Is 75 the cut off age to be offered an ablation ?

I don't feel very happy this morning after an appointment with my cardiologist.

I was diagnosed as having intermittent A/F and atrial flutter, that was just over 3 years ago,

it was pick up at a routine ECG prior to having a hernia operation.

I tried various drugs until a suitable combination/quantity was found to stabilise the condition

( 10mg bisoprolol and 62.5 digoxin plus warfarin) however I believe bisoprolol and digoxin's main purpose is to control heart rate but has little effect on the actual regularity of the heart beats.

Twice last year I took myself to A and E and was admitted to hospital when my heart rate reached 200 bpm.

On both occasions I was offered the choice of an ablation or try a different drug combination,

I decided to try drugs and this keep me functioning reasonably well so far.

Yesterday I was told that due to my age (76) there would be dangers in having an ablation.

( yet just a few months ago when I was 75 I was offered an ablation)

He said if the symptoms get worse a pace maker would be fitted.

However this does mean that the electrical signal pathway which fires the ventricle would have to be ablated for the pacemaker to operate successful.

This sounds just as much a risk to me as the more common ablation, where the rogue signal sources in the atrium are found and ablated.

I would be willing to try this rather go straight to having a pace maker fitted.

What does make me feel a bit down is that the main reason for the decision not to offer me an ablation is my age. but I suppose the NHS in Scotland have limited resource and maybe a cut off age for certain procedures has been decided.

Also in Scotland there are only 3 EP surgeons (2 of which do private patients) and that for the population in Scotland of approx. 5 million.

( incidentally I am fit , I walk at least 2 miles per day ,go to the gym, I do a bit of mild exercise usually twice a week, gardening etc.) I know I am old and really lucky to be as fit as I am but it hurts when someone actually confirms am old.

Maybe I haven't grown up what ever that means no point now at 76,

I am just a 30 year old in a 76 year old body

13 Replies

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  • I feel you are correct to be rejecting the age barrier- everything is riskier as we get older but lots of older people have ablations. I wonder if you have the choose and book system in Scotland as , if you find those are the rules for hospitals in Scotland, you could ask to be referred for a second opinion at another UK centre.

    I am under the Royal Brompton in London and I think they have reasonably priced accommodation nearby for patients and family.

    You could ring the Brompton to check whether they have an age cut of for ablation ???

  • Thanks Rosy,

    I think I will do that.

  • HI, im 77 and up until af I was fit as a flea, when I saw an EP he did intially

    offer me a pacemaker along with the option of trying other medication

    or ablation. I immediately opted for ablation as I explained that being quite

    active I wanted to stay that way as long as possible. He readily agreed and

    after a 3 month wait I went last Friday but after 2 hours the proceedure

    was stopped as he didnt feel happy with how things were going. So I

    have to wait 6 weeks until Ive recovered and then have an ablation with

    a general anaesthetic and camera etc. I feel that its not just Scotland

    where you have an age problem but other areas also as there was someone

    else complaining on this site a while ago. I must admit I was surprised I

    got the option and I fear that if it doesnt work first time Im not sure if there

    will be another chance although nothing has been said, I think they would

    probably think I was too old. Have you seen an EP, Im a bit like you, I think

    a pacemaker is a bit final and I know lots of people have them and have

    no problems Im not ready yet. If you havent already see an EP, but if they

    are few and far between in Scotland it would mean you waiting a long time

    for an ablation as there seems to be a waiting list wherever you live at 3 months I was quite lucky. I live in North Yorkshire but I have to go into

    West Yorkshire to Leeds Infirmary for my ablation, lucky I live between

    the two. Hope this helps a little but I do sympathise. Shirley.

  • Thanks shirly,

    I should have taken the ablation when it was offered to me last year as you did.

    Hope all goes well for you

  • At the Patients Day last year, an EP said the oldest so far to have an ablation was an 87 ear old woman.

    Sounds like a second opinion might help.

    Koll

  • Hi rosailor,Did you have an hiatus hernia,Just wondering as when I became Ill in Oct 2012 after a load of tests I was diagnosed with that and AF,Had pacemaker fit for irregular heart beat and ablation done 3 months after but not had hernia sorted yet

  • I was told that the age cut- off in Liverpool is 80.

  • My understanding is that age is an indicator but should not be used as a absolute, that everyone should be assessed on clinical risk/benefit ratio.

    As to pacemaker, my husband had one fitted in Jan for sick sinus syndrome but didn't have the sinus ablated so it only kicks in when his heart rate drops below 60. Interestingly because his heart is now much steadier, he hasn't had an episode of AF since.

    I think you need a lot more information from the cardiologist about his reasoning, ask him all your questions and ask for a second opinion,

  • CDreamer,

    Thanks for your reply, I will do as you suggest, on my next appointment with the cardiologist I will have a list of questions prepared to ask him.

    Also I will arrange an appointment with an EP surgeon to get his opinion why the cardiologist suggests moving direct from drug treatment to sinus ablation and fitting a pacemaker without first trying to locate and ablate the source of the problem in the atrium.

  • Thank you every body for your interesting replies,

    I will arrange a second opinion (or two,maybe) before deciding as you suggest.

  • The NHS is not allowed to be ageist, we are treating 92 year olds were I work if we turned a patient away on the basis of age there would be trouble. I know its Scotland but people come from all over to be treated in our hospital...even as far as the Isle of Man, ask for a referral to someone in England get a second opinion!

    In comparison to a 92 year old you're not old! Still a spring chicken and entitled to the better quality of life that medical science can provide....your being fobbed off.....I don't see what the difference is in one year older??......these days 60 is the new 40...so I calculate you're only mid 50s..right!

  • Thanks Loo53,

    that really good advice,cheers me up no end,

  • You're welcome dear :-)

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