Dr Sanjay Gupta for those of you who ... - Atrial Fibrillati...
Dr Sanjay Gupta for those of you who may be interested.....ref Ablation
Clearest advice yet.
Brilliant, thanks for sharing, kind regards.
Dr Gupta's primary reason for not choosing an ablation is because it is an invasive, non-natural procedure. Doesn't that apply to almost any form of medicine or surgery? Fillings ain't natural Dr Gupta but without them, most over 60s would have been toothless years ago. I had my appendix out aged 23 - how unnatural is that? - but, at the time, it probably saved my life. Of course it's not natural but let's leave, short, brutish, and natural death for wild animals, shall we? (Sorry Mr Hobbes). As humans, we are lucky to have science, medicine and doctors. So go ahead and intervene Dr Gupta. It's what you're paid to do!
He tells us we must work on the underlying causes of AF which are being overweight, unfit and the wrong mindset! So slim, athletic types don't get AF? You have AF because you are fat? Or because you snore? You are thinking yourself into AF? He tells us that the success rate of ablations is 40 to 70%. Think about that for a moment. How can anything have a success rate of 40 to 70%? If you mean that it's 40% after 1 ablation but 70% after 3, then say so. If you mean it's 40% in Bristol but 70% in Leeds, then say so. If you mean you don't know what the success rate is but it might sit between 40% and 70%, then say so. If you mean the success rate depends on the criteria used to describe success then say so. But don't use meaningless statistics that simply seek to discredit the procedure.
Ablation aside, AF does not go away. It is a progressive condition and episodes will become more frequent and last longer. If a patient is entirely without symptoms - ie life is wholly unaffected, there is still one good reason to consider early ablation. Your AF, almost certainly, won't continue to be that easy to put up with. And the longer you leave it, the less likely it is that ablation therapy will work.
Of course we should try medication first - and who of us doesn't? Not to cure the AF, because it won't. But it might return one to NSR sooner or it might alleviate the 'yukky' symptoms. But it won't cure AF - all the drugs in the world won't stop the AF becoming worse. And worsening AF will begin to affect the heart structure, firstly by enlarging the atria. So the argument that says "I can cope with my AF so I won't have an ablation" is no argument at all.
Ablation therapy - and that means it could be more than one procedure - is the one and only option that Afibbers have to end the misery of AF. But if you heed those who tell you not to have it, your AF pathway is sealed. Perhaps in a few decades there will be something better but ablation's replacement will probably be too late for everyone reading this. Of course there are risks associated with ablation - just as there are with any surgical procedure but gosh, they are so, so overstated. Where are the statistics on death or disability from a failed ablation to reinforce the words of the detractors? I suppose they lay between 0 and 100%!!
I'm driving from home to Manchester today. Forty miles of motorway where tons of metal are hurtling past me every moment at high speed. Next week I'm going up to 35,000 ft for a few hours before throwing myself down a mountainside on a pair of skis. God, I love danger......
Life is a risk Dr Gupta and life without AF is bloody wonderful..... Stop scaring folk!
Now, THAT is the clearest advice yet.........
I agree RobertELee - too many unsubstantiated assertions and contradictory comments. I also disagree with his take on the most up-to-date research findings
I am so glad to hear you say this. Although i know that we owe it to ourselves to be fit and healthy, i get fed up with being told that diet and lifestyle will sort it all out. In my case, it hasnt. I lost 4 stone and my bmi is 21 my blood pressure and heart rate are if anything on the low side. I was and still am very active and generally well ( or was until i had to take 300mg flecanide a day). I have never smoked and now dont drink alcohol at all. Did all this halt the A.F.s progression? No it did not. Roll on second ablation. If it doesnt work, so be it, but at least i willhave tried.
Everyone should try to follow a healthy lifestyle, i do not dispute that, but it is not necessarily going to cure A.F. although it is well worth a try. X
It may not have been your intention but your response to the video made me laugh out loud. I am recently diagnosed with AF and am really struggling with all the widely differing opinions of experts out there. Thank you for stopping me worrying for a short while!
Well said! My being overweight and unable to exercise as much as I should is because of my AF not the other way around. Plus I eat very healthily.
ncbi.nlm.nih.gov/pubmed/238...
This study finds that ablation significantly reduces one's risk of stroke to levels comparable to those without AF. Of course, he is undoubtedly correct that many should remain on anticoagulation following ablation - but his assertion that ablation has no benefit for stroke risk is debatable at the very least.
Thank you, very interesting! I was particularly interested in the comments about inflammation as I have often linked episodes of PAF with infections/inflammation. When I was young I always experienced ectopics with viruses/infections and dizzy spells with stress. I also have breathing problems connected with inflammation and stressing my breathing is a sure way of bringing on AF.
My ablation was plan A to deal with pauses exacerbated by my AF meds, plan B is the AV node ablation and pacemaker.
I have noticed that in the USA (only from comments posted here so it may not be true in general) the favoured procedure seems to be to go straight for ablation. I would be interested to hear more comments on that?
Your last comment infers that there might be another procedure for ending AF. There isn't of course. So, if the only procedure which resembles a cure for AF is ablation, why wouldn't it be the favoured procedure? Unless you find AF fun and don't want it to end or, more likely, you are put off by hugely exaggerated anti-ablation scare stories that creep into these pages, sometimes from people who should know better.
And talking of scary things.......I chose Leeds for my therapy. I could so easily have chosen York and then where would I have been.....?
There is no need to be rude just because some people don't entirely agree with you.
For me ablation was a risky procedure and although I'm pleased I had it I would not want to risk another one. That is not scaremongering, it is being truthful about my situation.
My comment about the USA referred to the possible preference to go in all guns blazing before addressing health and lifestyle issues.
How on earth was I being rude???? I don't do rude Buffafly!
Clearly not everyone agrees with me...too many folk live with their AF, terrified of a straightforward procedure carried out by teams of very clever people. I'm afraid there is scaremongering going on though I am not entirely certain what motivates it. If you are fearful of another ablation, that says a lot about you and what you have been told rather than the procedure, doesn't it? Or do you still think I'm just being rude?
Finally, in your last sentence, are you criticising a system that "goes in all guns blazing before addressing health and lifestyle issues"......when health and lifestyle issues have practically no bearing whatsoever on atrial fibrillation?
I went for a pip assessment by an ex midwife!!! Asked why I didn't have ablation I sais I was afraid and some people have to have it a few times so I wouldn't do it.why say that to buffafly? That she may enjoy AF? Ewe are all different my cardiologist knows my fear and would use it as last resort.Buffafly ur right do ad u feel
Well, your name is certainly appropriate!
My last word, I have HAD an ablation in spite of the risks for ME, and the complications I suffered and the information I have since from a CT scan have convinced me I was right to be fearful, nothing to do with what anyone has told me, in fact I only became aware of one of the risks after the event.
We all have to choose what is right for us and shouldn't be made to feel ashamed if what we choose is not what others think we should.
OK, my (first) ablation is the day after tomorrow, so I'm just not going to watch this!!!!
Judging from the comments here, though, I, too, have made lifestyle changes (not that I was massively unhealthy anyway) and the AF only gets worse. Ablation is my first choice (apart from beta blockers).
None of it is ideal, is it? The only ideal thing is not having it in the first place.
Best wishes for your procedure! The main point was that Dr Gupta is not evangelical about performing ablations and that you should make your decision based on QOL which you obviously have, so hope you have a great outcome.
My QOL is much better three months on so worth it in the end!
The only heart rhythm specialist listed in the link from the AFA website in York is Dr Maurice Pye. Just sayin..........
Realise you don't have to be on the list to be a knowledgeable guy. Everyone is sure to have a degree of disagreement depending on their life experience - even doctors.
Yes, clear advice and I enjoy his talks.
I've had two unsuccessful ablations and I would certainly say for people to think hard before having one. My heart is now so scarred inside I cannot have any more. If my ablations had been successful I would be writing a different story here, but they weren't so I state what I feel.
Jean
I have to say that if I had heard this talk by Dr Gupta before I reluctantly had my first ablation in 2009, I doubt whether I would have gone ahead !! At the very least I would have postponed it.
My cardiologists words to me were that i would not be prolonging my life by NOT having an ablation.
Sandra
its a very sobering assessment of the procedure and quite surprising given recent advances.
An assessment by one of the leading EPs would be more enlightening. See professor Schilling's and others.
indeed - I posted one the other day on a different thread
Before my ablation my quality of life was so bad I was almost suicidal. I had failed 4 different arrhythmic drugs and was in AF most of the time, most days. BUT - it was still PAF, just.
Having an ablation has changed my life for the better. I still get ectopics, I still get odd sensations BUT thanks to the PVI ablation and IL ablation I am still AF free.
I am thankful for that, really I am.
I think this video is an honest appraisal of options for an AF newbie, its not for us who have been driven so low. I knew all the risks and possible long term complications but I'd still have another tomorrow if needed.
Still, a valuable resource for the newbies.
how can you tell what has caused your afib????
i know quite a few afibber including myself who have a low heart rate , mine being 49-52 bpm and so my af attacks mainly happen while i am asleep and my heart rate goes even lower. so i really cannot see how a ablation can fix that. unless my heart speeds up after the ablation is done.
Cheers Mike , my hr as always been low through keeping fit but I haven't done so much in the fittest department for over a year but my hr remains low. I hope to god I can have a ablation and get back some kind of normality in my life.
Thanks Chandaal - what's interesting about that study is that they're simply providing an informed opinion: when a patient has many risk factors for stroke such as high blood pressure and previous heart failure - moving the patient off anticoagulation merely because they've had a single ablation may not be advisable. I agree. Anyone, regardless of whether they have AF or have had an ablation - might benefit from anticoagulation if they have several risk factors for stroke. An ablation does not eliminate one's overall risk of stroke - it can only address one risk factor which is AF (and it's not always 100% successful, as the authors note). Thanks for posting.
Ablation may reduce a person's risk of stroke, but it still may be advisable to remain on anticoagulation, if there are other risks for stroke. To give a concrete example, a clear "benefit for stroke risk" might be that you've reduced the risk of having a stroke from 10% probability over the next year to 6% over the next year. That means your risk of stroke is quite a bit lower, so the ablation was indeed a "benefit" for stroke risk. However, you might still be advised to take anticoagulation in order to reduce your stroke risk even further, for example down to 3%. Just because you decide to continue with anticoagulation, that doesn't mean the ablation had no effect on your stroke risk. Hope that makes more sense 
See my seperate response in this post.
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