It is now exactly three years since I realised that my breathlessness and general lack of fitness was not related to aging, but due to a medical problem. I made an appointment with the Doctor, but could only get in to see a practice nurse, and had to wait four weeks. A few days prior to the appointment, I developed a noticeable persistent arrhythmia. I was referred for an ECG and told not to exercise.
After a month (and some considerable chasing) it was confirmed that I had AF. I was called in for a full blood count and put on the waiting list for an echocardiogram. This took place in June 2016 and confirmed that I was in AF and that my left atrium was significantly enlarged (37 mls/m2 compared with a healthy max of 28)
Another month and I saw the cardiologist (luckily, he was an EP). I was put on Bisoprolol and Rivaroxaban. At this point, my symptoms worsened; I suspect the Bisoprolol was the cause, rather than any progression of my AF.
I had a successful cardioversion in October 2016, although it only worked for a couple of weeks; it felt marvellous while it lasted.
In November 2016 I saw the cardiologist (not the EP this time). The treatment plan was to be another cardioversion, this time supplemented with flecainide, followed by a referral to Sheffield for an ablation. I was more than happy with this.
In January 2017, I met the EP who suggested that I was a suitable candidate for a medical trial. The treatment was in two stages: First a Mini-maze; entry made through the chest wall, the atrial appendage clamped off and a scarring pattern made on the outside of the heart. This was followed six months later by a catheter ablation on the inside of the heart that completed the maze box set, a CTI line for flutter and cleared up any rogue signals. In between, I was amiodarone for six weeks to stabilise me.
The Mini-maze, in April 2017 was rough; it took me quite a few days to get over and three weeks before I was able to go back to work. It was pretty successful, My Kardia said I was in AF for a lot of the following week and I had some minor arrhythmia over the next few months and ectopics which are symptomless; I took regular Kardia readings, but the cardiologist said they were nothing unexpected or untoward.
The Amiodarone caused no problems except for a scorching summer clad in long clothing, hats and factor 50.
The catheter ablation in October 2017 was a doddle: it was done under GA and I missed all of it. Immediately afterwards I was full of life and felt 100% recovered. I came off all medication in November 2017.
I took it easy throughout 2018; I exercised, but kept to sensible limits. I returned to club cycling in September, but with the beginners’ group rather than the racers. I am still taking it steady with the social group, not wanting to risk my recovery. I am definitely enjoying life.
I still have a few bouts of ectopics; some of which confuse my Kardia into unclassified and the occasional AF diagnoses, but generally I have been in good health and I have been in NSR 99.99% of the time. The cardiologist in charge of the trial suspects a 80% success rate over 20 years (i.e. no significant AF in that time) I think this is probably overoptimistic, but am very pleased with the treatment.
See below for my current ECG.