Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Atrial fibrillation, Blood pressure increased, Cardiac ablation, Cardioversion
Clinical narrative: I received my first dose of the Moderna COVID-19 vaccine on 3/3/2021. On 3/6/2021, my heart started racing out of control at 168 beats per minute, and my blood pressure was also elevated. I could feel my chest pounding. I went to an urgent care clinic. They verified through an EKG that I had atrial fibrillation. They then called 911 to summon an ambulance to take me to an ER that was located nearby. While I was waiting for the EMTs, a nurse put an IV needle in my arm to prepare me. There was no solution in the IV, but the pain from the needle apparently stopped my atrial fibrillation, because by the time the EMTs arrived, my sinus rhythm was back to normal. Even though everything was back to normal, I was still taken to the ER, so they could make sure that everything was okay. When I was at the ER, my situation was monitored. My heart was still racing a little faster than normal. The ER talked to a cardiologist, who suggested that I be put on a beta blocker, metoprolol, which slowed my heart rate down to a level at which it was safe for them to release me after about an hour or so. I later did some research on the metoprolol, and I didn't like what I learned, so I had my doctor switch me to another medication, sotalol. After I got home from the ER, everything seemed to be okay. I would still have occasional heart palpitations, but I was able to use a phone app to check for atrial fibrillation. On or about 3/13/2021, I had another attack of atrial fibrillation. My heart rate was about 158 beats per minute, so I called 911. I was then raced to an ER. I don't remember all of the details of that day, but I do recall that I was given some medication, including a blood thinner. I was in the ER for about 3 hours or more before my sinus rhythm returned to normal. I was not admitted to the hospital. When they released me, they advised me to see a cardiologist as soon as possible. I don't remember the date that I went to the cardiologist, but when I went, I saw his PA, who did an EKG and switched me over from metoprolol to sotalol, as I mentioned earlier. Later on, I came back for a follow-up appointment with the cardiologist. Another EKG was done, and the results were normal. The cardiologist explained to me the causes of atrial fibrillation and advised me to check my BP daily and to be on the lookout for signs of atrial fibrillation. Before I began having issues with atrial fibrillation, I had been taking hydrochlorothiazide to manage my hypertension. Maybe about a week or two after I started the sotalol, I noticed that my systolic blood pressure went down to 100 and the 90s, and the diastolic blood pressure went down to the 60s. My cardiologist suggested that I stop taking the hydrochlorothiazide, which I did. At this point, I had also been taking 80mg of sotalol in the morning and another 80mg at night; the cardiologist advised me to half the dosage and take 40mg of sotalol in the morning and at night. These measures brought my blood pressure back to normal. For almost 2 years afterwards, everything was fine. I had occasional heart palpitations, but I was told not to worry about them as long they were brief (e.g., 15 seconds) and fleeting. However, on the evening of 11/18/2022, I felt a huge heart palpitation that ended up lasting for 3 1/2 days. I grabbed my phone, and the app told me that my heart rate was 180 beats per minute and that I had possible atrial fibrillation. I then called 911. I was then taken to the ER at the closest available hospital. I underwent an EKG and a chest X-ray. I was given blood thinner and various other medications and IV fluids whose names I don't know. I was admitted into the ICU at the hospital. The doctor had me given CARDIZEM intravenously on a slow drip. For two consecutive days, I was given an injection of heparin in the abdominal area. The atrial fibrillation did not subside until 11/21/2022. I saw the in-house cardiologist on 11/20/2022, and he prescribed me digoxin (125mg) to help slow the heart down. Later on, 11/21/2022, the digoxin dosage was doubled to 250mg. I was released on 11/22/2022 at about 1 PM. I then went home. I called my cardiologist's office and saw his PA sometime shortly after my hospital release. The PA confirmed that I should continue taking the digoxin and CARDIZEM. She also did an EKG, which indicated that all was well at that point. She referred me to an electrophysiologist for a cardiac ablation. I saw the electrophysiologist sometime thereafter, and he indicated that I was a candidate for cardiac ablation. He told me that the cardiac ablation would ideally stop future incidents of atrial fibrillation. I underwent the cardiac ablation on 1/10/2023. The electrophysiologist was able to do the ablation on the left side of the heart. However, while he was performing the cryoablation on the right side of the heart, the cryoablation affected not only the heart, but also the phrenic nerve, which was situated against my heart rather than away from the heart, which is the position of the nerve in most people. As a result of this, the movement of the right side of my diaphragm and the functioning of my right lung were deleteriously affected. Not only that, but as a result of the accident, the electrophysiologist, was not able to complete the procedure. The right side of the diaphragm doesn't fully expand when I breathe, anymore. The chest X-rays from the period before the surgery indicate two healthy, clear lungs with a black background. The chest X-rays taken after the operation now basically show that the area with the black background in the right lung seems to be gone. As a result, I can no longer take deep breaths like I was able to before the surgery. Not only that, but I very easily run out of breath now, even when I'm performing tasks that don't require much effort, such as talking. The electrophysiologist installed a loop recorder to detect any anomalies in my sinus rhythm or other cardiac phenomena. He also given me an electronic device with a button, which I am to hold over the loop recorder and press in case I have any atrial fibrillations or other anomalies take place. On one morning, I woke up gasping for air, and I pressed the button. The electrophysiologist read the data recorder by the loop recorder. No anomalies were detected in my heart or circulatory system, so he guessed that the lack of air was due to the effect of the surgical accident on the right lung and the right side of the diaphragm. On 1/17/2023, the atrial fibrillation returned, and I called 911. I went to the ER, and the electrophysiologist was contacted. He suggested that they put me on amiodarone (200mg). They also performed cardioversion, which put me back into a normal sinus rhythm. I was then sent home. About 2-2.5 after I was sent home, the atrial fibrillation returned again. I called 911 and was sent back to the ER. My electrophysiologist was contacted again, and he suggested that the CARDIZEM dosage be increased to 300mg. I was admitted to the hospital, where I ended up staying until 1/19/2023. At the time of this writing, I am slowly returning to my normal activities, though I am taking it easy. My electrophysiologist told me that in the 5 years he has been performing cryoablations, this was the very first time he had had the phrenic nerve affected in the procedure. He has done some research about cases similar to mine, and according to what he has read, the recovery can take anywhere one day to a year to happen on its own. Out of the 500 people, only 26 people did not recover after a year. Because of this, we are holding out hope that I will recover from the effects of the surgical accident.