Electro physiolagist

[higgy52]

Going to see E P. private at Glenfield this week ,as i am in AF 24/7, To see with i am suitable for Ablation, Any one got any tips on what i should ask him. Thank you

[Danny44]

Hello higgy what is ablation ?

[CDreamer in reply to Danny44]

A treatment for AF - to ablate means to eliminate - it is a procedure where a catheter is threaded through a vein into the atria - once there either freezing or Radio Frequency wire burn tiny areas of the inside of the atria - scar tissues then forms and so builds a type of wall so that rogue electrical pulses which cause AF cannot get going. I no longer have AF after 2 ablations. It is a painless, relatively quick procedure which has a high success rate and means no more AF & no more drugs.

Plenty of info on the AFA website - also look on YouTube and type in search box Ablation and you will get quite a lot of informTive videos come up,

[Danny44 in reply to CDreamer]

Thanks for that well atleast there's a lot of ways to try and get over the condition.No meds is a good thing.!!

[CDreamer]

Ask if he/she can give you his estimation of chance of success, what is his average success rate (80%+ is acceptable) how many ablations has he carried out what type of ablation - RF or Cryo, balloon - if he will do a TOE and if so when - day before or on the day - if/ when you would stop anti-coags, how long will you be in hospital, does he use sedation or GA, what, if any, complications should you know about, what about recovery, what drugs will they use - ensure he knows your medical history & co-morbidities and a list of all the drugs you take for those and when or if you should stop them - don't assume he will have read your notes - be very clear and make sure he knows everything there is to know, medically speaking, about you,

[higgy52 in reply to CDreamer]

thanks for your tips, have wrote them down, good imput, cheers

[PeterWh in reply to CDreamer]

CDreamer / Higgy.

80% is a high percentage OVERALL and even if someone has paroxysmal AF. See the slides from last year's AFA patient day. Flutter is typically getting around 90%.

For someone with persistent AF that is almost unattainable unless the EP does not do many "severe" cases and it would unfair on patients if EP's only looked at those with the mildest sympoms to ablate. Also the percentages are after multiple ablations. With persistent AF a typical success rate for the first ablation is typically 30% to 40%.

There is also the big question as to what is the basis that what determines success. I haven't seen a clearly defined standard / measure which is vital!!!! I have seen / heard that some may classify success as being in NSR 3 months after ablation at the consultation and others maybe as long as 5 years.

The key question to ask (providing you want to know the real answer) is "what do you think the chances of success are in MY case in the short term and the long term and after how many ablations. Please be frank, honest and realistic - I would prefer this".

I asked that question (a few extra words added above). EP said that in MY case there was no chance it would work first time but that he would see me 6 weeks after ablation hoping that I was still in sinus rthythm so he could do an echocardiogram to see how the heart was in NSR. In the event I went back into persistent AF less than 72 hours later.

[CDreamer in reply to PeterWh]

That is why I said ask about his assessment for you - every case is different - but some EPs are more skilled than others and have more experience so the very fact of asking implies you are serious about checking out everything before you agree to a treatment.

[PeterWh in reply to CDreamer]

To me / the way I read your comment was an open question and allowed the EP to quote general statistics rather than stating "in MY case" to try and get a realistic assessment.

Higgy - don't worry if the chances are low first time.

[Janco]

Higgy52

I agree with CDreamer, all that I can add is:

Write those questions down, and maybe take someone with you when you go for that "interview". Sometimes the doc talks so fast and we just say yes yes, but do not really understand. Ask until you understand.

My cardiologist did not want to send me to an EP because, in 2003 I was not a "suitable" candidate due to the previous open heart surgery I had, if you want to read more myafibheart.com/ . Luckily I was sent and although the EP could only perform the ablation 70% it was a success.

Very important: It is the skill of the EP that matters most, like CDreamer said, ask about his experience and do your own research about him - you only have one heart.

Janco

[Mike11 in reply to Janco]

I had open heart surgery (quad bypass) 4 years before my ablation and the EP didn't regard it as an issue. In fact I have a suspicion it was the healing of bypass that initiated my AF but hard to prove.

[Rellim296]

Hi there! I would also ask how long the waiting list is: i.e. when would it be carried out.

[higgy52 in reply to Rellim296]

Thanks will write it down on my list.

[Mike11]

Whilst not trying to be negative in any way, ask him how many strokes have been induced by HIM doing the procedure, and were they recovered in time.

That said, go for it. I did and have never regretted it.