretoria.

Ablation of the heart.

Thursday morning at 06:00 I booked in at the Zuid Afrikaanse Hospital in Pretoria. My wife was not allowed to go further than the steps. She left me at the entrance -Thanks Covid!

I took my time and was captured by the beautiful green courtyard, taking pictures and videos. Here are the results of the few pictures and videos I secured for posterity.

I wasn’t there as a tourist and the nurse who had to book me in reminded me of that immediately. I had to be ready for surgery by 07:00. Things moved very swiftly from there.

I changed into a beautiful hospital gown, saggy underwear, took off my ring, received a few hospital wrist bands, and got a shave! You know where. Then you know something is going to happen here.

The final step in securing your fate is when they wheel you to the theatre. Panic and fear? Just a little bit. I know you cannot compare cardioversion to ablation but I’ve had 4 cardioversions this year so I was used to this hospital episode by now.

But little did I know that the cardioversions were a forerunner for this ablation. Anybody will tell you that cardioversion is nothing compared to an ablation………

Updates to follow.

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