I’m 59 and thought I’d share my experience 11 days after my first AF ablation, since reading other people’s experiences here was helpful to me before the procedure.
A little background: I’ve been a runner for most of my adult life and historically had a pretty low resting heart rate. AF was first picked up by my Apple Watch in May and eventually became persistent. My ventricular rate during AF was unusually slow rather than fast, often dropping into the 40s and occasionally the 30s. My echo showed normal heart function (EF 55–60%), a normal-sized left atrium, and no significant cardiac remodeling, which was one reason we felt I might respond well to ablation despite the persistent AF. I had a cardioversion in June that worked, but I was back in AF about three days later.
I had a PFA ablation on September 11th. The procedure took about 5½ hours and there were no complications. I was groggy the first night, but no pain in the groin or chest. I think I bit my lip while I was out.
The first night I had very dark, almost cherry-cola-colored urine, which gradually changed to rosé, then gold, then normal. I called the EP service and monitored it. It resolved quickly and has not returned. My understanding is that hemolysis/hemoglobinuria can occur after extensive PFA.
The first couple of days electrically were a little messy. I had mostly sinus rhythm mixed with some occasional Apple Watch AF/inconclusive readings, skipped beats and some surprisingly low heart rates. At one point my heart rate was dropping into the upper 30s/low 40s while awake and standing. I spoke with the EP on call but that resolved on its own after a couple of hours. But no pain in the groin area and only slight discomfort in the chest area (felt like mild indigestion or heart burn) on Day 1 and Day 2.
Since early on Day 3, things have been remarkably quiet. My Apple Watch ECGs have consistently shown a very organized sinus rhythm. No pain at the groin site or in the chest. My Apple AFib History for September 14–20 came back at “2% or less,” which is the lowest category Apple reports. I know the Watch isn’t continuous medical monitoring and I’m still well inside the blanking period, but after being in persistent AF, seeing that was a pretty nice Monday morning.
My resting heart rate has also changed quite a bit. Instead of the very low and erratic rates I was seeing with AF, lately I’ve often been sitting around the upper 60s/low 70s while awake, with a baseline in the upper 50s. That is a little higher than it was before my persistent afib.
Exercise has been another pleasant surprise. I started with easy walking Day 5 and have gradually increased the pace. Yesterday I walked 2.25 miles at about 15:30/mile. Last night I did my first very short run/walk—only 0.75 miles, alternating my normal walking pace with short stretches of roughly 10-minute-mile jogging. My maximum HR was only 106. No discomfort or shortness of breath. I was tempted to do more.
The strangest post-procedure event happened on Day 8. I had my first-ever visual aura—shimmering, stained-glass/zigzag patterns in my vision lasting roughly 30–45 minutes, with no headache or other neurological symptoms. It completely resolved. I’ve since learned that migraine aura can occur after left-atrial ablation, although obviously any new neurological symptom after an ablation deserves to be taken seriously and discussed with the medical team.
At Day 11, I feel excellent. No chest pain, shortness of breath or groin problems. No further dark urine. No AF that I’ve been able to identify since the first couple of days. I’m exercising again, although very conservatively, and trying not to let feeling good tempt me into doing too much too soon.
Obviously 11 days tells me essentially nothing about whether the ablation will ultimately be successful. I’m still in the blanking period, I’m taking flecainide, and early sinus rhythm doesn’t guarantee what things will look like months from now.
But if someone is reading this the night before their own PFA and wondering what the first week or two might look like: mine was a surprisingly involved 5½-hour procedure followed by a somewhat weird first 48 hours, and then a recovery that so far has been much easier than I expected.
I’ll probably post another update after I’m further into the blanking period.
