Questions?

[paulh1]

Had a visit with my ep yesterday. Explained about the issues I was having sometimes when I exercise and how I feel in general. He suggested that it was entirely possible I was having more afib attacks than i realized(trouble while swimming and issues on the bike). He also suggested that I take my Alivecor to the pool and when I have a problem stop and take a reading to see if I was in afib. Never thought of that. Then he says that I could have Cryoabalation which,according to him, has a 70% success rate. I also asked how many he does a year. He says over 100. I don't know if that is a lot. Seems like about 8 or so a month. Is this a good number?Now the thought of all that sounds great. Also, the thought of getting off my meds was even better. The more I thought about it I realized I wouldn't be off all my meds due to my stents. I would still need to be on my anticoagulants which is the drug that concerns me the most. Now , I'm not sure if it is really worth it. Sure,I might be off Tikosyn , carvedilol and maybe the pravachol but the ones I'm most concerned with I'd still be on. Now. I'm just not sure about considering this at all. My ep asked me how I feel. I told him I can count the days on my right hand when I woke up feeling really good. Sorry to go so long about this but I know many of you have faced similar decisions and can relate. Thanks

[BobD Volunteer]

My own view after three ablations is that any amount of time in NSR without rhythm or rate control drugs is worth the effort. I am six year post my last and on no drugs for AF but of course still on anticoagulants. It may not last forever but then neither will I ha ha.

[PeterWh]

Great that there is movement forwards.

My view (and that of my GP) is that things or circumstances that reduce the number of medicines that people are on long term will be of benefit. If you are on Warfarin then, depending on your particular situation, it is possible to go onto one of the NOACs, but not sure if possible with stents, etc. Check with EP rather than GP as EPs have no vested interest.

100 cryo ablations a year is not a low number at all. As an example on the day I had my ablation (RF not cryo) my EP and his team started at 08:00 and the man before me was having his second and it was essentially a touch up procedure. Then I was taken down and it took 6.5 hours for me, finishing just after 5.30pm and it was well gone 6 by the time they had packed up, etc. So only two in the day!!! I think that my EP essentially only does 2.5 days per week on procedures because the rest of the time he is in clinics, reports, training others, etc, etc. Don't forget things like DCCVs will be in that procedures time. He will also have 5 weeks holidays plus lectures, conferences, training, etc. One of my EP's procedure days are Mondays so some extra days will be also be lost because of bank holidays.

[paulh1 in reply to PeterWh]

Thanks for the replies. I'm on apixiban and clopidogrel . There is a lot to consider at this point. The thought of having to do this multiple times is very daunting. BUT the thought of being free of afib like Bob and some others on this site is wonderful. Being able to sort of resume my life(within reason) would be great. Right now I never know when I exercise if I can do it without complications. Pretty scary to swim out in the middle of the pool and wonder if you can make it back

[PeterWh in reply to paulh1]

My view is it is like a journey with a number of different legs. If you don't start on the first leg you can't start on the second and you will never reach the end point!!!

In my case my EP said that there was zero chance the first ablation would work (ie just a question as to how long it would last - he was hoping I would be in sinus at 6 weeks at my follow-up consultation - the normal is 13 weeks). However I lasted less than 72 hours in sinus. That has not worried me and I am waiting for my second ablation.

My view is go for it now whilst it is on offer and while you are deemed suitable (subject to other things being OK). Hope that this helps.

[Hidden]

I had an ablation in 2006 and came off all drugs thereafter (except anti-coagulants) for the next 8 years. I just went back to normal and could do anything I could before. Problems now started again, but different this time and being controlled well by drugs so far. Hope to offered another ablation as and when, would jump at the chance to be frank, don't like drugs.

Koll

[AnticoagulateNow]

From what you say it's the thought of having to remain on apixaban (and other drugs?) afterwards that is putting you off an ablation. Why? Are you having problems with them? I don't know what other drugs you are on for your stent work etc but presumably you'll still be on them whether you have the ablation or not, so why not at least try and end the AF?

I'm post-ablation, cured of AF and perfectly happy to pop an apixaban twice daily to give myself the best possible chance of being stroke free too for the rest of my life. What's not to like?

[paulh1 in reply to AnticoagulateNow]

If I have the ablation and if I stay afib free I would probably be off of the Tikosyn, pravachol, and the carvedilol. Due to the stents I need to remain on the anticoagulants(apixiban) and the clopiogrel. My ep says it is better to do this now since I have Paroxysmal Afib rather than wait until it gets worse. Bob likes to say "Afib begets Afib. After reading all the posts on this site I KNOW what needs to be done it's that fear of pulling the trigger and just doing it. Once again thanks to everybody for letting me vent .

[PeterWh in reply to paulh1]

I was already in persistent AF when diagnosed. After ECGs, echo, cardioversion (only lasted 24 hours in sinus) my EP said only realistic option in my case was to have an ablation but to go and read more about it. After initial consultation last September and then end of November I had looked on main AFA site and also other internet sites but hadn't seen HULposts (wish I had). Decided December yes for an ablation. Saw HUL end of January - shame because it would have made the decision easier and quicker. No regrets even though I lasted less than 72 hours in sinus rthythm. Go for it!!!!

[pip_pip in reply to PeterWh]

Absolutely !!!