Five weeks post-maze

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Posted by Ken Willis on June 29, 2002 at 20:19:40:

It's been very interesting reading about the highly varied experiences of people who've had the maze operation. This forum is such a valuable source of real-life experience for those who are afflicted with afibs and are looking for the best solution to their problem that I thought I'd add my own post-maze experience to the others so afibbers would have one more data point in their overall picture of the procedure.

I had a maze operation on May 23rd, 2002 at the Cleveland Clinic by Dr. McCarthy for drug-resistant, ablation-worsened, atrial-pacemaker resistant afibs. I'm a 57-year old man with no other noteworthy medical problems. The procedure went well and my hospitalization was relatively uneventful. I had a headache (probably from my position during surgery) that was easily treated with pain meds, some nausea that kept my appetite down, and a low hematocrit and reduced lung capacity that combined to put me on oxygen for a short time and in the hospital an extra couple of days (I got out on day 7). I didn't detect much incisional pain or any other pain at all. I was in NSR and paced at 90 by my dual-site atrial pacemaker. My wife and I were incredibly impressed by the staff and facility at the Cleveland Clinic and felt that I received the very best care available anywhere. I left the CC in NSR and without any antiarrhymic drugs (though I was on 25 mg. of atenolol).

For 16 days I remained in NSR, but then every other day I started getting afibs lasting about 2 hours that morphed into atrial flutter for another 10 hours or so. My local cardiologist started me on 150 mg. Rhythmol twice a day, and that drug reduced the frequency and duration of the episodes and also allowed me to terminate the afibs by exercising, which gave me a feeling of some control. After about a week, things changed, and I no longer got afibs, though I did keep the flutter. The arrhythmia was extremely weak and easily converted to NSR after a couple of hours by just moving around. My last episode on June 26th was just barely out of rhythm and didn't even feel as disruptive as flutter. Twenty minutes after taking my morning Rhythmol tablet it was gone. The trend is clearly toward no more arrhythmia.

For several weeks my exercise tolerance increased at a phenomenal pace because, I think, I'd been building back the red blood cells popped by the bypass machine. I think that progression is basically over because I feel I now probably have a near-normal hematocrit. I walk uphill for exercise because it has excellent crossover value for backcountry skiing, hiking and climbing. Each day I would beat my previous day's time by a matter of minutes at the same level of effort. On June 22nd I started doing my usual course of 1 3/4 miles and >900' elevation gain (and back again), and am now within about 5 minutes of my usual time without pushing nearly as hard as I used to to achieve that time. It feels very good. My wife and I have gone on several hikes in the mountains of up to 8 miles and all with about 1,500' elevation gain, and I feel good and not particularly tired afterwards. The only thing fatigued have been my feet. On a perceived exertion scale of 0 to 10, I have never exceeded 7 since my surgery. I don't plan to push my aerobic threshhold the way I routinely used to do because I'm afraid that perhaps that stretched my atria and brought on my afibs in the first place. I feel very lucky to feel this good. The reports by Ed, Anders, et al have been very inspirational to me, and I hope that I can more or less follow the trail that they have blazed.

Side note: Atenolol has always had a negative effect on my exercise tolerance, but since maze surgery its strength-sapping effect has become really magnified. I have to make sure that I don't take it within about 8 or 10 hours of when I want to exercise.

The only reason for offering up this much personal information and perspective is to give folks considering the maze one more real-life story to use in reaching their own decision. I clearly have not reached a stable endpoint on either my arrhythmia or my rehab, but at this juncture I'm very encouraged on both points. I'll keep the forum posted of any major changes.

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