Heartburn

After having a successful electro cardioversion treatment in 2020 to fix a persistent irregular heartbeat, the condition returned in February of this year, 2024. This was probably due (according to my cardiologist) to my first bout of Covid-19 in January. 

Only this time, instead of an arrhythmia called atrial fibrillation, (which occurs in the left atrium), it was atrial flutter (of the right atrium). This was accompanied by an abnormally high heart rate which leapt from about 45 to over 135 bpm overnight and eventually settled to around 124 bpm (about the same speed as the Danny Dove Radio Edit mix of “After The Afterparty” by Charli XCX featuring Lil Yachty). Which when experienced continuously all day and night can become completely exhausting, normal range being between 60 and 100 bpm.

The flutter had a more debilitating effect on me than the fibrillation did. Apart from the constant palpitations, being unable to lay on my left side, there was the constant fatigue. I went from someone who walked three or four miles every morning before breakfast, to someone who couldn’t walk up a flight of stairs or a hundred yards up a slight incline without stopping to catch my breath. 

Neither flutter or fibrillation are life-threatening in themselves but they increase the chance of stroke, and left untreated they will ultimately lead to heart failure. So, not great. In July I had a second cardioversion – an electric charge applied to the chest to shock the heart back into regular rhythm – which again was successful. But cardioversion is only a temporary fix as the arrhythmia can return at any time. I was lucky that I had had four years symptom-free, but the consultant suggested that I now required a more permanent fix.

So I was offered a procedure called cardiac ablation, with a 90% to 95% chance of it being a permanent cure and only a 1 in 500 chance of death, stroke or some other severe complication. Death being the most severe. Cool beans. I was duly booked in for the procedure for September 19th 2024.

Cardiac ablation is a slightly more invasive treatment than cardioversion; a catheter is inserted into a large blood vessel (in my case, the groin) and fed up to, and inside the heart, guided by a combination of x-ray and ultrasound and a live 3-D imaging system. Fine wires are passed through the catheter to the heart to either burn areas (using high energy radiofrequency) or freeze areas (using cryotherapy) inside the atrium to create scar tissue that blocks the rogue nerve signals that cause the arrhythmia. All while you are sedated but conscious. Not scary at all. 

Fortunately they give you drugs – in my case midazolam – as mild sedation (which is both a psychedelic and produces amnesia) and the painkiller fentanyl (yes, that one that’s up to 100 times the strength of heroin). I’ve had a pleasant relationship so far with midazolam (which I’ve enjoyed during both cardioversions and an endoscopy) as the amnesia effect doesn’t entirely remove the memory of trippin’ balls.

All this took place in the cath lab – a state of the art operating theatre – in Basildon hospital. I was walked into the theatre by the nurse so I got the full reveal – a large, darkened room, with a consultant, a doctor, a physiologist, an anaesthetist, a radiologist and various nurses all efficiently buzzing round in scrubs and masks. There were glowing rectangles on monitoring equipment covered in knobs and switches, hooked up together with neatly bundled cables, hulking pieces of expensive-looking equipment on articulated swivel arms, all hanging from a central track, and a cinema-worthy flatscreen ready to cast the image of my heart in real-time 3-D. It looked like something out of a Black Mirror episode, but with a bigger budget. “All this for li’l ol’ me?” was the first thought that entered my head. 

Then there were the backlit panels embedded in the ceiling directly above where I lay, serenely casting ambient light into the theatre, depicting a tranquil scene of summery sky and treetops, while at the same time being rather worryingly reminiscent of the thanatorium scene from Soylent Green.

I was attached to a heart monitor with various sticky pads and cables, and much larger, metallic pads stuck to my back and chest, so that very little flesh remained uncovered on my upper body. The massive x-ray machine was positioned over my chest, and my pre-shaved groin was cleaned with antiseptic. Then the drugs were injected into the cannula in my arm, and from there my memory gets fuzzy (if very colourful). Although doped up, I did feel (and remember) some “mild chest discomfort” (as the pre-procedure literature puts it) and I let the medical team know by shouting “Fuck, that hurts!” every time the radiofrequency ablation device buzzed away. Although in truth, it probably felt more like sharp indigestion than someone burning little lines on the inside of your heart. Whatever that feels like.

Despite my deranged exclamations, I was soon in recovery, having a tuna sandwich, my first food in about 18 hours, and I was out of hospital and home by 10.00 pm on the same day that I was admitted. The procedure appears to have been a success and only having to take the occasional paracetamol for mild pain for a couple of days afterwards. It will take eight weeks or so for the scar tissue to fully form and hopefully prevent any further flutter, but so far, so good. There’s always a possibility that my other ventricle might get jealous and that I’ll need a slightly more complicated procedure to have matching scars imposed, but my regular medication might keep that at bay indefinitely.

Finally, I have to say that I wouldn’t have had this life-extending, quality-of-life-improving procedure if it wasn’t for the UK’s free, nationalised health service. This is what socialism looks like in the 21st century. Yes, it did take six months from diagnosis to treatment, but it cost me nothing (apart from the hospital car park). I’m sincerely grateful for everyone that contributed to my treatments at Southend and Basildon hospitals, especially the lovely underpaid nurses, and to my local GP surgery. A round of applause (and a considerable amount of additional funding) for those kind people, please.