New to this site and considering whether to have my first ablation. it's been difficult when you are just given treatment options and the doctor just gives you a list of :no treatment, drugs probably forever, or ablation and you have to choose yourself. So its been very useful to read about other peoples experiences of ablation and helped convince me that this is probably the best way to go (after initially being a scaredycat about it) and interesting to see how food can trigger AF. I never even considered the possibility until i read about MSG here and then remembered i had been for chinese the night before my last 48 hour bout. I don't have many that long, last 24 hour tape showed 3 episodes of no more than 37 beats.
So anyway, just saying hello and thanks to all of you that contribute here and help us newbies to make a more informed choice
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Mattpga
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Thank you for replying to my post. As you know I had an ablation on Tuesday. I will post shortly about my experience. I feel lack- lustre today but am otherwise fine.
I resisted ablation originally but after meeting the EP reconsidered. It was an opportunity that I would regret if I did not take. AF always gets worse. Did I want to be on drugs for ever? My quality of life had deteriorated badly and I was losing confidence because I felt so rotten so often.
I studied all the posts on this site and I learned a great deal. My medics seem to appreciate a savvy patient who understands what they are talking about.
I am glad that I had the ablation. They don't know what they'll find - my heart was a surprise, odd plumbing and more damaged by AF than they expected.
Hi Matt and welcome. AF is ALWAYS a progressive condition and many people believe that early intervention by ablation is the best solution. You may still have to take some drugs but limited. You should also understand that it may take more than one procedure to sort you out. Ask any question and we will do our best to answer.
Hi Bob, thanks for the reply. I understand that one ablation is not guaranteed to stop the AF, and reading more on here of people needing 2 or more.
Its a huge arrythmia clinic at St Georges in Tooting and you only get 15 mins per patient with the consultant, but the secretary has been helpful and pointed me in this direction. The other option is bisoprolol and flecainide but no guarantees there either, and as i am 'relatively young' at 50 ablation is looking like my best first choice.
You can spend days going round in circles online looking at pros and cons so great to be able to hear from fellow AF ers
Had my first two episodes at 50, thought I got lucky, 10 years later its back and will only get worse and worse. I had my ablation a week ago and my second one is in 8 weeks because I'm on a trial. Get it done is my advice. I hate the drugs so taking my chances with surgery.
Hi there Mattpga! Yes, ablation sounds very scary, but it can be hugely beneficial. It has a very high success rate and the risks, whilst significant, are low.
I have to say that I regret taking so much medication and not moving towards a second ablation earlier. I can always take the pills when no more can be done in the cath lab! In the meantime, I feel I am so much better off than I was a few months ago, thanks to a second ablation in March.
Hi Matt and welcome, glad to know you but sorry you are here in the first place.
If I could go back and have my time again I would have had an ablation in my 50's but although my GP recommended it my cardiologist called it 'a dangerous and invasive procedure' and wouldn't reconsider. I didn't know different until I found this forum and I have learned a huge amount through the sharing of experience and knowledge.
I have had 2 Ablations and they were much easier than I ever imagined. Glad you have a doctor who is giving you the choice.
thanks. i've been on warfarin and bisoprolol since may, while they did all the tests and 'decided what to do with me'
My approach is change lifestyle first (principally avoiding the triggers and other common sense moves), drugs second for a limited period (9 months max) and ablation third. I am on the second bit at present, 200mg Flecainide per day and no AF since March.
I draw some optimism from SRM Grandma on this forum.
I'm not disagreeing with you, orchardworker, but it took me almost a full year from appointment with cardiologist (April) to appointment with EP (July) to ablation (March). The delay was partly because my INR was too low and the ablation had to be postponed. I would say if one gets in the queue, one can always defer treatment if it's felt appropriate. You can't say - unless you go privately - I think it's time now to have an ablation. Some EPs of course have longer waiting lists than others.
Hi, thanks for your reply. Its a bit of a toss up, with the consultant saying she is 60/40 for ablation, which didn't really help, but speaking to other staff there, with it being intermittent and my age they think this is more likely to be successful, and if not theres still the drugs.
I think a lot depends on frequency of AF and symptoms so it's a very individual choice about ablation. I agree with those who have mentioned life style- I have found having food high in potassium and magnesium and low in sodium is helping a great deal. If you do a lot of athletics you may need to lessen the amounts as the heart can be affected by too much muscular build up!!
thanks rosy, yes i do go to the gym, and run, but have scaled it back a bit. Haven't been given any advice about diet, except for warfarin but will be worth looking into. thanks.
My experience is talk to the cardio and EP first and take a decision then, which is very individual. In my case cardio said pills, EP said ablation with 70% chance of success. It ends up being a decision based on gut feel and whatever you choose you can't be wrong as the alternative could have been worse…..a bit of good news!
I've never seen an EP (that i know of) and it does slightly bug me that they just present you with options rather than recommending a course of action. I guess with this particular thing there is no way of knowing whats going to work.
'As you are relatively young – we do not want to leave you with AF albeit it was intermittent for you – therefore, we are opting for rhythm treatment which can be either suppress AF with strong drugs called anti-arrhythmics eg Flecainide and/or have ablation treatment which is more definitive. This is because as AF progresses – the mechanism causes the heart to beat irregularly & sometimes fast – causing the heart muscle fibres to stretch and this can distort or alter the heart structure. The implications are – more AF in the future or heart muscle pump failure is the extreme case. Generally, ablations are more successful for intermittent AF. The longer one is in AF – the harder it is to maintain long term normal heart rhythm. Furthermore, we also consider patients’ symptoms as these procedures are not without risks. Therefore, you need to weigh the risks vs benefits.'
AF is a very personal condition, in so much as we all have different types, different approaches: success (or not ) with various meds, abilities to feel triggers, incapacities with regards to our work... Unfortunately since there are risks with an ablation (and meds) we all seem to arrive at a point where we just "know". It is wonderful when you find friends, family and this forum who provide such wonderful support.
I tried:
-stress reduction (which increased despite my efforts as the AF increased)
-internist GP who is full fledged homeopath (AF increased as no remedies worked and naturally stress increased
-cardiologists (2 who varied wildly from me having 1 episode of Rapid AF and he wanted only betablockers but every day), in my opinion was absurd given I'd only had 1 episode
2nd insisted I was only having "petits palpitations" until I went back to A&E just for the ECG which showed 9 hours of rapid AF (150-220bpm) which converted with Flecainide intravenous. He had to "eat crow" and wanted to put me on permanent flecainide and betablockers. I convinced him to go with pill in the pocket. I feel over the long term, the flecainide although stopping the episodes in the beginning they destablized my heart and have increased the pro-arrythmia.
With time the AF increased in intensity and frequency, until I was sure I was ready to go for an ablation. I can't say I regret not having had the ablation sooner, as I need to prove to myself I'd done everything possible first. All that said, knowing what I know now, I would go sooner than later.
I found a fabulous EP, who saw how extreme my situation was and took me straight away, once I'd decided. He only gives out the information and without alarm or promises and waits for the patient to decide. Things go better if we are well informed and make the choice on our own.
We adapt - we are like the story of the boiling frogs, AF becomes almost "normal" and it isn't. We cease to tell people when we've had a bad day, night, weekend as we find our discours so tedious even to ourselves. It becomes and is an exceptionally isolating condition.
I came to the conclusion that my quality of life was so poor it was worth whatever risks were involved. I am still convinced of my decision. Wait until you are too! No one goes into that catheter lab without apprehension but such is wise, find a doctor you trust and then trust your instincts.
Hope this wasn't too long, and you find the answers you need from this very supportive forum.
No its not too long. I really appreciate everyone taking the time to reply and share their experienced and advice.
it's not really affecting my quality of life at the moment (apart from when it won't stop of course) but that is not a regular occurence, but the 24 hour tapes show its happening, if not for long periods. But its been on and off for 10 yrs now and as everyone says, its not going to do anything but get worse over time.
i haven't heard anyone say they regret having an ablation so far....
If I were in your situation I would not be ready then either! I went too long though... I never missed a day of work even after marathon nights. From first recorded AF episode to now has taken 4 years! Always smiling, always working, and I stand all day.... I still smile, though I have become more reclusive! Just don't let yourself get to that point! One of my cardiologists did not believe that AF always becomes worse, so do as your instincts tell you.
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