Ablations and Blood Thinners

10 years ago I was diagnosed with an AVM.

Which never gave me any disturb so far.

3 years ago I was diagnosed with A-Fib .

My episodes vary from once a month to once every three to four months.

Now I am in a dispute with our health authorities about having an ablation.

Because I cannot take any blood thinners, because of the AVM.

The professor ( E P ) who wants to do the intervention on me, from abroad.

Not from my country.

In my country ablations cannot be done.

The professor ( E P ) suggested 3 options.

In his center they can do Mini-Maze surgery which normally doesn’t involve using blood thinners. Though it’s more invasive and traumatic, it has a good chance of getting rid of your A-Fib. And by removing your Left Atrial Appendage, it protects you from having an A-Fib stroke. It would normally replace having to take blood thinners, which you can’t do.

They also do a Hybrid Surgery/Ablation. The surgeon does a Mini-Maze, then the E P looks inside your heart to check on the surgeon’s isolation of the pulmonary veins. This is a very innovative strategy combining the best of the surgical and ablation strategies.

These are the 3 options

1. A PVI combined with insertion of the Watchman device. This is probably the most effective option because the E P can also work in other parts of your heart which may need ablating.

2. A standard Mini-Maze operation with removal of your Left Atrial Appendage. This has a good chance of curing your A-Fib, though it isn’t always as effective as a PVI. But by removing your Left Atrial Appendage, you would be protected from having an A-Fib stroke and wouldn’t normally need to take anticoagulants.

3. A Hybrid Surgery/Ablation. This is a combined approach with the EP checking inside your heart if the Surgeon has effectively isolated your pulmonary veins when doing a Mini-Maze. But I don’t know if heparin has to be used during the ablation part of the operation.

If options 1 a 3 aren’t possible, you will still have option 2 the Mini-Maze. That should give you confidence and hope. You know there is a way to help you.

Has any one have been in this situation?

And if yes what was the final result.

I be very obliged if some one will answer my questions.

Thank you

4 Replies

  • What is an AVM?

  • Check up about the PVI because I thought that's done by the EP and not the surgeon.

    Ask why on 2 a watchman can't be inserted. Does the removal cause any additional issues or risks rather than blocking?

    Does a mini-maze truly stop AF or does it just mean the effect of the AF is mitigated but it is still there.

    Look at the main AFA website, especially it's publications and data sheets sections. Also look at articles and other websites from leading specialists (eg Professor Schilling, etc). Also look at YouTube.

  • Dear Peter,

    To answer your questions.

    You are right to say that a PVI will be done by an EP and not by a Surgeon.

    May be I was not so clear about that.

    Re the removal of the left Atrial Appendage it is only in the case of a MINI MAZE Operation. Sorry I can not answer you if it will cause any additional risk or not. What is for sure is that you want need blood thinners any more

    A Mini Maze is not as effected as it is a PVI in stopping A-Fib, but yes it could stop the A-Fib for ever, and yes still there is chance that A-Fib will return.

    Re the Surgeon, The Surgeon will take part in the procedure only if a HYBRID/ABLATION is being done.

    If you send me your e mail address I will send you a video showing the whole procedure.

    I have tried to send it on here but I can't . is not allowing me.

    Peter my problem is not which procedure I take, my problem is that I can not take any blood thinners.

    That what I was trying to ask on the forum . If any one has ever been in this situation. May be he can help me.

    Thank you



  • AVM = arteriovenous malformation.


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