Has anyone else read the paper publis... - Atrial Fibrillati...

Atrial Fibrillation Support

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Has anyone else read the paper published by nice recommending ablation as second treatment for AF ? I read it but can't find it again.

Terjo profile image
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It's dated 1/10/13. I wanted to show it to my dr. I've just come out of AF attack and it was horrid, pulse went down from 146 to 60rpm in about 3 or 4 mins. Awful whooshing noise so I'm thinking seriously about AF. I'm still sweating and lying on the bed. It started last night so I'm very tired. Any help to find the paper would be very welcome.

Terjo

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Terjo profile image
Terjo
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Terjo profile image
Terjo

My grandaughter found it on the machine.

Japaholic profile image
Japaholic

I'm not a Doctor but for my limited understanding an ablation would be the last line of defence.

I still have a sense that there is an underlying cause to my AF. When I think about the way it initially manifest, the gaps in between when I've been AF free and when it came back I still feel there is a lot of preventative measures one can take.

I'm working out my own triggers, these are mainly stress (getting angry), too much caffiene and salbutamol (an asthma inhaler).

I am going to try acupuncture along side my medication as this has been shown to increase time between attacks.

Doctors seem to only operate at a curative level, it's very very difficult to find anyone who will talk to you on a preventative level.

Robert42 profile image
Robert42

Hello Japaholic

I agree with you that we should look for triggers. I think I have been lucky so far in that my pulse is not taken me over a 100 bpm as far as I am aware. One of the things that I am looking at is the statins in particular simvastatin which I am on. I have tried to do some research on this but there are mixed reports. Diet is of course another issue and I'm trying to readjust that. I also have diabetes and interestingly since I started eating a lot of fruit against all advice my blood sugars have fallen.

As a retired nurse I always used to follow the party line but I can see myself drifting away from that and questioning a lot of orthodox on medical thought.

Please keep us posted with anything you have found and I agree with you that invasive procedures should be avoided unless there is no other way.

Robert…

BobD profile image
BobDVolunteer

The point that most people seem reluctant to accept is that your heart MUST have a predisposition to AF for it to happen. This can be by genetic or physical changes in the left atria as for sure we know that once you have AF it is likely to continue to change the atria making AF more likely. Hence the saying AF begets AF.. There is a body of evidence that suggests that early intervention by ablation has a greater chance of successful outcome than waiting till the condition has become persistent or permanent. At present NICE guidelines in UK require that a patient have failed to respond to two types of drug treatment before an ablation can be tried under NHS payment .

Many people claim that the drugs such as flecainide have a limited life, suggesting that the body gets used to them but the reality is that it is the AF getting worse which causes the failure. There are no receptors for the drug in the body so it can not be treated in the same way as narcotics where the body needs more and more to respond.

Regarding triggers, these are what it says on the tin. Triggers. If you didn't have the pre-disposition they would not be.

If you are lucky enough to find one which helps you limit your episodes then good for you but for many people this is not possible. Those with vagal induced episodes may well find foods they can avoid which helps them in this way but AF is such a mongrel condition that no two people experience it in the same way (apart from wishing it would stop! ) I have found no scientific evidence to confirm anything other than possibly alcohol as bringing on AF although asthma pumps which accelerate the heart should be avoided where possible I understand. There are some patients where the rogue impulses come from elsewhere and for these people there are no things such as triggers as the signal may well come from deep in the brain.

Food related triggers, if you are luck enough to find one , are an easy way to limit episodes but please don't expect it to cure your AF.

BobD

Terjo profile image
Terjo

How true, BobD. Believe me I've lived with this long enough to have tried just about everything apart from acupuncture. At first an AF was just an inconvenience that left me feeling pleased that it had finished but now I'm exhausted after an attack and have to rest for at least a day.

The paper I read is on the NHS site I wondered if it was going forward for approval in

October or if it was just an idea. I'll try and find the number and post it up.

The cardioversion did give me nearly three years AF free.

Terjo

HealthFan profile image
HealthFan

Same for me, I have several triggers - eating more than usual - very steep hills :-) - alcohol - bending over to tie laces - but I also get AF when I am doing none of the above.. oh and cold water more often than not can set it off - but then again drinking very cold water can stop an attack - so I agree with Bob if your heart has a predisposition to AF then you need medical intervention with drugs/ablation. A bit grim but true.

dedeottie profile image
dedeottie

I agree. Sometimes I think ive found triggers and then other times I think there are no triggers! I am personally much more relaxed about it now I've just accepted that I've got it and that's that! Being less anxious certainly makes the whole thing easier to live with. I've just decided that as far as possible I will just get on with my life and A.F. Will just have to come screaming.g and kicking along with me. When it's really bad I rest and when it's ok I just carry on as normal and appreciate the good times. Of course,I'm writing this on a good day. Might change my mind next week!

Terjo profile image
Terjo

Here is all I could get from what was saved on my iPad :-

NHS England.

A09/s/b

2013/14. NHS standard contract

For cardiology : Electrophysiology and Ablation services ( Adult )

Can anyone find it and read it (18 ) pages and explain and discus it here?

Terjo

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