Ablation options

[GazzaD57]

I recently had an unsuccessful Cardioversion attempt. At a follow up appointment with my Cardiologist he told me they tried three times, the first i had NSR for less than 2 mins, the second no NSR and the third attempt an NSR for less than a minute. He then offered no further option except to return in 3 months and reassesss my medication. Not being satisfied with this i asked for and received a copy of all my information and have now made an appointment with an Electrophysiologist for another opinion. My question is even though an NSR was only achieved for a very short time would an ablation be an option or likely to be successful? I have been in persistant AF now for 10 months but luckily assymptomatic, its really just the breathlessness that causes me any issues. should i consider Ablation if offered or just accept the minor symptoms and live accordingly. Will having an Ablation, if unsuccessful, put me at risk of making the symptoms worse. I'm currently only taking Apixaban and Metaprolol.

Thanks.

[BobD Volunteer]

Difficult call Gazza and one only your EP will be able to answer. For sure the chances of success with ablation are greatly reduced when you look at your history and since as we know , ablation is about quality of life, ie relief of symptoms, one may question the risk/benefit equation for a person who is asymptomatic with failed cardioversions.

I know that isn't what you want to hear and as you know I am a great fan of ablation but one has to be realistic.

[Lorna058 in reply to BobD]

Sometimes ablation does work in these circumstances. Last year the above scenario happened to me, three successive attempts at cardioversion failed. After 10 days in coronary care. I had an ablation in Liverpool and remain in nsr 9 months later. My EP says the procedure was " extremely challenging" ! But it worked,so there is hope Gazza.

[BobD Volunteer in reply to Lorna058]

Oh there is always hope Lorna but we aren't in a position to demand what treatment we get and only the EP can decide on balance whether the risk /benefit equation works for somebody who is asymptomatic. We are all different with different needs and abilities so even as a great fan of ablation I do wonder.

[reedman]

Hi Gazzer, I have been much in the same place for some years now. 2 failed cardioversions i.e. NSR only lasted a short time. Tried Amiodorone, that didn't work. Various combinations of drugs inc betablocker (Bisoprolol). Cutting a long story short, I felt generally much worse than pre AF diagnosis (asymptomatic). Ablation was considered by the medics to be not worth the risk because I am asymptomatic. With the advice of my GP I have gradually reduced the drugs to Warfarin (anti-coagulation meds essential with AF) and Losartan (apparently helps my heart). I now take nothing else. Following the cessation of the Bisoprolol the breathlessness I experienced when trying anything strenuous has gone and I now feel pretty much as I did before I found out about AF. The upshot of it all is that my life has just about returned to normal except that my heart beats irregularly, my fingernails split very easily (Warfarin?) and I tend to sweat easily. Hope this helps George (age 74)

[Oldcarol in reply to reedman]

I seem to have the same symptoms. Had ablation 7 weeks ago and heart beats irregular 2-3 x day, lasting only a few seconds. Otherwise very regular especially compared to pre-ablation. I have got to stop listening to see if I am regular. It is driving me crazy! I have also found chocolate and sugar causes me to skip beats. Working on cutting that out of my diet. I'm 69. Good health to u.

[seasider18]

Snap! Reduced drugs to just Wafarin and Losartan. My heart beats irregularly, my fingernails split very easily (Warfarin?) and I tend to sweat easily and have hot flushes just sitting at home or on a bus and I'm eight years older than you.

Since reducing Losartan to 25mg my BP seems to have gone down considerably. I have an appointment at the Hypertension Clinic this week. I wonder what his reaction to that will be? Previously he wondered if I'm not truly hypertensive but just have peaks and surges and so that meds have caused more than usual side effects as I have not really needed them!

[Oldcarol]

I am on the same med post ablation 7 weeks ago. According to my electrophysiologists persistent will go into permanent. U r lucky if u don't have symptoms, but with age they will get worse. If u are otherwise healthy, ask your doctor if doing the ablation now will have a better outcome than if u wait till u develop other complications with your general health.

[PeterWh in reply to Oldcarol]

If you wait then other health conditions may prevent you from having the ablation later. Similarily AF can prevent you from having other operations and procedures.