To have ablation or not

I've just watched Dr. Gupta's video on You Tube on whether to have an ablation or not, and it has really highlighted all my concerns.   It makes me think I would like a second opinion and wonder whether anyone can recommend an EP in Bristol.  The trouble with Consultant Surgeons is, to my mind, they are all too keen to get their knives, or whatever, out - had a lot of that with knee problems - but I've got two knees and could live without either if it came to it, but the heart - we only have one and it's kind of vital!   So, I don't want to rush into having ablation without having done all the research and if possible trying a more natural approach.   I don't know what triggered my PAF, I am overweight, but not grossly and I don't have sleep apnoea, but do have a fair bit of stress. I am 73 and otherwise very healthy.   I'd really appreciate any thoughts or suggestions.   Thanks,   Tricia

65 Replies

  • I saw Dr Glyn Thomas at the spire in Bristol I found him very good he did mention ablation but not before discussing all the other options by the way he has AF so it was nice to talk to some that really understood

  • Thanks for that.   Interesting that he has AF.   I didn't know the Spire did Coronary.   Thanks again.

  • Hi Tricia 

    Like you, am anxious about having an ablation but I am now booked for 8th April, arranged time off work,

     and am hoping for some AF free years ahead.

    As Bob rightly said, EPs are really trying to help us AF sufferers and improve the quality of our lives. Ablation so may well not be the answer long term, or something else better may come along, but I have tried for 20 years to treat mine naturally, but as it has got worse with age over last few, I realise I really do need some experts to help me.

    Good luck with your decision and I will let you know how I get on. Hopefully very well!!

    Best wishes


  • Tricia you have AF. You don't need a trigger. There could easily be a genetic pre-disposition for AF as you don't sound like an endurance athlete or fighter pilot.

    I guess it depends how debilitating you find your PAF but do be aware that it is almost always  a progressive condition.

    By the way. EPs are not surgeons but experts in the electrical functions of the heart. OK it has been said that if you go to see a carpet salesman he will sell you a carpet but in general they are trying to help you in the best way that they know. A lifetime of drugs is not ideal is it.?

    Do read all you can about ablation from the AF Association booklets available on the website. Yes everything we do carries risks, even doing nothing. Also consider that thanks to the blame culture we seem to have these days every little risk , however small, has to be  explained so that you can't sue the poor old doctor. 

    As I have said several times over the last few years, this forum may not give a balanced view of ablation since those with success do not remain here as they no longer need our support so please think carefully about that. Very occasionally we do get people come back a year later saying how pleased they are that they went ahead but they are in the minority. I can think of dozens who we have never heard back from.

  • Thanks Bob.   Perhaps they weren't heard of again because they popped their clogs!!!  Only joking.   Anyway, I'm sure you are right and I must just 'man up'.   Thank you again.

  • Hello Bob.Sound you have a lots of knowledge and experience of AF.I came across the "STOP", where the hosted Dr.explained the pros and cons of rhythm control vs.rate heart control approach.Again, it is sponsored by pharmaceutical companies, and hard to outweighs benefit one over another.What is your comments.Of course, every patient needs different control. Also. About magnesium intake-  it should be taken very careful,providing that the accurate test can be done through urine or blood cell tests, that are not authorized by doctors here in Canada.

  • Any treatment should be about improving quality of life obviously. Here in UK rate control is the first port of call and only if that fails is rhythm control looked at. Many EPs feel that early intervention by ablation should be considered especially if the patient is highly symptomatic.

    Regarding magnesium I prefer not to comment as this is such an emotive subject amongst some members here. You will find some strong views I am sure.

  • Thank you.

  • Look on the main AFA website for the patients day presentations from last year and previous ones. You will see a lot of good info there. 

  • I did. You are right. It is the best way to have more updated info.


  • Hello Tricia,

    I understand you dilemma as I was very much in the same situation as you "shall I or shan't I."

    There is a EP who posts on this Forum every so often. I Believe he is based in Bristol and interestingly he has an Holistic approach to medicine. His name is Jonathan Pitts Crick.

    I would certainly want to see him if I was in your situation.

    Kind Regards,


  • Many thanks, I'm sure I've heard that name before, so I'll look out for him.  Thanks again.

  • I would try Dr Glyn Thomas in Bristol.  He spoke at one of the afa patients days and was very open, honest and approachable.  He is quite young and is an af sufferer himself so knows all about this nasty condition.

    I think you would find him helpful.  Good luck.

  • Many thanks.   Someone else mentioned him, so guess he's a good bet.  Thanks again.

  • I  read on previous thread here that at the patient day Dr Glyn Thomas also said that he refused an ablation himself that his colleague offered. He managaed his condition with meds. However, it wasn't clear if he had PAF or persistant and whether he was symptomatic. I have seen him a couple of times at the Brsitol Heart Institute (NHS at BRI) and he didn't try and push any particular course of treatment. I found him very likeable and his opinions balanced. He very much gave me options and choices for ME to make. Pity I'm such a ditherer!  :/

  • That's really interesting.   Wonder why he refused.    I'm a ditherer about this too, but since my original post I've now been given an approximate date of 5 May - so that's making me focus even more.

  • Hi Tricia.I am 76. Not overweighted,watching diet,had AF occasionally ,and using bisoprolol as PIP was helping to stop the episodes.When episodes became longer ,I refused the ablation for the same reason as you have mentioned.But I am on anticoagulant and Flec.taking only 50 mg.instead of 100mg..Of course, Dr. Promised, that ablation will help to stop AF completely. But after reading people pols about ,I still hesitate.Of course, everybody's hearts are different,and many symptoms has to be taken into consideration .Plus, with the age, the heart muscle,the vessel conditions and many others play sagnificant role in making decisions. I have AF for over 20 years.always was active.Blood preasure is normal.i am not exersise, and going up to hill is not easy.My concern,as I have read, often AF enlarged atria.How dangers is it?

    As a note: I have had a tremendous stress over the years.But who doesn't?

    Good luck to you in and keep posted. Thank you

  • Thank you for that.   What every professional tells me is that the AF is likely to get worse with time.   I reacted badly to the Flecanaide so can't take that.   I think I'll just have to be brave and have it done.   Seems like we can both blame stress!!!!   Some people just seem to sail through life, others have a few more spokes thrown in the wheel!   Still, at least can't say it's been boring, although that might have been preferable!   Thanks. 

  • Ancient Chinese curse, "may you live in interesting times."

    My Grandmother was 101 when she died but  slept every afternoon and thus had only been awake for about 70 of those years. I am 71 but have been awake for about 120 years.  It's been fun!

  • Good for you - keep it up!

  • Big difference between me and you Tricia?     I don't have AF.    An ablation did that.    Your choice.

  • Well that's very positive - thanks.

  • Ultimately, a personal decision to have an ablation or not. Risks and rewards each way. The ablation does not "fix" the underlying problem; hence, most people end up needing a second or third. I'd rather pursue mitigating the cause and managing the AF to get to an acceptable quality of life. EPs, etc. are "advisors" for me; "I" (the patient) own the decision. My advice is to become as educated as you can, weigh the risks/rewards and then do what you think is best for "you". Good luck!

  • Thanks.   I guess that's what I'm trying to do.  

  • Ablation therapy most certainly does fix the problem for so many people.     The need for a second or third procedure has nothing to do with returning problems - it's simply that the earlier procedure(s) did not go quite far enough.      As the cause of AF (if there is such a thing) is so obscure and the triggers (if they even really exist) are so numerous and diverse, then I wish you luck in your pursuit.

    Of course you must make up your own mind.......just don't wait too long though, otherwise it will be made up for you.

  • Just come out of a nasty attack, so yes I will be brave and go for it.  Thanks

  • I saw Dr Glyn Thomas about 4 years ago and he told me that he would never have an ablation. Its a shame I can't see him again 

  • Would he say the same today with all the intervening advances?

    Also would he be wiling to take all the drugs including the dirty drugs as so much more is known about long term effects now?

  • In fairness to the doctor a number of the dirty drugs have been a long time and for some people have  proved relatively safe - ablations have not been around that long - certainly not multiple ones so no real idea what that amount of burning does long term - clearly for some it works but rarely once - it is certainly not like root canal treatment in risk terms - this is a balanced decision so I can see his point - I think it really depends on how bad AF is affecting your quality of life. As far as advances are concerned apart from cryoablation I am not aware of many significant ones in the last 5 years.

  • True that a number of dirty drugs have been around for some years but it is only more recently that the effects of their long term use has been better understood.  Yes some have been OK on them but many haven't.

    Multiple ablations have, from what I have read, been around for at least 10 and probably 15 years.

    Yes cryoablation has been a "fundamental" change so to speak.  However there have been quite a few developments / enhancements with RF ablation including such things as the tip (that does the burning), the temperature, the wattage, etc.  In addition the mapping techniques and equipment have seen significant advances which in turn improves the accuracy and the consistency of the ablation.

  • It is a balanced choice dependant on how badly your quality of life is affected by AF , but, despite all the improvements they are still saying that you will need 2/3 ablations to see any form of sustained relief and quite often this needs to be bolstered by Flecanaide or another such drug. The point I was making is that it is not Root Canal treatment v Nasty Drugs - that would be a no-brainer.

  • Depends on the type of AF and the origins and whether it is true AF or flutter.  For flutter some EPs are quoting 90% success rate first time.

  • Many thanks.  Having spoken to a specialist nurse, she is of the opinion that for my type of PAF an ablation should be very successful and basically the only way forward.  I do seem to get a flutter almost every day, late afternoon, but touch wood I haven't had an attack of AF for a few weeks now - which makes me more hesitant to have the ablation.  However, everyone says it doesn't get better of its own accord, only worse!  So I guess I will just go for it.   Thanks again.

  • So you know how many people died in the UK while undergoing dental surgery last year vis a vis the number of deaths from catheter ablation?      No?   Just speculation then eh?

  • Putting all comments into perspective. Far, far more people die on the roads each year than people who die from ablations and dental treatment put together!!!!

  • I'd really like to know why he said that.   Did you ask him?

  • Personally,  I can't wait for an ablation.  Got to wait til June to discuss my suitability,  but couldn't tolerate amiodorone way too many side effects. 

    I want at least some of my life back

  • Yes, I know what you mean.   I'm not good on the meds, and suddenly I feel old - I know some might argue I am, but I haven't felt it up until recently with AF and betablockers.  

  • I'm 48,  I was active but very over weight when I was hit with the craziness.  I feel at least 70 now. I was overtaken on a walk last week by a guy that was at least 80 with a walking stick.

    I used to walk 6 miles a day to work and back   plus the occasional cycle ride. Pretty good for someone with ankylosing spondylitis I thought. 

    Now I can just about make it to the top of the stairs :(

  • Tricia, I was much like you. Didn't want an ablation so I took drugs. I was on apixiban,tikosysn,pravachol, and coreg. I wasn't feeling any better. I have Paroxysmal Afib which generally means it comes and goes. I also have three stents. I noticed as time progressed the quality of my life was not getting better but plateauing or getting worse. I couldn't exercise consistently without some form of afib. Was waking up in the morning feeling dragged out. I decided enough was enough. Had the ablation at the end of January. Making the decision took a load of my mind. Secondly, I am feeling much better. I've started my exercise again but slowly. It seems to be working. I also got a second opinion before I had my procedure done. Find a doctor you trust and talk to them. I was ready after that. Didn't realize how slowly things had been getting worse. Hopefully, I'll be off all my meds except the anticoags soon. Wishing you the best on whatever decision you make

  • Thanks for the encouragement.  I know I'm slowing down and I don't like.   This time last year I was decorating my grand daughter's house and she was amazed at my energy, said she couldn't do what I was doing - really don't think I'd be able to manage it now.  Also I'm frightened to re-join the gym - can't be good to let fitness level diminish.   So thanks.

  • You might find this site and the videos helpful.

  • Very useful site. Thanks

  • Hi Tricia, I too am 73 and weigh more then I care to, but am not grossly overweight.

    In 2010, I underwent a cardiac ablation, biggest mistake I ever made,the Ablation was not successful, I developed a blood clot in my right leg and was put on Warferin for 6 months after a bout in the hospital for this. Suffered a second clot two years later in the same leg after a long auto trip. Am now permanently on blood thinners and suffer a DVT, deep vein thrombosis.

    Must wear compression stockings along with this. If I had to do it over again, would have educated myself on ablations and would not have gone for it.

    My present Cardiologist put me on a beta blocker, Sotolol to control bouts of rapid heart beat. Diagnosed as Sinus Tachacardia. For 12 years I had this problem, my heart would suddenly start tripping at 180 beats per minute, many trips to the ER,

    perhaps why I was anxious for this procedure. Needless to say, am still on Sotolol and have not had an episode in over two years. I also stay away from caffiene.

    I wish you the best in whatever decision you make, perhaps you might have better luck then I did.

  • Sorry to heart your story.

    However if you are saying that you having the ablation was the biggest mistake you made because of you suffering the 2 strokes then I believe that is a serious false assumption / conclusion.

    In my view there is a moral in your misfortune in that once diagnosed with AF you should definitely been prescribed an anticoagulant straight away and stayed on it for life. Even if you hadn't then given your first clot you should definitely have stayed on an anticoagulant for life which almost certainly would have prevented the second clot. From what you have said I am guessing that at the point of the AF diagnosis you had a CHADSVAC2 of 2 which meant you should have been on Anticoagulation, period.

    From your words ER and you are on solatol I am guessing that's you are in the USA because in the UK solatol has been withdrawn as a treatment for AF  for almost 2 years.

  • Thank you for your reply, actually, I do not have AF, I was diagnosed with Sinus Tachycardia,which began in 1997, have had several bouts with this  throughout the years, other then that my heart was fine. My Cardiologist put me on a Beta Blocker, Topral, and said perhaps up the road I might want to consider an ablation This is a very fast regular heart rhythm that would happen out of the blue maybe 2 or 3 times a year if that, and was treated with intravenous medications in the ER

    When this occurred in March of 2010, the Hospital Cardiologist strongly suggested  that I have an Ablation, he suggested this as the possibility of a stroke might occur, however, again..all tests came out fine. I decided to go with the ablation,

    After the Ablation, The blood clot occurred in my right leg and I was put on blood thinners after a few more days in the hospital. Perhaps you were correct in saying they should have kept me on blood thinners. Perhaps the second clot would not have occured.

    I went to a different Cardiologist who put me on Sotolol and have not had a problem since, 80 mg, taking a half pill every 12 hours.

    Stopped the Toprol.

    I never had a stroke, and I also think an Ablation might be the answer for others with abnormal heart rhymns, it just didn't work out well for me.

    Wishing all the best to Tricia239, whatever she decides.

  • Oh dear, I am sorry to hear that.  This getting older isn't much fun is It?!

  • not much future in it !!

  • I guess you are nearing the date for your ablation. I am having the same dilemma. I am 64. One Cardiologist told me his aunt lived with AF for 30 years, which made me think I could. But the EP said Ablation was the definitive treatment with 70% success rate and 1% chance of adverse effects. What to do?

     I felt awful on Flecainide and Bisoprolol. A cardioversion has helped by stopping the PAF, but I still get fluttery feelings every day. So to cut a long story short,  I have decided to go for Ablation on 20th May because it seems to be accepted that AF will get worse over time and the heart will remodel and the left Atrium  will enlarge (mine not yet enlarged but at the top end of normal). I was having a bad time with the AF. Panicky, breathless, slowing down and agorophobic.  I hope it works.  Fingers crossed. Good luck with yours.

  • It does seem to be the right thing to do.  My news is that the hospital overlooked my papers and I had to do a fair bit of chasing. So now I don't know when my ablation will be but I am seeing the Consultant on FRIDAY 13TH! this month.  I have also learned that before the procedure I will have to have a camera put down my throat to check for blood clots.  I had an endoscopy a few years ago and found the experience horrendous, so I'm even more jittery now!  Not to mention worrying about the said clots -I guess I hadn't really been aware that I was at such an increased risk of, thinking that the Apixaban really was magic!  I wish you all the very best on 20th, I hope it goes well for you and that it is successful.  By the way I couldn't tolerate Flecainide, very scary and Bisoprolol gave me nightmares.  Let me know how it goes. Tricia 

  • Thank you for your good wishes. I hope it goes well with the consultant on 13th. I'm told the endoscope goes down your throat after the general anesthetic so less problem than an endoscopy!  

    I'll let you know how it goes. I was so het up before the pre-op assessment that my "white coat" blood pressure was through the roof. Normally it's pretty controlled. I hope this won't get in the way of the procedure. Best wishes,  Janet.

  • Hi,   Thanks, I sort of guessed I would at least be quite sedated but I shall still tell him on the 13th how anxious I am about it.  From the way you talk about it, it seems it is quite normal for them to do that before the ablation - I was fretting that perhaps I was at greater risk of clotting than most people because one GP told me that 'something' that I have can just finish me off within seconds.  I mentioned that to my EP in Exeter and he said 'no', but then when talk of this endoscope reared it's head I started to think that maybe I was at greater risk.   But then I guess loads of people are but don't know it.   Sorry, but I can't remember when your procedure is - please do remind me, and, I will certainly be thinking of you and look forward to hearing from you how you got on.   Best wishes,  Tricia

  • I can only speak for myself Tricia, but personally I was so fed and distressed with the symptoms of AF that I couldn't wait to get into the theatre. I had an ablation at Barts Hospital in December just gone. I didn't ever think I would feel this well again, and so happy. I'm still on medication, as I experience a bit of AF here and there. I was at risk of going into permanent AF, and I am so happy that this was prevented by an ablation. I would have absolutely no hesitation going for a second ablation if it becomes neccessary. I'm back at the gym, working nightshifts again, and have never had to cancel any event due a episode of AF. There has been no more loss of sleep, due to night time episodes keeping me awake.

    After the ablation I did not experience any pain, either in my chest or groin. The second night after my ablation I was able to sleep all night on my left side, this hadn't been possible for years. Unfortunately I was undiagnoised for years, and my AF just continued to get worse and worse. All I can say is Thank God for ablations and Thank God for all the skilled and marvellous EP's. Especially mine, Mr Sporton.

    I spent along time wondering why and how I had developed AF, and now I know it was a waste of my time. It's here and thats it ! The only thing I have to worry about now is limiting my alcohol intake at social events, in regards to my AF.

    I wish you well Tricia. xx

  • Hi Jacky,

    Thank you so much for for telling me about your experience. I went to the Bristol Royal Infirmary on Friday to discuss my ablation and unfortunately it heightened my anxiety, until I met my Consultant, who made me feel much more confident. So, to read your positive experience was really good. I just hope mine works as well. Thanks again, and thanks for your good wishes. Tricia x

  • I can echo much that Jacky has said.

    I found doubts and trepidations almost evaporated when I got into the Cath Lab. The technology and professional excellence are very impressive. I am grateful to the lady who told me her job was to monitor me to ensure my wellbeing and that I might not be aware of her, but she would be watching everything like a hawk throughout the procedure.

  • Jacky, just came across your post here by chance but would like to say how lovely it is to read something so positive. I hope others who are dithering get the chance to read this, particularly as you had been undiagnosed for years.

    Best Wishes


  • Thank You Sandra x

  • Hi! Tricia239. Two Ablations and free of AF. Feel great. Had AF since 2008 and only cracked the ablation last September. Had a pace maker fitted at the beginning. Went through all sorts of tests, drugs and trips to A and E. 6 cardioversions! Really felt like a guinea pig Perhaps I was. Felt so bad all of the time. AF incident in Norway in 2010 and after cardioversion there, was told that automatic AF treatment in Norway was catheter ablation and that was a small country hospital. Given 6 alternatives by a young Doctor at the hospital and then had to push like mad for the ablation. My cardiologist was not keen. Best thing I ever did was go for it. Feeling on top of the world now. It's Norway Day today!!! Bob's probably right. Having got into Sinus Rhythm by Catheter Ablation people do not return to this blog site. They are all feeling so much better!! Go for it! Dave.

  • Thanks Dave. I will - but with some trepidation. Guess I'm just a wimp, but I like living and anything that puts that in the slightest danger scares me rigid, plus I've got to have the camera down my throat and having had that done once before I'm not looking forward to a repeat performance. Then again, I keep telling myself we are very lucky in this day and age to have these procedures available to us. So glad to hear you are feeling so good.


  • Tricia, I am sure if you explain the difficulty you had with the previous camera invasion they will take extra care. They were very good with me. It would not be normal if we did not feel under pressure with both that and the ablation and they all appreciate that. So chin up. Think about the bloom of youth it will put into your cheeks!! Dave.

  • I wish!!!!! Tricia

  • It IS hard. As the wife of a sufferer, we found ways of control his intermittent AF for years with the usual - diet, stress reduction and, interestingly could stop episodes fully developing by taking a dose of sea salt. Now last August a big stressful event and he went into P AF.Again we tried alternative means and used an Acupuncturist with immediate results. We only had the heart rate app on mobile to record it (which only measures 12 sec's) but clearly a good regular strong beat after acupuncture.

    Showed the before/after results to the Cardiologist who didn't want to know/ rubbished what we thought were great results. The Cardio ECG only measured 12 sec's too but showed back to permanent AF but then again, hubby was naturally stressed, white coat effect methinks. I might take your great advice to get a second opinion. Hubby is on no medication at the mo' and has very few symptoms if any so why not continue to try alternative treatment before resorting to ablation?Thought I share this with you as I feel we had some elements of control. Sorry for the ramble but it's quite a journey :-)

  • Dear Petrac. Thank you so much for taking the trouble to write to me. It was really good to hear your thoughts because curiously enough, over the last couple of days, I have been seriously thinking of putting off having an ablation. My stress level has, touch wood, gone down since 17 April and I haven't had an episode since then. I am seriously trying to lose weight and am going to attempt to come off the protein pump inhibitors which I've been on for ages because I was on NSIADs as I have just discovered the connection between both and AF. I also want to research the vagus nerve because I understand that affects AF and IBS, which I also suffer from. So your message has served to spur me on, so, many thanks. Wish me luck. Tricia

  • Hi Tricia239, it's good to share especially positive experiences. Good luck and god bless. Keep us posted Petra :-)

  • Will do. Thanks

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