I'm in Afib again

I'm in Afib again

I had an ablation in 2010 and spent the next 6 yrs. Afib free. It was wonderful, I had my life back. At the first of the year I just wasn't feeling like myself, there was nothing specific , a feeling of unease. It was then that I joined this forum, I started with a few flip flops, maybe 1 or 2 a week, became very tired, had to pee a lot and then Tue, night there it was going at full force, but only for a few minutes. My Dr. verified it today and now the testing begins. I dread those test more than anything especially the chemical stress test. It all has to be done before I can have another ablation. I'm hoping there have been improvements in the last 6 yrs. and I'm wondering if there are any meds now that would control heart rhythm. Your thoughts.....

29 Replies

  • It is always upsetting when such things happen. I am about seven years post my last ablation but although I haven't had AF since then I have had some small arrhythmias so I have never forgotten the damned thing and always had it just in the corner of my mind. I think all we AFers are like that to be honest.

    Since I have been around here for a very long time I can be pretty sure that there are no new drugs which were not around when you were treated , apart that is from the new anticoagulants and of course I do hope that you have addressed this issue with your doctor.

    My advice is to go to AF Association website and start reading up on all the latest developments and booklets etc. so that you are well prepared when you see you EP. I never had a chemical stress test before any of my three ablations although I did have a rolling road one right at the beginning .


  • I have never heard the term "rolling road" stress test. I'm guessing that's a treadmill?

  • Sorry Grandma yes. We use rolling roads for testing cars a lot so it is the fall back term for me.

  • Morning Bob, I had an ablation in November 2015. It is still early days but I saw the EP on Friday 12th and have been discharged.

    I mentioned to the EP that I was on Wafarin and could I have the newer anticoagulant, he said that because I was only 72, I would not be eligible.

    His guidelines for prescribing the newer drug were a recommended tick list, the first proviso being that I was 75.

    He did show me the tick list on his laptop.

    I would like your opinion on this when you have time. Many thanks.

    The sun is shining in Coventry and all is well. I hope it is the same for you and all our AF friends.


  • B-ll--cks!. Sorry about that but NICE approved NOACs for anybody regardless of age. This must be a local CCG edict which could be challenged.

  • Thanks Bob, I will be seeing my GP in the next month or two and will most certainly question same.

  • I would go to the GP this month to get the ball rolling. The NHS new financial year starts 01 April.

  • Thanks Peter, will keep this in mind.

    Keep well.


  • If you don't get a positive result then write or email the chairman of your CCG (your GP surgery will have that info) asking to go along to their next public meeting so that he or she can explain publicly why the Group is ignoring the NICE approval for NOACs for anybody, regardless of age. They are required to hold regular meetings to which the public are admitted and they may ask questions.

    I did the same concerning the issue of testing strips for Coagucheck(?) when I was on warfarin. There couldn't have been a quicker reversal of their policy that patients had to pay for their own and I didn't need to attend the meeting.

    Many CCGs are Cosy, Cosy Groups and they don't like anyone rocking the boat.

    STOP PRESS: You're in the States! Disregard Vintage Me but I'll leave it posted for the interest of UK NHS users who may have similar issues.

  • Thank you, I will see my GP and hopefully he is up to date with the NICE recommendations.

    Be well my friend.


  • I think it is the opposite as we are more prone to bleeds as we get older. The leaflet with apixaban warns that we need to check this if we are over 75. So I think he's got the wrong end of the stick with this.

  • Thats an interesting point Lallym, is it possible that the EP has got the wrong end of the stick?

  • Don't really know but the leaflet definitely says to check with your doctor if you are over 75.

    If you Google it however the consensus seems to be that it works well for over 75s so there you are.

    As Bob says, there is no reason why you can't have it. I am 66, no particular problem with warfarin but this was a personal choice and my EP happy to prescribe it.

  • In the States, where I am The really insidious thing that is happening is the refusal to give older people certain medications, They are for the young and viable. I know this is true it's happened to me several times. Big Brother.

  • That is appalling! My understanding is that the new NOACs did have a bleed risk, especially in older people, when they were first introduced in the states, especially with older people and when the dose was once per day - there were some big class action cases. It was then recognised that older people needed a reduced dose and the recommendation was to take 2 smaller doses in one 24 hour period rather than 1 every 24 hours. Even then older people often take a lower dose because of the higher bleed risk. So just don't get why they would be limited UNTIL you are older? Did you ask for the reasoning behind that restriction? Are there any exceptions? Is it the doctor's recommendation or the insurance companies? The only explanation would be cost which is insurance check list?

    I am on another forum for another condition and suddenly people are being denied essential, but very expensive, treatments for life threatening condition in the states, when they have received them for years. Your doctor should be on your side and fight for what is best for you, otherwise change your doctor.

    One argument for NOACs is that unless you can be certain that your INR is in range for 60% of the time over 12 months. Has your doctor reviewed the % time over 12 months that you are in range? If not, why not?

    I started taking NOACs at age 59, stopped now after successful ablation.

  • I have asked my GP, cardiologist and registrar about going on an alternative to warfarin without success.

    According to my GP I am in range more than 65% time - only because if my INR is 2.00 then I go for 8-10 weeks between tests ( and I am sure I must go below in that time) BUT if my INR is 1.9 then I get another test in 1 week - so my time out of range is minimised. Then back to 8 or 10 week testing.

  • I think you have just highlighted for me all my reservations about going on Wafarin rather than a NOAC - unless there are frequent and systematic monitoring how would anyone know what your average INR range is? An INR will only be, at best, a snapshot for that particular time when the blood was tested.

    There are going to be day by day and person to person variances in efficacy with any medications but I think my preference would always be for the NOACs and to date my GP and my consultants have always discussed openly with me med choices and have always included me in the decision making and supported my choices, thankfully.

  • I was on Wafarin for several years after my first ablation. I was tested twice a week, then every two weeks, and finally once a month for a couple of years. I never had a problem with it.

  • Pleased to know you have been able to discuss NOACs with a supportive GP.

    My GPs aim is to get me on 12 weeks testing - he says it states this in the NICE guidelines.

    If I was tested every 4 weeks then I would have to accept it.

    I will mention NOACs to Cardio again at the end of the month.

    Will keep you posted.

  • I am being treated for PAF and have had my first ablation in December. I have been prescribed Pradaxa 110 twice a day because of 2 brain haemorrhages and 2 TIA's. Previously I was taking aspirin, and then clopidogrel. I was prescribed Pradaxa when my AF went through the roof, and been on it since. Maybe my EP will change it when I next see him next month.

  • I had my ablation 18 months ago. I didn't have any sort of stress test, thank goodness.

    I use 100 flecainide as a pill-in-the-pocket. That would certainly be worth trying. It needs to be prescribed, initially, by a Cardiologist/EP.- or perhaps your GP can contact them to OK it.

    Best wishes.

  • Sorry to hear it. As Bob said, it is always not far from our minds that the next heartbeats could be an arrhythmia. Well, the good news is that if you've been doing everything you can to be heart healthy with diet and exercise since the last ablation, then hopefully this bump in the road will be easier to address. Thinking good thoughts for you! Keep us posted.

  • I had ablation 2013 and no stress tests, chemical or otherwise

  • Oh, I will be having a whole bunch of tests. To start an Echo cardiogram and the stress test possibly a heart cath. cat scan and MRI I had all this before so it's likely I will again.Just before my ablation I had another MRI which lasted several hours so they couds watch and map my circulatory system .

  • Do you live in the US by any chance? I have never heard of any of this!

  • Oh, yes you are!

  • Interesting that they will spend money on very expensive testing (not all of which may be necessary?) but won't offer you NOAC.

  • Did you not take any meds before? Was ablation the only thing on offer?

  • I should be a little more explicit. Before my ablation I had a cardio version which was successful for a time, Drugs , I don't remember what they were didn't work. I had to wait 6 mo. for the ablation and was on a blood thinner at the time, The test I have to have are standard over here, they are to insure there is nothing else going on. I'm sure money has something to do with it, but then I;m a cynic. The Dr, I see is an Electrocardiologist and I go to T he University of Michigan HospitalThey seen to set the standard over here.No ,matter how you look at it, it is an ordeal to be gotten through, but well worth it if it;s successful.

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