Ablate or not

Hi everyone, I have been relplying to posts the last few days and have gotten lots of wonderful and caring response. There has been a lot of talk about ablations and since I'm scheduled for a Cryoablation this month I have been feverishly reading every post on the forum. I have been left with one question, the persons who have had Cryoablation , has anyone had PAF with less than six episodes a year? I question my decision to ablate because I have no health issues and don't suffer many episodes although they do last 12-24 hours and leave me weak. I am on a high dose of Flecanaide which scares me so that's why Ive gone down the path to ablation. Am I making the right decision? Are the risks worth it? I'm so appreciative of your support, Gracey

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  • I had 6 long episodes that had to be cardioverted and lots of little ones that resolved it's self it's not an easy decision but it would not be offered if they didn't think you needed it I was petrified but once you are there you get caught up in all the goings on and don't have time to worry I think everyone is managed to their own needs. From talking to the four other people in my ward all had something done slightly different and they all took different lengths of time ,when my daughter asked how long it would take the doc said how long is a piece of string mine took 5 hours regards Marie xx

  • Marie, I appreciate your response and I hope for you to get complete success. Will keep you posted and please keep us posted on your recovery , Gracey

  • I had an ablation for a-flutter in spring of 2014. After that I had two or three episodes that sent me to the hospital (ER as we say here across the pond, A&E as you Brits say). Those were several months apart. After the last one I had occasional episodes that were not bothersome but I knew the AF bug had bitten me. I had my second ablation in spring of 2015 in order to knock it out before it had a chance to dig itself in deep, so to speak. It was a cryoablation and worked perfectly.

    Wishing you as good a result as I got.

  • Kodaska, I'm in the US as well! Glad all worked well for you. I also had a flutter ablation and it worked but AFib has persisted. I'll keep you posted as to my decision, still unsure, Gracey

  • If u have no other health problems u r the perfect candidate for ablation. Don't wait till u have other things failing, like congestive heart failure. The healthier the tissue they have to work with, the better the outcome.only my opinion, of course.

    Hoping the best for you.

  • I also had cryoablation for AFib after a AFlutter ablation. Only nearly 8 weeks ago. So I hope mine is as successful as yours. I went privately to have the cryoablation done because the AFib episodes increased to a daily basis where as before I had a fortnight in between. I did not want it to become persistent.

    Otherwise, I am healthy and not over weight. The Consultant was surprised that my condition deteriorated. As far as I am aware all AFib suffers will have persistent AFib.. However, some will take longer to progress to that stage, decades even. It varies from person to person.

  • Good luck!

  • Thank you.

  • In my experience, the risks have been worth it. I don't feel washed out when in AF, either when it occurs or afterwards, but it does my heart no good. I have had three ablations (but ignore the first as it wasn't for AF).

    When I had the second one I had moved towards weekly episodes and was on 150mgs x 2 of flecainide a day. I had no weapon to control AF when it occurred, although it would revert to NSR spontaneously after an hour or two - or sometimes 16. I was able to give up flecainide on a daily basis four months later.

    I still get AF sporadically but now have flecainide available as a pill in the pocket. My big regret was relying on daily flecainide for a couple of years and not going for the second ablation sooner.

    If your EP thinks in your case ablation may be your best way forward, what benefit could there be in not following his advice?

  • When you say a high dose of Flecainide what do you mean? The maximum allowed is 300mg in any 24 hours in the UK. I was on 150 x 2 earlier this year and didn't like the nausea so was dropped down to 100mg and feel fine. I have been taking 100Mg x 2 for many years and I don't think you need to be scared. I have had numerous ablations as well whilst still taking Flecainide.

    Regarding the frequency of PAF over the years I have swung from once every 2 - 3 months to once every 2 - 3 days and back again. The unpredictable nature of this condition is what makes so many of us so wretched at times and having the feeling of foreboding.

    Regarding ablations I think that if your EP thinks it is a good idea and it is such a long time until the wedding next year you should take his advice as because of your low frequency I would suggest that you are a strong candidate for a successful conclusion.


  • Pete, I take 150 mg of Flecanaide 2x daily which I know is the Max dose. Yes, the problem with this dose leaves you with no ability to take additional when an episode comes on. Thanks for your reply; helpful, Gracey

  • Yes Gracey

    You are right - by taking 150 x 2 each day it does not leave you any scope for a PIP to enable you to kick it back into rhythm.

    I felt awful taking 150mg x 2 yet have no problem with taking 100 x 2.

    Recently, just before my ablation 3 weeks ago, my heart was going in and out of AF almost every other day. I decide to take 300mg at once on more than one occasion. Whilst it worked and I was back in NSR in 1 hour it made me feel very very bad particularly as I had taken my daily dose earlier in the day on one occasion.

    The following week when I told the EP at the hospital during discussions about how I deal with any future episodes that might occur I told him what I had done. I got told off quite severely and was told categorically that I must not take more than 300Mg in any 24 hours.

    10 days ago I did have an episode of AF and had taken my daily dose of 100Mg about an hour earlier so I took one more 100Mg. It took 10 hours to revert to NSR. I have been in NSR since so am keeping my fingers crossed that the stable heartbeat I have now will prevail.

    I think that taking 150Mg twice a day is too much and I am not sure what extra control it offers over 100Mg twice a day.


  • Pete, I agree!

  • YES it is worth it. I think it well known that AF is progressive so best to get it sorted before it becomes too much of a burden.

  • Bob, I'm one of these people who believes I can handle this until I get an attack. When the mongrelcomes on me all my positivity goes out the window. I don't like the anxiety this causes and that's why I'm going to go ahead with the Cryoablation, at least that's what my gut says today! Thank you for all your advice, you help so many Gracey

  • I had PAF for 20 years (it started long before ablations were being offered!) is steadily got worse over last 4 years and I think that is what "it" likes to do.... The good news about having a cryoablation is that it appears to work very well on PAF and my EP gave me an optimistic 85% success after the procedure! (80 before)

  • Sorry sent too quickly! Anyway to cut a long story short, I am very glad I am off all drugs for my heart and so far so very good! Your decision but I am very happy with mine!

    Good luck

    Best wishes


  • I was having episodes approximately every six weeks before I was given Sotalol, then they went up to every two weeks. My episodes weren't too bad - they would come on in the evening and stop overnight. When I saw an EP I was asked if I would take part in a blind three legged trial and I was assigned an ablation. I've had no problems since. Now on no medication apart from anticoagulant. So glad that I had it done.

  • I wish I had had mine done before I went into persistent AF as mine has now been very difficult to deal with. It's a decision to be made looking at all angles. now you have made the decision just go with the flow and it will be done and dusted before you know it. Good luck.


  • To me, ONE episode is one too many. If you can prevent them, why not?

  • If you dont in 5 years time still taking meds you will say wish i had tried Ablation 5years ago

  • I had cryoablation almost two years ago and have been much better off since then. Cardiologist says there is no more a fib but I do have infrequent episodes of extra beats but they self correct within one or two minutes.Before the ablation I was a frequent visitor to the ER with very rapid Afib. Now the only meds I take are coumadin and 25 mg. metropolol which is a beta blocker.

    I'm very glad I did it!

  • To distract you a bit, try reading, and watching this post

    Is AF ablation a big placebo?


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