Ablation or not?

Oh dear- I replied to a post instead of typing a new post so here we go again! Good start!

Your posts and replies really do help me through days when my PAF rears it's ugly head and I'm not quite as frightened by each episode as I used to be. Over the past twelve months my episodes have crept up to approximately seven a month - very irregular heart beat with ' jumping frogs' but never very fast. I am on medication but am reluctant to take up the offer of ablation as many of you describe your post ablation 'angry' heart symptoms as worse than mine are now. I don't really want to make it worse before it gets better, if you see what I mean!

I'm paying to see my EP privately in Leicester next week as several of you have said this was worth it's weight in gold. I've only seen members of his team in Outpatients and the lady I saw in December was useless-total waste of the four hour round trip.

So, should I opt for ablation and cope with the consequences or hope the EP will take an interest in my medication and maybe make a few changes ? I would appreciate your comments.

11 Replies

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  • Meant to add that my episodes only last for about two hours.

  • Well you know my view I'm sure. Three ablations sorted me out and yes always consider it an ongoing treatment rather than an instant fix. Six/ nearly seven years free of drugs make it all worth while. Also remember people always complain but seldom praise. That is not a moan merely an observation so you will see far more bad things said here about treatments such as ablation than good, as the successful patients tend not to come back. They no longer need the support.

    I was first offered an ablation in 2004/5 but like many found the idea quite scary but as my condition became worse that thinking changed and I had my first in 2006. It has been said that you will know when is the right time as the symptoms will be so bad as to drive you past your fear of the procedure. MY only comment is don't leave it that long if you do go that route as the sooner it is done the better and more successful the outcome. Purely personal advice obviously but many EPs think that early intervention has the best outcome and for sure most data suggests that. Others have a different view I know and seem to think ablation is the devil's spawn so my advice is to read all you can and make an informed choice in company of your EP.

    Bob

    P S Do also consider that with NHS cutbacks such procedures will be under pressure and may not always be offered in the future, It is an expensive procedure in time and equipment even if long term outcomes are often better than drugs so never guaranteed. I think there are probably no more than 6000 ablations a year performed in UK (I don't have latest data) so those offered it are really quite lucky when you think of the million odd people who have AF.

  • Hello Bob, you say you had three Ablation procedures. How far apart did you have them? I'm asking as I had my first in April and everything was going fine until about two weeks ago and now my AF has returned, i was wondering if my EP would offer me another Ablation.

    Thanks Steve.

  • First one never worked and actually made things slightly worse, second 11 months later lasted 8 months , third a years after second fine after 61/2 years. So 2006 2007 and 2008. all around Easter or up till June I think

    Bob

  • That's really interesting, Bob. When I was in hospital at the weekend, my Cardiologist started talking about one...... And then decided to leave it six months.

    When I first had AF, I was terrified of the thought of a DCCV. Now I welcome it just to get back into sinus rhythm as nothing else works.

    Good luck with your journey, and trust me, the advice on this forum is worth it's weight in gold

    NJ

  • Hi, Im10 weeks post 1st ablation, the ablation wasnt painless as I had to have

    GA with a camera down my throat but I would do it again. My first month

    or so were great felt back to my old self but unfortunately things have

    deteriorated and I have rapid heart beat on exertion and going into af

    every few days but for much shorter duration than before. I too was

    very reluctant to have an ablation as my af attacks were infrequent and

    of short duration but they quickly developed into more frequent and

    lasting much longer so that by the time my ablation date came round

    I was very eager to have it. Yes Im having problems but Im told thats

    the way it goes, I would certainly think again before turning down the

    chance of an ablation if I were in your shoes. Im seeing my EP tomorrow

    so itwill be interesting to see what he says. Its also interesting that you

    have to pay to see your EP privately, Im in the York/Leeds area and my

    treatment from the start of my af has been excellent, and waiting times

    have been no more than 3 months which I think is quite good.

    Hope this helps.

  • Hi Bob, I was really interested in what you said about getting an ablation sooner rather than later. I have had AF occasionally since 2002 until 2012 when I had a TIA because I was only on aspirin up until then, so put on to Warfarin which could not get on with so one pacemaker later and Rivaroxaban, I am now in permanent AF since October 2014. They have tried me on 10mg Bisoprolol and Digoxin since then but they have done nothing to ease AF. I saw my GP this morning and I have asked for a further private consultation with the EP who put in my PM. I am wondering if he suggests an ablation now, how much is it likely to cost if I went private, do you know? Also I am now 78, I also have a mitral valve leak. Any advice would be gratefully received. You have helped so many of us for which I thank you from the bottom of my heart!

    Hope you have a nice healthy and calm 2015.

    Di

  • Jenbo - I doubt if anyone can really advise you which route to take - ablation or drug therapy as it is something which is very personal and must feel right for you. It depends on so many factors - the type(s) of arrhythmia and their location(s), your health, age, competence of the EP and the hospital, statistics of the hospital and your 'gut' feeling about what you need from the treatment (apart from the absence of AF, that is).

    I had about 6 episodes per month lasting on average about 2 to 3 hours and in pure frustration at delays and other problems in the NHS I saw an EP privately last August. He prescribed a new cocktail of drugs and so far they are working, leaving me almost 'normal'. After an awful lot of research and reading of the posts on this forum I decided to stick with drugs until/if they need to be increased or stop working and the points I have listed in the first paragraph were the deciding factors for me in not seeking an ablation.

    If you can approach your EP with an open but fully informed mind and get as much information from him/her as you can, especially about the type of arrhythmia which you have, you may be in a better position to make a choice - indeed your EP may recommend a course for you, which might start with different drugs.

    I hope your appointment goes well and that you can get proper evaluation and advice.

    Best wishes.

  • Thank you all for your comprehensive advice and suggestions. Finding this site has been so enlightening. Finvola, your PAF sounds like mine and it's pure frustration that's moved me to see the consultant EP privately. I'm hoping he'll suggest a different cocktail of drugs to help reduce the episodes.

    Good wishes to you all.

  • Hi Jenbo,

    Could I ask who your EP is and who recommended them? I'm almost certainly going to need an ablation myself....... In Leicester.

    Thanks

    Nigel

  • Nigel. My EP is a lovely man called Prof Andre Ng. Great guy and I'm very pleased I spent the money to see him privately. He explained all my options and gave me his secretary's number for when I decide an ablation is the next move. I see members of his team in Outpatients at Glenfield Hospital every six months but after a disappointing appointment I just wanted some reassurance and advice from the top man. There are other good consultant EP's at Glenfield - if you go to the info page on this site it will give you details. I was referred to Prof Ng by Dr Roberts, a cardiologist at Glenfield when my symptoms changed to AF. We are very lucky to be referred to Glenfield as it is one of the top heart hospitals. I moved from Leicester to Sutton on Sea but still make the four hour round trip. Good luck with your AF journey. I have decided to stay on medication and reconsider ablation at my next OPD appointment in June.

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