AF Association

are ablations only offered as a last resort,

Hi 2 all

I have recently been told I have afib,and have been put on warfarin and flecainide.i know this may sound silly but i have an awful phobia when it comes to taking tablets in any form. i suffer with Crohn’s which I have controlled well with a good diet and exercise and haven’t had any problems for years, i don’t know if its the tablets upsetting me or just all the anxiety of dealing with afib but i have started getting stomach problems i.e bloating lots of gas and discomfort and am hoping this isnt the start of my crohns again. i know very little about ablations pros or cons but would like to know those of you who have had ablations how you got to that point in your treatment before an ablation was offered to you

6 Replies

NICE guidelines for NHS patients is that they have to have failed to respond to two drug therapies before ablation can be considered. If you have problems with drugs as you suggest then you may argue that you do not pass go and go straight to ablation. best to discuss with your EP.



I wish medications worked with me so I may not mead the ablation

I tried both bisoprolol and flecainide but still having AF attacks , so I start thinking about ablation

In regard your symptoms where it maybe the tablets side effects , check any other suggestion with your doctor

All the best



Hi Llamudos and welcome to the forum

Sorry to hear you are having problems with the drugs and there are alternatives, so you should explore these with your Cardio or doctor, as it takes some of us some months to find the best combination from a number of alternatives.

I hear you about the Crohns, but what you didn't really say was what you are experiencing from the A Fib.

I say this because although ablation is a wonderful operation, which is getting better and better with the research going into it and new techniques, it's not a cure-all definite. If it was then people like me with long term A Fib would be on the waiting list like a shot.

You really need to discuss what you are currently experiencing, and then balance that against the risks and potential rewards of the ablation, and this discussion should be with your GP and with your Cardio ideally. The AFA offer on their website some downloadable pdfs on both catheter ablation and surgical ablation, you can find them here

It's very much an individual decision, I can only really talk about mine, and with almost no symptoms, but permanent A Fib, I was not even offered an ablation, but even if I had been, I would have to weigh up the balance between how I feel now, and how I am likely to feel afterwards. At present I fully agree that in my case an ablation is not probably suitable, YET. However no-one really knows how their A Fib will develop, or as in my case what damage is being done to the heart in the meantime (the doctors say none, but I am not yet bought into that)

I suggest a lot more reading, and then a real sit down and examination of current symptoms and what you are going through compared to the likely ablation outcomes. The articles on the AFA website discuss this.

Good luck and be well



I've recently been put on the waiting list for catheter ablation since my long-standing drug propafenone/arrhythmol and bisoprolol stopped working after 13 years. I can't tolerate most of the others and the amiodarone is not a consideration with me due to long term side efffects. I've been on diodarone for 2 months now and feel as though the heart is really 'held down', apart from a few irrelevant arrhythmias from time to time. My E.P. at Bournemouth Hosp tells me the risk factors for ablations he does are almost non-existent and he hasn't had any fatalaties at all. The procedure will take about 3 hours under general anaesthetic and my family and friends are all delighted that I've been offered the chance of a new lease of life. I know it's not guaranteed to work first time, but fingers crossed it will. I was really not interested in ablation when it was offered to me last year, but things seem to have moved along quite substantially. I will have a scan so that the EP will have a 3-D image of my heart and where the rogue cells are so that they can be isolated. I'll let you know how it goes, although it might not be for about 4 months from now.



I'm not sure about the meds and your Chron's. I understand your pain because I have had IBS for about 30 years and have not seen any change with the meds I take. I am on warfarin and I take Propafenone (Rhythmol) and saw no change in my IBS. You are correct that it could be the stress that comes with being diagnosed with AF. I know that with IBS stress is a definite factor and will bring on a flare up quickly.

As to the ablation....

Bob is correct. Most require you to try (fail) at least 2 rhythm control drugs before discussing another procedure. That being said, those requirements can be modified with different situations. Here in the states, most insurance companies have the same requirements. Many EPs are now considering ablation as a first line procedure. My ablation was done in Feb this year. I am almost 6 months past it and I have been AF free for about 5 months now.

As Ian said, the main AFA site has a wealth of info on the procedure and also the different meds used for AF.

Opinions and experience with AF varies greatly with GPs and specialists so It will help to learn as much as you can about AF and it treatments. It could save you a lot of trouble and wasted time.

Welcome to the forum and be sure to ask anytime you have a question.



Thank you all for your replies, very interesting and informative. But there never seems to be a straight road to treatment. If ablations are more likely to be successful sooner rather than later why are they only offered after a long haul on tablets?? Surely it should be at least discussed at the early stages


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