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AF Association
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Left or Right Decision.

Seen my EP Consultant on Tuesday regarding my forthcoming Ablation which will be in the next 6/8 weeks at the Golden Jubilee in Clydebank nr Glasgow..After scrolling thru my various ECG's he said to me we have a choice...You definitely have Atrial Flutter,with the odd occurrence of AF,then he said,I believe that the flutter is the main problem,therefore we shall go for the left side of your heart,it is less invasive,and safer,with a higher success rate,and I think that there is a good chance of "nailing it"..but he also added IF,it isn't successful then we will have you back in and do the right side,then added but I reckon the left side is the problem..and iam quite hopeful..

Has any of my friends on this forum had this procedure of the left side only?...and if they did ,what was the outcome,success? failure?...I know this condition affects everyone diffirently,but when I had time to think about it,why doesn't the EP do both sides when iam in and under so to speak,..oh well I do hope he is going for the correct side....a bit like heads or tails. Thanks Terry.

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Hello Terry .

Regards to Glasgow and it is all hit and miss this AF lark .

I would listen to the Doc as my Auntie would say " I've seen it all at the Hackney Empire ." .They certainly have !

Andy

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Hi Terry,

Actually I think you have it slightly confused here. For A/ flutter the EP will be accessing the right side. The left side is harder to access as a trans septal puncture had to be made between the two atria. This is normally how AF ablation is performed.and so is more difficult and time consuming.

I've had a flutter ablation which gave me great relief from my symptoms. They have a much higher success rate than AF ablations.

Good luck!

Sandra

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Hi Terry , whilst flutter is often the cause of AF and stopping that may well stop the AF you have your rights and lefts crossed. Flutter tales place in the right atrium and is much easier to sort out as the catheter does not need to be punched through the septum between the two atria as is does with fibrillation ablation. Always assuming that we look at our hearts from inside our own bodies that is. lol This at any rate is the way it is normally described.

Flutter ablation may take only an hour whereas to do PVI may take up to six and is much more difficult.

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Hi terry I also saw my EP this week and like you I have flutter and AB Fib the EP offered a cyro and confirmed he would do both at the same time. I will be going to the Liverpool heart and lung hospital in about 2-3 months. Good luck Roy

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Hi Terry, can't tell you much about left or right but the Golden Jubilee is a great hospital with fantastic staff, also possibly the best hospital food I have had 😀. Good luck for the ablation.

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Hi Terry. I had to make this decision 2 months back. Doc suggested to go after the flutter (right atrium), as he was hoping it might clear the AF. While it somewhat relieved the ferocity of my AF, it didn't do the job. I am booked in for the end of this month for a cryo on the left atrium (AF pulmonary). The risks do increase with the left atrium procedure. Having my time again, I probably would still have taken the docs advice - why create further risk if you don't need to. BUT - if you want to knock both out in one hit - go for the left atrium procedure

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Thanks folks,yes I do think I have my left and right mixed up,it will be the right side....I just hope it is the right side when it comes to the Result...I have faith in my EP,he certainly came across as knowing what he was talking about....so onwards and upwards,can't wait to get the ablation. Done and dusted....Terry.

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I had both sides done in January. I had AF and Flutter, the flutter was getting worse and more of a problem. Although having AF every other day as well.

If offered a choice I would definitely go for both AF and Flutter now, get the job done. My procedure they went in via both legs, it took 3 &half hours. I'm feeling fine recovering well, was back at work after a week.

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Thanks Wendy, I just hope my EP is correct in his assumption that the flutter is the main problem,I'd prefer getting both sides done to be honest,but have to go with the specialists opinion...

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By the time I got around to doing an ablation, my atrial fibrillation included flutter, too. He didn't say anything about right or left side, but when he was done, after three hours, he had hit six areas, and it was completely successful, lasting 15 months. I'm now having a second ablation to "clean up" where he believes some connections have grown over the scar tissue. I'll ask him Monday, when I go in for it, about whether he did left and right at the same time, but may not get back to you for a couple of days!

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Thanks Teach...I'm just hoping they do both sides if required...Good Luck with your second procedure.

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Thanks. Best wishes on yours, too!

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Hi Terry, I had an ablation for flutter about three years ago. My EP suspected from my EKGs that my episodes were flutter also like you. The flutter was successfully ablation but during the procedure he said they were able to create AFib and had to convert me on the table. Afterwards he suggested I stay on Flecanaide but I opted to go without. I was totally AFib free for six months and then wham it came back. I am now on 300mgs of Flecanaide daily and am planning on scheduling an AFib ablation. My situation was different because the EP wasn't set up to do both ablations. I don't know if they can do both but if given the chance I would suggest to you to do that. Good luck and I hope your procedure is a success.

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Hi Gracey..I was kicking myself after my consultation,I meant to ask if they were going to jolt me into a fib during the procedure,and if so would they work on it...but will be asking when I go into the hospital...Funnily enough I was taken off Flecanide,it wasn't really cutting it for me...since I have started on the digoxin it is better,but by no means perfect...still getting visits from rock n roll bands in the chest at the most unwelcome times namely between 2 and 3 during the night...but the anxiety ain't near as bad...due to more understanding of this condition...and that is thanks to this forum,and all the sharing of info and symptoms..Thanks.

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I had my first ablation in 2013 to correct flutter. Dr Cardio told me that I had about a 25% chance of getting AF afterwards, which turned out to be 100%. I had my second ablation in 2014 to correct AF. I think his approach was correct. When I did develop AF, it was paroxysmal and the symptoms were pretty minor, though inconvenient. I could have lived with it.

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Thanks Kodaska..looks like my EP is going down the same route..

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My husband had ablation surgery fo Afib on both sides of the heart and Atrial Flutter on the right side at the same time. It was Cryoablation and catheters were used on both sides of the groin with no puncture between the sides of the heart. Other ablation procedures seem to involve such a puncture but my husband's EP here in the USA doesn't take that approach - which may be older.

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Hi Cheryl, I think you may be mistaken about "no puncture between the sides of the heart" - all veins (from both legs) go to the right side, so there is no way to get to the left atrium except through the septum. You husband may possibly have had a hole in his septum (congenital ASD or PFO) already so they didn't have to make a new one but you definitely have to go to the left atrium to ablate AF.

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He had several catheters from both sides of his groin going into his heart during the cryoablation surgery. I remember reading somewhere that this approach did not require going through the chambers of the heart surgically, but I will have to look deeper to be sure of this.

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Thanks Cheryl...was your hubby's AF and flutter cured?

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The procedure seems to have alleviated both the Afib and Flutter, and he plans to stop taking Flecainide in about a month. He will stay on Eliquis (apixaban) for the rest of his life, as Afib can always recur and undiagnosed Afib caused him to have a minor stroke in August 2014 - which was treated promptly. This whole recovery process has definitely required patience.

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Thanks Cheryl...Good Luck to you and your hubby in his recovery..

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There are two sorts of atrial flutter - usually called typical or atypical. If the ECG looks like "typical" atrial flutter there is a good chance that it is just on the right side and the very simple and safe right atrial "isthmus" ablation has a 90% success rate. And if the AF attacks only happen when triggered by the flutter these should stop as well.

When the "isthmus" ablation is being done, the first step is to map the flutter path in the right atrium. This may show that the flutter is, in fact, "atypical" and starts in the left atrium. In this situation the flutter and fibrillation attacks can occur independently and so a combined left-side ablation is advisable. If the lab is set up for this it can be done straight away but it takes much longer and does carry a small but significant risk of complications. A good strategy is to abandon the ablation at that point and then try regular drug treatment (which is often effective), proceeding to left side ablation later only if required.

"Atypical" atrial flutter sometimes occurs for the first time AFTER undergoing AF ablation and may require long-term drug treatment or a redo left side ablation.

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Thank Youvery much Jonathan...very informative post...in that case I do hope it is typical flutter...Thanks Again Terry.

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