Ablation or meds

I am recently diagnosed - February 2013- and am on 2.5mg of bisoprolol and warfarin. I have no real problems with the meds. I just had my 2nd appointment with cardiologist/ep to discuss ablation. I am thinking that as yet i have not had much meds, am in early stages of this disease and stats seem to be saying success rates may be better if ablation done earlier I think I have made the decision to go for it and have the ablation. I am 64, no high blood pressure and otherwise in reasonably good health. The Ep says decision is mine and he seems to agree that better now.

What do you all think. Marie

20 Replies

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  • Marie, That would be my choice. And yes it does seem to increase the chances the earlier you do it. While meds will probably control it for years, the meds themselves can cause other problems and then still have to deal with the AF. Knowing that AF is progressive, I am never a fan of trying to control it with meds.

    Just to be clear... You are not speaking of the Pace and Ablate procedure are you?

    Tim

  • Thanks for reply TIm. No, not pace and ablate.

    My thinking is that it will probably get worse and meds will become more powerful with more side effects so may as well go for it now and hope it works. Marie

  • Marie, You are correct in your thinking. AF get worse over time and the meds have to get stronger. That road usually ends at Amiodarone and most do not want to go there.

    If you have any questions about the Ablation just ask.

    Tim

  • Same here Marie. I had ablation done early on as well. Very glad I did. I am 41 and also know AF is progressive. Good luck and prayers for you to have a wonderful outcome on any decision you make. Ask away if you have questions..

    Naomi

  • Same Here Marie, had my ablation the same day as the Stand and very happy with the result

  • Agree with all those Marie. I was 60 at first ablation. Needed three before AF free but wouldn't have changed my decision anyway. Now 68.and all OK You must understand that although it may stop your AF you may well be left with other arrhythmias like multiple ectopics from time to time and such but the problem is that many people get these but don;'t notice. We AFers are so darned aware of our tickers that we notice EVERYTHING!

    BobD

  • Marie, I am in the same position as you. Diagnosed 2 years ago but similar age, meds and also otherwise in good health with good blood pressure.

    After much reading and deliberation I have decided to have an ablation. It's hard to choose an operation when I feel well and don't have symptoms but, as the wise people on this sight keep reminding us, things will only get worse.

    Best of luck with your choice and hope to hear how you get on.

    Angela

  • Hi Marie and porridgequeen

    Pleased for you both if I am honest, but at 59 and with permanent AF and no real other symptoms, I am not even being offered any treatment, the last time I saw the cardio after an unsuccessful cardioversion he said I could come off the warfarin (I haven't) and he would see me in six months with no actions.

    So I am curious how you even get to the point of being offered an ablation.

    I am just worried that it will only ever get worse and they are waiting for it to get worse before they treat me.

    Ian

  • Hi Ian,

    I'm not sure how this works.

    I was taken to A&E after a couple of hours of rapid heart rate my second incident, the first being 18 months earlier. The cardiologist offered me ablation there and then as he thought it was a better alternative to medication as the incidents were so far apart. It was only after all the usual tests that they discovered I had more frequent AF activity and flutter. However, he still sent me to Guy's and St Thomas's to see an EP who left the choice to me but said that if ever I changed my mind he would perform the ablation.

    Now that I am much better informed about AF I feel that I have now changed my mind.

    I can see why you are worried when nothing is being done to improve things.

    Have you suggested ablation to your cardio or asked why it is not being suggested as an option.

    Maybe next time you should put a bit of pressure on. It's possible it all boils down to money!

    Sorry I can't be more helpful.

    Best Wishes

    Angela

  • Which is what happened to me. I wasn't offered ablation becos it was persistent for years. Not everyone sees ep quick. I have had 2 ablations now and worked wonderfully, but showing itself again recently after 2 years. I think I was left to it for longer than I should

    have been. When I was diagnosed, 1998, info was sparse, and internet concentrated on sudden death.

    H

  • Hi

    Thanks to all for replies, support and input. I have said yes to this procedure so fingers and everything crossed! Ep says waiting time about 3 months.

    Ian, when I was diagnosed I was told by ep it was my choice which route I took. I asked for this second appointment to clarify that and to ask questions about ablation. Ep seems to think earlier is best and was involved in a trial to look at this - trial abandoned due to lack of volunteer. However, looking at past cases he still thinks earlier is best so happy to do mine asap.

    Wendy- this will be guys/St Thomas' so will keep informed of outcome. Marie

  • I'm 37, diagnosed after one episode and see my cardiologist (NHS) twice a year.

    I am on Diltiazem but no warfarin. I have never been offered an ablation, nor an appointment with an electrophysiologist.

    Is it possible to request an appointment with an EP whilst under the care of a cardiologist?

  • Hi Romeo

    Most seem to reckon that ablation is the way forward and EP's are the specialists. Don't see why you couldn't ask to see an EP on those grounds.

    Koll

  • Hi

    Thanks for responding to this. I hope someone better qualified than me answers your question. I think in general ablation is not offered until at least two types of medication have failed or caused problems - that seems to be NICE position. My ep seems to disagree with that and maybe nice is also changing stance. I do 't know the answer re your cardiologist but can't see why you can't ask gp to refer you to ep.

    Although only recently diagnosed I had been having episodes for years - just thought harmless until they started happening nearly every day.

    Why not ask GP, nothing to lose and a lot to gain. Good luck.

    Marie

  • Be prepared to explain. I asked my GP and he said "what's an EP?"

  • Hi Marie, Just back from very wet and cold, but great yoga week in France and have read your post. Am green with envy as I am fighting to be offered an ablation without having to fail with meds first. I too was diagnosed in Feb. but am still waiting for 1st appointment with Cardio. I asked to see an EP without going the cardio route, and took European Soc. of Cardiologists guidelines to my GP re early ablation without meds, but my appointment is with a cardio first, very frustrating. Can I ask who your EP is? I do need to find someone who agrees with this way forward. Good luck.

    Lizzi

  • Hi Lizzie

    Thanks for response. I am also in France at the moment and weather rotten but nice today.

    My cardiologist is also an ep. He is Dr O'Neill from Guys/St Thomas' in London and he seems to be in favour of early ablation.

    Good luck with your journey. Marie

  • Merci Marie,

    Enjoy your stay.

    Aren't they doing a trial on early ablation at St Thomas'?

    Am determined not to take no for an answer!!

    Lizzi

  • Hiya

    The trial has been abandoned due to lack of volunteers. I was asked to volunteer but when I considered it I decided I did not want the decision re ablation vs meds to be that random - I wanted to make the decision and presumably others felt the same.

    Agree with you so good luck and let us know how you get on.

    Marie

  • Will do.

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