I have been reading this forum for a few years, contributing occasionally (when I thought that it may be helpful) so I thought it time that I made a more significant contribution. I have had PAF for more than twenty years, originally with just one or two episodes a year, but gradually increasing in frequency, each episode lasting from seven to twenty-four hours. I am now 69 years old, and ended up taking Flecainide (2x100mg) and Sotalol (2x80mg). In addition, I had recently given up alcohol (only modest anyway) together with wheat and coffee, as potential triggers. I have also been taking magnesium, transdermally and orally, together with COQ10. The magnesium did seem to quieten episodes down. It became apparent, however, that I was losing the battle and the PAF would soon become persistent, so although the episodes were not disabling, I felt that I had to act. I arranged to see Professor Schilling at London Bridge Hospital, and although he was careful not to recommend ablation, it was perfectly obvious that I should go ahead. Incidentally, he changed my medication from Sotalol to Bisoprolol, and I finally found out why Sotalol is an issue when used in combination with Flecainide. Apparently each drug carries a very small risk of pro-arrhythmia which is can be fatal, but when used together this risk is more than doubled.
The suggested cryo-ablation of the pulmonary veins was carried out in the early evening, followed by an overnight stay. I have seen the procedure described as no worse than a trip to the dentist. Well, at the time this did not seem to be the case, although a couple of days later it is rapidly appearing less daunting. All the team at the hospital and in the CathLab were charming, kind and helpful. A lovely cardiac nurse came down to the CathLab with me, to keep me calm until I went in. Very scary, to go into the CathLab. I counted eleven, possibly twelve, people in the room full of high tech equipment. The ablation itself was carried out under a light general anaesthetic. The anaesthetist was superb - no after effects whatsoever, and, even better, no memories of feeling of anything, including the TOE, which I had been dreading. Prof. Schilling said that the ablation had gone well, and I was removed to my room for the four hours of lying prone. Unfortunately, I had what seemed to me to be a massive bleed when the clamp in the groin was removed, and I was got out of bed at about midnight. This bleed was heroically stopped by the night nurse applying considerable pressure with her fingers, but it means another seven or eight hours lying prone. I was really fed up with the view of the ceiling! I was discharged mid-morning, and advised by the very capable arrhythmia nurse to stop taking flecainide altogether, except as PIP, to halve the Bisoprolol, advised that I should not worry about any arrhythmias during the first three months, and to contact her in the event of any problems. I have since had a further episode of about six hours which terminated with the help of the PIP, and am hoping that I am one of the 80% in whom a first ablation is successful. If necessary, I would be quite happy to go in for a second ablation, but am obviously hoping that I don't have to.
Overall, though, my treatment has been wonderful, and I hope that, despite the length of this post, it will be helpful to those facing up to the idea of ablation. If anyone has any detailed queries, then I am happy to help.
Regards to all,
Peter
Update on ablation and follow up
Ablation or to stay away
Post Ablation Episode
PAF FLECAINIDE AND SHAKING
Where to go for ablation
