Adventures of A Racing Heart - Cardiac Ablation number 2 (APRIL 2021)

Cardiac Ablation 2

I’d hoped to go into this one very fit, but in the event three bouts of AFib (and two DCCVs in the previous 50 days) on top of the ‘fatigue’ all through February put paid to that plan.  I was only given four days’ notice of this procedure, which meant only four days of worrying.  Due to Covid-19 restrictions, once again, Hubby dropped me off at Royal Papworth Hospital in Cambridge early on the morning of Monday 26 April 2021.  I was well prepared from the first time and so I took my tablet, mobile phone, glasses, books, water etc etc as well as my drugs and overnight stuff – just in case. 

The new Papworth hospital looks like a spaceship and the facilities are second to none.  I had a private room with glass doors to keep the noise out, a window overlooking the centre courtyard and a private shower room.  For some reason, I had thought I would not be treated later in the day and settled down with a book that I couldn’t concentrate on ready for a long (and hungry) wait!  Therefore, you can imagine my surprise when the nurses told me I would be going down at 10 am!  This time, they would use radio-frequency and it would be a General Anaesthetic.

The Electrocardiologist, Dr M, came to see me and gave quite a gloomy account of what they planned to do – he said that if they couldn’t work out where the “electric signals were leaking” (my description, not his, by the way!) then they would just burn some straight lines across the atrium and hope that did the trick. 

He hoped that, at least, that would make me easier to chemically cardiovert in future episodes of AFib.  To say, I was disappointed would be a colossal understatement.  I signed the consent booklet but didn’t read the risks – I was quite scared enough already without adding to it!  He explained that this time it would be under general anaesthetic this time and that it would take a lot longer – about three hours.

In no time, the porters (and a brief aside here, aren’t porters just the loveliest people, they always realise how scared you are and have a nice chat to calm your nerves and remember to reassure you and wish you well – great blokes – not being sexist but they have always been men in my experiences).  A short wait before I was admitted to the Cath Lab.  It is always so cold in the Cath lab, I wonder why.

The anaesthetist introduced himself and asked me the usual questions and I told him that I was worried (as ever) that I would get a nosebleed due to my HHT and nobody would realise and I would choke (I know this is completely irrational and I sometimes wonder if I only worry about this because it is easier than worrying about the scary idea of someone meddling around inside my heart?).  He reassured me and the many other staff bustled around asking me my name and date of birth and why I was there whilst sticking icy pads to me and inserting a catheter into my left hand.  A nurse appeared at my side and said that he had heard me worrying about my HHT and reassured me that HE had worked at the Royal National Throat Nose and Ear Hospital in London (where I have been treated on many occasions) alongside Professor Lund (the patron saint of HHT) and he wanted to reassure me that I would be okay.  How flipping nice is that!  Everyone is so kind.

Then, I was given some ‘liquid’ into the hand, told to think of something nice and slipped gently away.

It’s always difficult to know how long you are asleep for in these circumstances (for example, after my DCCV at Addenbrookes they said I was only out for about seven minutes, yet it felt a long time) and it took me a long while to surface into some form of consciousness. I remember the recovery room nurses were discussing their local gym which was run by the same company I work for.  I was desperately trying to wake up so I could tell them that NHS staff got a discount, but I couldn’t manage to speak! When I finally became more human, I did get to tell them and I remember asking the time and being shocked it was 4 PM!  Six hours had passed!!

Eventually I was taken back to the ward, but I was still very zombie like and couldn’t manage to text my Hubby or drink or read or any of the things I had planned – instead I just laid in a zombie state for a long while.  Dr M came to see me and he was in a good mood. He gleefully informed that there had been “loads to do”, which is why it had taken a lot longer than expected, and detailed how they had had to reburn around two of the pulmonary veins which had been done last time as they had not scarred in the correct way.  He then airily explained that they had “tried to put you into AFib” and only managed a “bit of flutter” so they had done some extra burning there too.  I asked how on earth they manged to put me into AFib and he said “Oh, we just speed the heart up and force it into AFib” in the same sort of relaxed way we might describe putting on the kettle.  And it turned out that they finished off by DCCVing me back to NSR! Anyway, this all meant he was quite optimistic about the operation’s chances of success.

The nurses came round and sat me up at some point after that and immediately I began to feel faint.  Suddenly all the alarms went off and I glanced up at my HR on the screen to see that it was reading ZERO in bright red.  I calmly thought to myself “Darn, I thought I might die during the operation, but I didn’t expect to die afterwards”.  Funny how your mind works…  Meanwhile the nurses were running around in full emergency mode, affixing defibrillator pads to me, positioning the emergency defibrillator in my room and running an ECG.

Obviously, in the event, it was just a blip as I didn’t even go unconscious. Dr M came to see me later and casually said, “I’m not worried”.  To which the only reply had to be “I’m glad you aren’t coz I am terrified!” which made us all laugh.  He explained it was the combo of the General anaesthetic, the high dose of flecainide and the trauma of the surgery.  He added that there was no need to worry as if it happened again the alarms would go off again and the nurses would see to me!!!!! 

Therefore, I was obviously kept in overnight for observation and left about 10-11 am the next day.  Hubby was very relieved not to have me home on the same day after that little bit of excitement!

And, just for devilment, I asked Dr M how long it would be before I could run (knowing full well it was five months last time) and he suggested three weeks!  Another example of the TTRMP vs TTRRL.  I’m currently at one month and cannot even walk more than half-a-mile yet!

 

Terminology

Addenbrookes            Huge teaching hospital in Cambridge.

Atrial fibrillation (AF or AFib) and Atrial flutter (AFl)                                                               two different types of heart arrythmias.

 Bpm                             Heart Beats per Minute

DCCV                            Direct Current Cardioversion. 

Basically, they stick pads on you and zap you with electricity.  This stuns the heart so much it stops beating.  Hopefully, it then restarts beating (otherwise you are in BIG trouble) and, better still, it beats with a proper rhythm (NSR).

Electrocardiologist    specialists in the electrics of the heart (think electrician to the normal cardiologist’s plumber!)

Flecainide          an anti-arrythmia drug.  A major side-effect is its tendency to cause further arrythmias.  One of the only drugs I seem to tolerate well. 

HR                       Heart Rate

NSR                     Normal sinus rhythm - what most people have! It's doing what it should, a nice regular lup-doop sound.

Papworth           Royal Papworth Hospital in Cambridge.  The UK’s premier Heart and Lung facility.

TTRMP               I made this up!  Time To Recovery Medical Profession 

TTRRL                I made this up too! Time To Recovery Real Life!