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AF Association
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Well - a few weeks back I had a Hter monitor for 7 days because I had voiced cover s about how my heart was beating - it seems to have settee down and it appears I am in NSR most of the time sometime dipping into AF.

So now having spoken to my EP and him emailing me I need to think about my next course of action.

1. Stay on sotalol - possibly increase the dose.

2. Go back into bisoporal but remain in AF ( Ido not want that )

3. Ablation for the AF ( which might I know take a few attempts - and the procedure carries risk which I am aware of.

I am thinking that # 3 will be my course of action.

Thoughts please 😀

15 Replies

Go for an ablation. The fact that you have paroxsymal AF means that the success rate is much higher and AF is progressive, though the rate can vary considerably from one person to the next. As my GP said to me before I had decided to take the ablation route an option that does not involve having to take medicines for years has to be very seriously considered. I would have though that this is particularily true in your case as you are on solatol.

I made the decision just over a year ago to go down the ablation route and don't regret it one bit even though I went back into persistent AF less than 72 hours later. EP had said it would not work in MY case so it wasn't a shock. Some aspects have improved as a result.

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I've gone down the ablation route and am very glad I did so.

Ablation does sound scary and yes, you are about 0.01% likely not to come through it, but I feel it is sometimes discussed on this forum - often by people who have not had one - as something akin to a heart or face transplant: a seriously daunting prospect, something to be considered with care and serious trepidation. I think some GPs and cardiologists may have the same view, scare their patients and prefer them to try a drug regime instead.

I think many of us have found ablation a very tolerable, problem free experience and most comments afterwards are that it wasn't the hurdle that had been expected.

Yes, you may need more than one, but as PeterWh says, an 'unsuccessful' attempt may bring significant improvement, even if AF is not completely eliminated.

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Perhaps a number 4 - stay off all drugs and see how you feel? I felt a lot better, particularly compared to when I was on sotalol. Sotalol has been shown to be pretty ineffective for AF. Then consider an ablation but with a very experienced EP.

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Personally Susiebelle I would rather an ablation than be on sotalol as I think it carries less risk. I'm with you on#3.



Some people get more side-effects with sotalol, especially feeling tired, breathlesness, poor circulation and putting on weight. So if side-effects are a problem, ask about alternatives such as a combination of a low dose of bisoprolol with flecainide (provided there is not much else wrong with your heart), which does not have these side effects and can be taken for years. Flecainide also has the advantage that you can take an extra one if required (e.g. if your heart is feeling jumpy due to stress or a bad cold).

But before making a decision about ablation it's worthwhile checking for causes of AF which can be avoided. The most important is alcohol - in some people it only takes a small amount can trigger AF (typically a few hours later). Another factor is blood pressure - even if mild or partially treated this can greatly increase the tendency to get AF so it must be kept down to normal-or-low (120/80-ish).


If it's any help my EP took me off sotalol yesterday and am back on motoprolol, with my second ablation scheduled for the end of April. I have been in NSR since November and had not noticed anything different with sotalol but feel more confident now given its 'bad press'.

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Umm I am on soltalol too and have used it successfully as PIP for 17 years but now I take it regularly as in AF daily now since menopause.

EP has suggested ablation and or go on a trial.

Am on NHS ablation list now as he is hopeful of 80% success rate as 57 and it is stand alone AF .

However might opt for trial as you either get your drugs changed(which he thinks I need to do as soltalol not really working anymore at the dose I take) and either ablation 1 or ablation2.

Brighton are pioneering one catheter ablation which is quicker and with less risk, or you have to have the two catheter regular ablation. They say either will be safe.

Also will get good after care and still stay on the list if I get the drugs option.

What do you think to that?

I think ablation seems to be the way to go having researched through friends and friends of friends who have had ablation as well as information gained on this excellent site.

Hope this helps a bit.

Good luck with making your decision.

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One catheter ablation / two catheter ablation - not quite understanding that ?


Hello again..

I am very well thank you.

I had a cryoablation in April 2016and started straight away to reduce my solatalol slowly over 3 months, then stopped.

All good so far...

How are you doing ? Did you go ahead and have ablation too?



Out of interest what did you have done and how are you ?


A ha well apparently the type of ablation I have been offered by my EP is the one catheter ablation which means they just put one catheter up your groin and make one hole from right side of your heart into the left side then ablate with the frozen balloon when they find out where the jumping is and don't put a second catheter up to double check as they have found no benefit to the patient in doing this. This will make for a quicker procedure and not making a second hole from right to left to double check.

The trial is I presume to establish statistics of the success of the one catheter against the usual two catheter approach. Also less exposure to x Ray I presume too.

Hope this makes sense?.,!

I will only be able to confirm all this after I have had my consultation before I make final desicion re going on trial.

It would be good to help research if possible.


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Thankyou - best wishes for a successful single ablation


I do not believe it is meaningful to compare the risks of ablation vs. Sotalol in general terms in ways that help an individual make a decision about their own treatment. In my opinion the biggest risk of ablation is the level of expertise of the electrophysiologist. I was very lucky to have mine done by one of the most experienced doctors in the UK. I had delayed having mine done because I did not believe that the doctors in our area had done enough procedures.

Would you be happy to have your ablation done by a doctor doing their first one unsupervised? I read a post 5 years back saying ideally choose someone who has done at least 1000 ablations.

Don't be afraid to ask the electrophysiologist

1. How many have you done?

2. What is your success rate?

3. What are your figures for complications?

Discuss the results with your GP.

He/she may not like that, but a good electrophysiologist will be confident enough to tell you. You are entitled to know and should know.

I have taken Sotalol for 6 years, four since my (successful) ablation for paroxysmal atrial fibrillation. I think it has helped but I am not totally convinced. It may be a question of how much you are taking. I have slowly increased to 120 mgs twice a day. I am not aware of it having caused any dangerous heart rhythms in my case, but some (a few) other people might have had problems at this dose. I am 70 years old.

I wonder if the most important thing for most of us afibbers is to be taking a blood thinning medication if at all possible.


Thank you for your response - it is such a mine field we’re in.

I am on Warfarin for life with simvastatin and bisoporal - keep

Well 👍


I totally agree about it being a minefield, my GP wishes to increase my Sotalol from 80mg x 2 a day to 160mg x 2 a day as I am experiencing high blood pressure at night, I said I would rather not due to what I have read about Sotalol; lead balloon springs to mind, consultation was ended promptly and I was asked to think about it! I have previously been on Bisoprolol but that seemed to have run its course so when I had a cardioversion I was put on Sotalol. I have PAF and am also on Rivaroxaban and atorvastatin.


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