Return to cardiology looming

I am not sure of when my appointment with my cardiologist will be, but it should be at some point in the first three weeks of April.  I will have a TOE (Trans-oesophageal echocardiogram) to check that the LAA closure has properly healed along with the usual ECG etc.  I suspect that this may involve two visits.

As I am now feeling much improved and have not had any AF-like symptoms since New Year’s Day, I have decided that it would be appropriate to notch up the exercise level slightly.   If it gives me a problem, it would be better to happen before my scheduled appointment rather than after.

The singlespeed is now going to be mothballed in favour of my Bianchi (winter bike fitted with mudguards) which means no more canal banks, instead, I will be back on the road.

I managed 28 miles on Saturday and 34 miles on Sunday.  I headed out east to avoid the steep hills of the Peak District and was taking it steady, with no sprinting and I was sticking to the small ring for most of the ride.  In fact, I was in the bail-out gear on some of the relatively gentle slopes, but still managed total climbs of 1800 and 2150 feet respectively.  I generally felt quite good, and progress on the flat was brilliant, but I think the hills were a struggle due to a general lack of fitness rather than heart issues.

Interestingly, I last did the Sunday route in July 2017, when I felt recovered from my first ablation.  Even though this was in nice weather with my best bike and summer clothing, I was still ½ a mile faster on average yesterday.  I think this bodes well for my future recovery.


No longer snowbound

The heavy snowfall between 27/02 and 02/03 had kept us relatively housebound, so no exercise except for a snowy walk around the woods on Saturday.  I am certainly missing the bike.

The last of the snow melted yesterday and temperatures are now a balmy seven degrees in the sunshine.  As I am now five weeks post-ablation and feeling pretty good, although unfit, I think I can nudge the cycling up a notch.  Nothing too ambitious, but I will get the Bianchi out for a few trips on the road; this should also keep me cleaner than the canal paths.

Slightly recovered

In the morning, I felt slightly better, but cancelled my meeting in Barnsley later in the day and in London the following day.  I managed to work from home in my small office, but downstairs was too cold for me.  It seems that the indigestion followed by flu like symptoms were fairly common locally.  I feel quite pleased, It’s not related to my AF after all.

More indigestion

It is now Sunday, eight days after the indigestion started.  If anything it is now worse than before. However I decide to attend the BC training day.  On the way back from Nottingham I called in to see my mother who is surprisingly cheerful.  Half an hour after returning home, I felt terrible; freezing and sweating at the same time, just like flu.  I went to bed very early after not eating.


I have been experiencing indigestion/reflux for the last week.  This should be potentially worrying to heart patients due to the symptoms: pain in the chest, particularly when breathing in, which mimic the symptoms of heart attack.  However, I recognise the feeling from a bout I had several years ago, related I think to a gall bladder infection. The feeling was similar to this and not as bad as the opiate induced reflux from last year.  A quick check on the Kardia confirmed a normal heart rate albeit with a few ectopics.

I decided this was nothing to worry about and perhaps needing to rethink my diet (too much fast food recently) if it is not gone by the end of the weekend, then I may call the arrhythmia nurse.


Looking back, and forward

Over the last year of treatment there have been a number of false dawns; on several occasions I received a form of treatment and declared myself so much better, sometimes almost claiming to be back to normality.  This happened after the successful cardioversion, a few weeks after the first ablation and immediately after the second.  Each time it took a short while to realise that these were just an overreaction to a slight improvement or perhaps even self-delusion.  Confusingly, the first treatment step that did not leave me feeling instantly improved was the removal of Beta Blockers which was the one thing I expected to give a magical change.

The run-up to Xmas was tiring, in spite of me using saved holidays to reduce my last month at work to a number of two- and three-day weeks.  The two and a half weeks of rest over Xmas certainly helped.  I have been feeling greatly improved since January started (with the exception of New Year’s Day) and have not regressed.

This week was my first real test.  I had a busy day in the office followed by a trip to London, which involved parking at Luton and getting the train in, arriving at the hotel in the Barbican at 8:30 p.m.   After an 8:00 a.m. start in the morning, a long intense meeting finished at 4:00 p.m., after which I returned to Luton.  I then drove to Norfolk, stopping for food on the way and arriving at 8:00 p.m.  This was followed by another 8:00 a.m. start delivering a pilot environmental course to our teaching and support staff.  I had planned a 4:00 p.m. finish, but I was not sure exactly how long the exercises and discussion would take.  It finally finished at 5:10 p.m., leaving me to tidy up and drive the 120 mile back home.  None of this was any problem, but would have nearly killed me physically and mentally two months previously.

On the bike recently, I had noticed that the small inclines on the canal were not impacting on my HR as before and my rested pulse is also starting to trend downward.  Bad weather and too much work away from home has kept me from putting my health to the test with further exercise over the last two weeks, but this time, I think that I can finally say that I am on the road to a proper recovery.  The weather is still atrocious, but I will attempt to get out for a few walks and rides, not pushing yet, but working steadily towards improvement for the summer.


Heart rate

I have been taken readings of my HR  while relaxed.  This is not my resting HR, which is lower, but a standard reading taken around the same time each evening while sat watching TV.

HR relaxed

The slight rise in Oct 16 seems to correspond with my cardioversion.  I am not sure why there is a blip in Feb 17 prior to my 1st ablation; I don’t recall anything unusual at the time.  I also don’t understand why my HR rose steadily after the first ablation and then fell before rising again at the end of June; I expected it to rise immediately and slowly get back to normal.  There does seem to be a similar response after the second ablation with a gentle rise over the first six weeks.  The elimination of the beta blockers caused a significant sudden rise, but there seems to be the expected slight downwards trend since then.

100 days of recovery

It was 100 days post ablation on Saturday 13th.  I am all but signed off by the Cardiologist, but still apprehensive about trying to get back to normal.  I am currently exercising fairly regularly but I am still in the blanking period, so keeping my HR to a peak of 160 (generally averaging 140 during exercise).  I am doing similar distances at a similar level of effort as I was at the same time period after the first procedure.  I am ½ mph slower, but then the weather is much worse and the ground is wet and energy sapping.

On Sunday, I tried the road bike for the first time in a year.  It was nice not to get muddy, but I did feel restricted on the hillier parts.  It wasn’t a problem going uphill with a 36 x 28, but my progress was slow.

I am about 5Kg heavier than six months ago, mainly due to reduced exercise and indulgence in comfort foods; ironic considering I haven’t been drinking. I now need to get back to a reasonable level of fitness, without risking a return to AF.

Three month review

I did not have an official review three months after the second procedure as the Cardiologist did not think it was necessary after my six week review; my next visit is in April, which will unfortunately include a TOE to check the Atriclip.

Overall, I am much improved on how I was two years ago, and am far better than I ever expected or even hoped for.  I don’t actually feel any better after the second one than before it, but the EP had severed re-connections on two of the pulmonary veins and dealt with Atrial Flutter so there must have been a further improvement.  The biggest bonus is no longer being on the drugs; no need to take Anticoagulants because of the Atriclip and no need for the bisoprolol as the AF is no longer present

I have tried alcohol; no effect from one or two units, but got a little carried away on New Year’s Eve and regretted it.

My current resting HR is around 90BPM, compared with 57BPM before I went into persistent AF.  I am not sure how much of this is due to inflammation and how much is a drop in fitness level.

I am still struggling for fitness; I am not pushing too hard on the bike, but I am still slow and walking is more of an effort than it should be.  I will continue light exercise and see in April what the views of the cardiologist are on my steadily increasing my efforts.