Ablation

I am due to have an ablation in sept. Since I last saw the EP my medi ation was changed to flecanide and bisoprolol and after the first month when the amount of medication was altered slightly I have not had an AF incident for 3 months. Should I therefore reconsider having an ablation. A friend who also suffers withAF told me today that he was told anyone over 55 should not have an ablation as it wouln't be successful . I am 68.

Ann

28 Replies

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  • I have never heard that one about age limitations and there have definitely been many on here over that age who have had successful ablations. I would definitely ask your friend who told him that and equally importantly when.

    As far the ablation goes personally I would definitely go for it since you don't want to progress to persistent AF if you can avoid it. Any of the medicines do not stop the AF per se they merely reduce or inhibit the effects.

  • Hi Peter, I posted the very same question a short while before my first one. From having frequent episodes I went to about 1 every 3 months. I told my EP on the thinking maybe somebody who was in real need of an ablation could be bumped up the list and his response was basically "It's up to you". I decided to give it a go and have now had two. He also went on to say for him it's about giving a good quality of life to the patient. If AF has been impacting your life in the past it could rear its head again. If your symptoms aren't too bad and your meds pull you round pretty quick, then how does that differ to any other medication. You will be anti coagulation so will be taking regular daily meds for that. I would say it's your choice. People will say go for it because you don't want to be taking tablets for the rest of your life, but with your age you will be taking Warfarin, etc. Remember ablation is ongoing treatment to keeping the beast under control, not a cure. As I mentioned I have had two ablations and no longer take any meds. For now the ablation route was the right choice for me.

    Good luck whatever you choose.

  • Firstly if you have been offered an ablation, Ann, your consultant thinks it is in your best interests. The earlier it is done, the better the chances of success.

    Secondly, exactly as Peter and Jason say, the medications merely inhibit the AF. If you rely on medication like flecainide for a couple of years and don't go down the ablation route you may find you have acquired unwelcome side effects that will only become evident with time. Also, the AF may not be suppressed with the same efficiency after a while and more and more medication might be required.

    I asked my EP about age restrictions and he said age itself is no barrier. It's more the health of the heart and a person's general condition that have to be considered.

  • That's the problem with friends isn't it Ann ? They all know somebody who told a friend etc etc

    Nonsense! I was 60 when I had my first eleven years ago and I know people well into their 70s who have had ablations. It has nothing to do with age trust me.

    I think it is quite natural to have wishful thinking but your AF has not been magically cured and you are currently being managed by tablets which control the symptoms. Ablation has the potential to give you this state without those drugs which all come with side effects. Anticoagulation of course is different and you will be on this pre ablation. anyway and for some time afterwards. You don't mention this and if September really is your date then you need to start NOW so please discuss with your EP.

  • Ann

    Although Jason wrote his reply under me and addresses me I think most of it was addressed to you. He makes some very good points.

    I also seem tobrecall that about 6 months ago someone who was about 83 was offered an ablation. I don't recall / remember seeing if that happened or not.

    Peter

  • Sorry Peter, you wouldn't think I worked in IT. Thanks for correcting my mistake :)

  • Your friend is not well informed. There is no age limit per se but some doctors may have varying views as to whether or not an older person is fit enough for the procedure - always a risk:benefit assessment and that will always be very individual.

    If a doctor ever told me it was 'my age' as an excuse for not offering treatment I would be looking for a new doctor, however, if they told me that the risks would out way the benefits in my case and explained their reasoning, I would take that as sensible advice.

    Hope that helps ......

  • PS - 1st ablation at 62, 2nd at 63. 2nd was successful, 1st was for a while but I mucked it up by doing too much, too soon.

  • It may have gone that way anyway.

  • My EP thinks that 80 would be the upper age limit.

    You say that you have not had AF for 3 months. You cannot be sure as it can happen when you are asleep and therefore unaware. I had a 7 day monitor fitted and it detected a 36 hr episode that I did not know about. However, it's possible to be AF-free for months and then for it to return with a vengeance.

    Finally, you can be very sure that you would not be offered an ablation, a £15,000 procedure, if the EP was not confident that there was a fighting chance of improving your quality of life.

  • I too am having an ablation in sept and I am 72 I also have other heart issues lqts and chf age has never come into it

  • Tha k you for all your prompt replies. I am on one of the new blood thinning drugs so am well protected for the chance of a stroke. I suppose we all want an easy route for AF and I know in the past 3 years my body works through the tablets bit by bit and AF comes back with avengance so I expe t this will happen with flecanide. But the honeymoon period is oh so sweet!!

    Ann

  • Hi Ann, I have been taking Fleicanide for 4 years, 50mg a day, I havent had an issue at all. I am 49, so yes there is a difference in age ( I don't think that matters ) and I don't take any other meds, I just stay as fit as possible. It's a big decision and one you can only make yourself, Fleicanide works for me and if it keeps me away from the operating theatre I'm sort of happy with that. Also I weigh up the 'longer you leave it' sentiment against progression of medical knowledge as time goes by. Best of luck with whatever decision you make.

  • I think you are lucky Keith to be controlling AF with a low dose of flecainide. Many of us are taking 100mgs twice a day and some are on 300mgs a day.

  • Always consider myself lucky, also speak as an individual as it affects us in different ways hence my reluctance at this time to have the procedure. Horses for courses.

  • Long may your low dose continue to work well for you.

  • The fact that you say but by bit and then comes through with a vengeance shows to me (I am not medically qualified) the the AF is getting worse underneath but your output symptoms and feelings are being being masked by the meds.

    In the Linder term you don't know how quickly if how violently they are going to develop. The longer it goes on the worse it is going to get and this reduces the chances of success. Also you are fit enough now to have the procedure and your EP is willing to do it. You also don't know what us around the corner with regard to other medical issues that may have an impact. The AF may prevent you from having a different operation or procedure and similarily something else may prevent you from having the ablation in future.

    My AF has got significantly worse in less than two years. I am not on any arrythmia meds because flecainide did not touch it at all.

  • I meant to add.

    In conclusion personally I would go for the ablation sooner rather than later.

  • My ablation was carried out a year ago at age 69. Successful and no problems.

    Peter

  • I think it's the dentist surgery syndrome ! You feel great just before you get into the chair after having been feeling rotten for the week before.

    Exactly the same thing is happening to me... I'm due for an ablation shortly and I haven't had an episode for a few weeks!!!

    But I'm still getting it done, I'm 64 and have a life to lead😊😊

  • Hi Ann, I have had AF for 15 years and for 13 of those was controlled with flecainide and BP tablets plus aspirin (which I now know was useless) and had short episodes of around 3-5 hours every few months then a couple of years ago I had a few long episodes 17-19 hours then went into persistent AF. I am now 70 had my first ablation last September which worked for 5 months but I reverted back to persistent AF after a tooth extraction and am on the list for my 2nd on Friday. Sorry for the life history but this is just to highlight how AF is progressive and when you think you have things sort of under control it comes back to bite you in the bum😤. I wish I had been given the opportunity at the start of my AF journey when I think maybe one ablation would have done the trick. Best wishes whatever your decision.

    Brenda🐝

  • Don't worry about writing a little potted history because it is always important to put things in the context and the setting and as so many new people join they won't know the "history" of those of us who have been on here for a bit.

  • From experience with PAF, I would suggest you go for the ablation. It does not get any better with time if left and you will kick yourself if you cancel the appointment and then experience a downward spiral. PAF is treated most successfully if caught early.....fact. Mine was bordering on persistent prior to my second ablation and I had suffered from infrequent bouts of PAF for 3-4 years prior to my first ablation. I believe success rate on first ablation to be 60-70% for PAF sufferers. The fact that I required a second ablation, in no way endorses what your friend told you. It was getting to the point where I could only work 2 days a week, damn, I work 7 now. :-)

    Catch it early!

  • Here are the latest results (2014) from Prof Schilling at the London Bridge Hospital, comparing outcomes between paroxysmal and persistent AF:

    network.londonbridgehospita...

    Interestingly, the outcomes aren't all that different, except that a second ablation is required far more often for persistent AF.

  • Have had 2 ablations in the past year and have just turned 69. Had PAF for 6 years and I wish ablation had been available/considered much earlier. Although I don't yet know how successful it has all been I would still do the same again. Yes when you get to the actual day, sign all the forms and put on the paper pants and walk into the lab you do begin to wonder - wouldn't be human otherwise. Although still on all the same meds I still hope there will one day be a time when I can ditch the metoprolol which I've been on since diagnosed. Too much living to do to be beaten by PAF.

    Good luck in whatever decision you make.

  • Apologies but I have not had time to read all the advice below. I am 62 and was told by 2 cardios and an EP you need an ablation straightaway, that was over 2 years ago and on the right level of just Flecainide with lifestyle/supplement changes I have had no further episodes. I may still need an ablation in the future but I am waiting for them to improve their techniques and maybe even bioelectronics will save on invasive procedures. Good luck on whatever you decide.

  • I have been on Flecainide 100mg BD and bisoprolol 5mg OD for 8 years and I haven't had an AF. Before these meds I had a AF episode every 9 days or so for 12 hours overnight.

    Over time I have noticed more tiredness. Last week I had bradycardia around 30 beats per minute. My flecainide dose was halved to 50mg BD and my bisoprolol was withdrawn - result a few days later tachycardia 145 beats per minute! Bisoprolol was reintroduced at 2.50mg and I'm continuing with flecainide 50mg BD.

    My cardiologist said I had done well on my meds but I ought to consider ablation. I might consider it but I want to see how the adjusted dose of my meds goes first.

    Conclusion - meds worked for me. I hadn't had a formal follow up until very recently and I wish I had had one. It's possible that I could have been managed on a lower dose. As for ablation - it's an option. I suppose if I had a choice at the start between meds and ablation now I might choose ablation but the success rate 8 years ago wasn't as good and I'm glad I chose meds.

  • First, I had an ablation aged 70 after 15 years of PAF which I thought was well controlled by meds, although the side effects were not good.

    I was determined not to have an ablation for all the reasons others have given but in the end I had no choice - because of slow HB and pauses I was told the only other option was a pacemaker and I would still have to take meds! So here I am, 7 months on, feeling great after a couple of hiccups earlier on. I had not realised how badly my QOL was being affected.

    One of the arguments used by the EP when persuading me to accept the ablation was that after 15 years my AF was likely to become permanent and then there was very little hope of ablation being successful.

    Good luck!