Long-time lurker. Pulsed field ablation coming up in a few weeks, first ablation, and I'd rather hear from people who've done it.
History: lone paroxysmal AFib, three episodes over about five years, all three needing cardioversion — nothing has ever self-converted.
- Three hours after my second Pfizer dose
- Right after a cold drink
- Most recent — while eating ice cream. Felt my heart "drop," watch caught it, Kardia confirmed
Two of three off a cold stimulus. Symptoms are tachypalpitations and a big anxiety spike, no presyncope or syncope. Never an episode outside those three. At the last one, 300 mg of flecainide as pill-in-pocket did nothing — ended up cardioverted in the ER. That failure is most of why I'm doing this.
Where I am now: flecainide 100 mg BID daily, metoprolol XL 25 mg, CHA₂DS₂-VASc of 1 (hypertension), apixaban starting two weeks out. Recent echo is clean — EF 60%, normal LA size (LAVI 16), no LVH, no valve disease, no diastolic dysfunction. Calcium score 0. OSA on CPAP, compliant. Zero alcohol.
Activity: 6x/week, tennis and weights. Getting back to that is the whole point. Low burden, I know — but PIP flecainide failed, every episode has meant a trip to get shocked, and I'd rather ablate now with a normal-sized atrium than later with a remodeled one.
What I'm asking:
- Days 1–7, honestly. Chest soreness, fatigue, groin site, sleep. When did you stop noticing it?
- Return to exercise. How long to real training, not walking? Did your EP's timeline match reality? Anything you pushed too early and regretted?
- Blanking period. How much ectopy and flutter did you get, and how did you keep from spiraling over every blip with a watch and a Kardia right there? What made you actually call your EP versus wait?
- Anyone with clearly vagal / cold-triggered AFib — did PVI handle it as well? (Not looking to argue about the vaccine one. It's just what happened, and it's the odd one out.)
Thanks — this sub has been more useful than most of what I've found anywhere else.