One year Mini Maze anniversary – flutter?

All has been going very well, my AF burden has reduced from around 30-35% to less than 2%.

I’ve been slowly building up my exercise, I did manage to return to hockey which was most enjoyable. I also got out on the bike in the recent dry spells, with some 40km routes, and since Dec I’ve been walking or running parkrun most Saturdays. I was running to set heart rates and slowly building that up, even if it. meant I had to walk. I’ve managed to get 15 parkruns in, as well as my local ones I’ve managed to visit Southport, Rising Sun, and some new Yorkshire ones including Dewsbury and Temple Newsam.

My first 5km after last years operation was a 41m 54secs at Wetherby on the 4th October 2025 (chosen for the flattest course close to me). I did manage a 2026 PR of 27m 54s on the 4th July at Wetherby with an average HR of 140 bpm compared to an average of 146 bpm for my 41m in October 2025!

However from earlier this year I was getting occasional atrial flutter (I believe), example single lead ECG below. I have been keeping on 1.25g bisoprolol which seems to help as when I weaned off it slowly the flutter was worse.

These would all self convert to sinus rhythm. Sometimes very quickly, sometimes it could take virtually all day. On occasion I also got regular double ectopic beats which made me feel very washed out and weary. Whilst the episodes were ongoing I was also prone to dizziness. ECG below from the end of January 2026 showing the double beats.

On contact with Mr Hunter he suggested that I “need to see my local cardiologist as flutters can only be treated endocardially

I contacted the very helpful arrhythmia nurses at the LGI in April, and they put me onto a wait list for a telephone consultation. That happened in early May and they agreed a touch up ablation should help with these issues. I was put onto a wait list, and had a call on the 10th June for a cancellation the following week. Unfortunately I had a planned (and paid for!) holiday then, so had to sadly turn it down. Fortunately I got a call last Wednesday 8th July for a slot on Monday 13th July.

I attended the LGI at 8am and after checking in was allocated a bed and told I was second on the list.

Around 11am I got changed into the standard hospital issue “reverse” gown and shortly after was escorted to walk into the catheter lab. This time I’d elected to be conscious and have the operation done under sedation, vs general anaesthetic for my first two ablations in 2019.

I didn’t feel any pain and was awake throughout the procedure. A few times I felt mildly uncomfortable around the chest and had to breath a bit shallower than usual but that was the worst experience. Near the end I could feel some kind of arrhythmia had been induced, the last thing I recall was the consultant saying he was using flecainide and then I woke up back on the ward. I can only surmise I actually fell asleep or they upped the sedative to remove the sheaths and place the stitch into the incision point.

I came around just after 3pm and closer to 4pm was allowed to sit up in bed and had a much welcome sandwich and cup of tea, having not had anything apart from 1/2 pint of water before 6am.

An AI translation of the medical terms in my discharge letter is:

The Procedure & Background

• Redo-left atrial catheter ablation: This was a repeat procedure. A thin, flexible tube (catheter) was guided into the left upper chamber of the heart (the left atrium) to use heat or cold to create tiny scars. These scars block the chaotic electrical signals causing the irregular rhythm.
• Atypical atrial flutter: A type of rapid, abnormal heart rhythm coming from the upper chambers. “Atypical” means the electrical short-circuit is taking an unusual path through the heart tissue.
• Post 2 x LACA and 1 surgical AF ablation…: This notes the patient’s medical history. They have previously undergone two catheter ablations (LACA) and one surgical procedure to treat atrial fibrillation (AF).
• LAA clip: A tiny clip was placed on the Left Atrial Appendage (a small pouch in the heart) during a previous surgery, usually done to lower the risk of blood clots and stroke.

Access & 3D Mapping

• RFV x 3 (USS): The medical team accessed the Right Femoral Vein (in the groin) three times using an Ultrasound Scan (USS) to safely guide the needles.
• CARTO 3D mapping / LA geometry and voltage map: The doctor used an advanced 3D computer mapping system (CARTO) to build a precise, color-coded virtual map of the left atrium. The map shows the shape (geometry) and measures the electrical health (voltage) of the tissue. Areas with low voltage indicate existing scar tissue from past procedures.
• TSP x 2: Transseptal Puncture. To get from the right side of the heart to the left side, the doctor had to carefully cross the internal wall (septum) dividing the chambers two times.

Key Findings & What Was Fixed

• Reconnection on anterior RSPV: The Right Superior Pulmonary Vein (a blood vessel connecting the lungs to the heart) had “reconnected.” This means the scar barrier from the previous surgeries had healed over or worn away, allowing abnormal electrical signals to leak back into the heart.
• ? bridging muscle bundle: The doctor suspected a tiny, surviving strip of heart muscle was bridging across an area of dense scar tissue, acting like an electrical wire transmitting the bad signals.
• The roof line was consolidated with proven block: The doctor touched up a previous scar line along the “roof” of the heart chamber to ensure no electrical currents could leak through.
• The RSPV was re-isolated: The doctor successfully applied ablation around the reconnected pulmonary vein, completely sealing it off electrically so it can no longer disrupt the heart’s rhythm.

Ending the Procedure

• Flecainide 150mg restored SR: Near the end of the procedure, an anti-arrhythmic medication (Flecainide) was given, which successfully returned the heart to Sinus Rhythm (SR)—which is the normal, healthy, steady heartbeat.
• Stitch following protamine: Protamine is a medicine given to reverse blood thinners used during the procedure so the patient can heal. The tubes in the groin were removed, and a temporary stitch was placed to prevent bleeding.

Overall, the report shows that the doctor successfully identified exactly where the old treatment had broken down, touched up those areas with a new ablation, and successfully restored a normal heart rhythm before finishing.

I was allowed home at 1830 the same day and told to take it easy for a few days, then slowly build up. No driving for 48 hours and to slowly return to exercise after 2 weeks.

Fingers crossed this is the final step in a journey that started in 2018 with my first Atrial Fibrillation diagnosis.

I will update this blog as my recovery and return to sport and exercise builds back up!

Somehow I suspect another chapter will get written as there isn’t really a permanent cure for Afib.