Is Ablation all it's hyped up to be?

I'm 42 and have PAF controlled by Flecainide at the moment. 2 x 50mg per day. One year and counting. I'm considering ablation myself at some point. My opinion is that overall, on balance, this forum is pro-ablation and anti poisonous drugs. However I have seen some recent posts that in my mind, seem to confirm that ablation is very much hit and miss, not guaranteed to make your life any better, perhaps a complete waste of time? and effort, and in some cases quite disabilitating? All I can see is months of taking nasty drugs beforehand. A nasty procedure. Nasty drugs after. A complete change of lifestyle while you recuperate and then BANG back to the drawing board. 2 or 3 ablations later people are still suffering. My question is therefore should this forum really be so biased towards ablation? Or should it be a little more realistic and balanced? Comments welcome...

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  • Hi and Wow! I'm glad comments are welcome, as that is what we are all here for...to share ideas and comments. I think approaches to handling AF are as varied as the individuals here, and also vary a great deal from country to country. If you read back over my posts (not that I am recommending that ;-) you will see I am the Queen of the LIFESTYLE CHANGES camp.....that before everything!! However, that does not mean that sometimes drugs, especially anticoagulants, are not a necessary part of the program to be well. The sentence that you wrote that interests me most is "A complete change of lifestyle while you recuperate and then BANG....." I am a proponent of the lifestyle change long before an ablation is even on the table, and then continued post-operatively FOREVER, because the research is clear that ablation is more effective in people who have done this, vs those who go back to their old ways of eating, sleeping, and stress management.

    Is an ablation a panacea? Certainly not. Its success is dependent on everything from the above mentioned lifestyle changes, to the skill of the electrophysiologist who performs it, to the extent of other co-existing heart disease, to how long the AF has had a chance to remodel the heart's architecture and electrical system.

    I'm sure there are a lot of people on this forum who feel that they are worse off post ablation, but there are also those, like myself for whom ablation has meant getting back to the very best of life; the life before AF started to cast a shadow on special events and be a life changing nuisance.

    I feel like this forum finds balance just by the virtue of so many individuals who share their experiences of frustration or joyful relief as we find a way to live our best life and be healthy in spite of A.F.

    Be well!

  • A forum does not have an opinion and people's experiences vary. What I think you might mean is that the concensus of opinion on this forum is.........

    I would agree with SRMGrandma - lifestyle changes - weight loss if overweight, meaning change of diet to one high in plants and low in red and processed meats, sensible regular exercising, quit smoking, alcohol intake limitation, stress reduction and management and adequate sleep which also means sleep apnea testing and treatment can improve AF management, for some people dramatically so that would be a desire able first line treatment strategy.

    AF management is about quality of life rather than extending life span and both drugs and ablation are significant factors in AF management, it is not either or. Neither is it hit or miss - physiology varies as does the skill and experience of your EP, multiple factors influence outcomes so it is not fair to judge one against another. It is always an individual's choice - if they are offered treatment - to assess the risk/benefit for their individual circumstances.

    All treatments carry risks factors, depends how pro-active you would like to be regarding your health and well-being as to what your are willing to risk.

    After 2 ablations I have been AF free and now do not take any heart rate drugs or anti arrythmic drugs and have had no problems since my 2nd ablation in Mar 2014. The first did make my AF a lot worse, that was a known risk I was willing to take because my quality of life at the time wasn't up to much. I was well aware that I may need more than 1 ablation for a successful outcome. Very pleased with the outcome, even though there were complications at the time.

  • Well my ablation stopped my AF completely and I took no drugs afterwards (except anticoagulants). The procedure went well, no problems, and I had virtually no recovery period, I was back doing very light work within days (against advice, but I was only sitting in a tractor).

    Eventually, after 8-9 years I had a little bit of AF come back, as predicted by the EP. A second ablation was booked but this didn't work, and I don't think I'm any longer suitable for one. Again this ablation was no problem, I felt great afterwards, not just OK. Guess that was the drugs, wish I could buy some 😃 !

    Koll

  • Hello Yanbart, you raise an interesting question but in my opinion, "The Forum" does not have a view. It is simply a vehicle for people to express their individual views about the way AF affects them. As has been said many times, no two sufferers of AF will experience the same issues. Like most forums, you tend to hear more about problems than you do about successes, simply because folk who are doing well tend to get on with life and who can blame them!

    In my case, my Cardiologist generally has conservative views about ablation, but when he said to me "if I were you, I would have a cryoablation" the decision was made. Yes, I am apprehensive and when I get the call I will be even more nervous but I will put my faith in those that have helped me deal with AF.

    I'm not sure if you will find any of this helpful, but I very much hope you get the help you need to move forward. Best of luck, John

  • As others have commented this forum does not have an opinion, just AF sufferers sharing experiences and offering advice/ help/ warnings.

    I went to see an experienced Electrophysiologist who offered me an ablation. I use the word " offered " specifically because I had a choice but he thought that ablation was the way forward for me. He was prepared to carry out the procedure having judged that I was a suitable candidate.

    My AF was ruining my quality of life. I had to do something. The drugs weren't working. So I had the ablation. No regrets - I gave it my best shot.

  • As you have probably read on here i had a scarey experience with my second ablation and am no longer able to have more but the point is that because my E.P. was on the ball actually disaster was avoided and I am still here to tell the tale. I think a lot depends on your personality and A.F. certainly forces you to know yourself in a way that not everyone does. For me the important thing is, that I have done everything in my power to improve my situation so now I can relax and get on with taking the flecanide.

    I would say however that I think we should read and consider the potential problems of the procedure, very carefully , so that we can make properly informed choices. If my heart conformation had not been part of the cause so that I had been offered another, i may well have gone for a third.

    We all have our limits and for me it is amioderone. All of the possible side effect are problems I have in my family eg thyroid, sun sensitive skin and lung fibrosis so I have made the decision that I will not take the drug even if it is last chance coralle! However I have a friend who has been on it for years with no ill effects.

    I dont know whether thats any help to you. It is not an easy decision to make I know. X

  • I think eveyone expresses their own personal views on this forum, I don't think it's biased one way or another, how can it be? I have read through many posts in favour of ablation and many in favour of medication. It's important people can express their own opinions either way, it's then down to the reader to decide what information is useful and then make their own mind up on future treatment.

  • The number of times I have asked myself the question in your title!! I always come up with the same answer - maybe, maybe not. To me, there is a feeling that 'the forum' is pro-ablation, but I think that is because so many posters have had their lives transformed for the better by ablation. As for anti poisonous drugs - who wouldn't treat Flecainide and co with caution?

    I think overall we do present a balanced view of the severity of the choices we face and the potential impact each of those choices may have on our lives and those of our families. The value of having so many different inputs to the debate, is that we can be better informed when faced with the decision to ablate or not.

    We all start from different perspectives - I take 150mg Flecainide daily, have a great active life and hope never to have an ablation. But, if I were 30 years younger (your age), I would probably not feel like that.

    Thank you for asking the questions - it's always good to consider.

  • One thing I think you should consider is that people who have successful ablations seldom hang around here very long so in fact the general "mood " may well be that ablations are often troublesome and not successful.

  • Thank you all very much for your replies. I have read them all and I am very grateful for you taking the time to respond. I think some of you have made very good points about those who have had successful treatments not hanging around on the forum, of course, why would they? It seems to make perfect sense that it is only the ones with issues (in the main) that follow the posts on the forum. Once again, thank you for helping me to put the context of what I read on here back into perspective. Good health to you all, Yan

  • Hi, Ive had 2 ablations...first one was Cryo, and it didnt work..second one was heat ablation and it worked a treat 4 months in and i feel like i have my life back...

    Regards

    Robby

  • Hi, I'm 43 and although I don't have AF so am in a slightly different category, I do have troublesome SVT. I had my first ablation in 2007 as advised by my cardiologist to enable me to have a svt-free pregnancy. Unfortunately it didn't work and in fact made things worse for me so that my second pregnancy was worse! I continued with flecainide and bisoprolol and still had several runs of svt daily which would stop me in my tracks momentarily but I became used to it and I guess normalised it to a big extent. Then towards the latter end of 2015 I started having a horrible arrhythmia associated with vasovagal/pre syncopal symptoms that meant I was admitted to ccu 3x and have been essentially housebound. Therefore they recommended I go for a second ablation. I duly did and not only did it not get rid of my fast (normal) svt or the supposed slower one causing the fainting symptoms but I ended up with pericarditis and complete heart block and needed a pacemaker to be inserted the following day 😥. I have therefore been housebound for a further 4 months, am now agoraphobic, terrified of all my ectopics, svts and on top of it all they can't programme my pacemaker around my intermittent normal conduction and my svts. I am back onto bisoprolol and after becoming really unwell on flecainide they started dronaderone (like amiodarone). Therefore when they suggested a third ablation I felt I had no choice left. The idea of being symptom and drug free even though I will be pacemaker dependent suddenly felt like an offer I couldn't refuse.

    So what I'm saying is that even though I found both ablations to be really traumatic (was awake for first one, GA for second one) and both have left me far worse off than I was before, I still know that they can be successful and that if they are then it's amazing. Therefore this means that I would still consider another one. So I wouldn't say I advocate having one and I'm certainly not biased towards having one but given that I'm 43 and feeling 83 I am willing to do whatever it takes to try to get back a bit of normality in my life. All about quality of life, if you have a good quality of life on medication then stick with that but if your life is compromised by your diagnosis then that's where ablation comes in.

    I live in hope of finding some relief from the way I am as I have become a shell of myself and I'm so frightened all the time. Hope I can be patched up even if never to be fixed!

    I am so grateful to all on here as in the middle of the night when I'm terrified and so low it helps me so much to read the posts and replies, so thank you, and I wish you all well.

    R

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