Should I Ablate ?

I have now visited my EP and have received a thorough report from him. He has left the decision to me if I want to go ahead with the procedure . The waiting time would be about two-three month .

I am 72 with underlying heart conditions , but very active in the gym and tennis player .

1. He does not see any point in DC cardioversion OR any role for pacing .

2. Due to my bradycardia and the fact that I am already on Metoprolol , he has ruled out any other medication .

3. As we discussed AF is progressive therefore the only choice that I have is catheter ablation ( balloon cryoablation )

Now I am in dilemma , as my condition is by enlarge asymptomatic up to now ( 80-85 bpm for 48 hours), and up to today's date I can only confirm definitely two episodes of about eight month apart .

Should I have the ablation and if so how would I know the procedure has worked as the episodes are so far apart ?

OR should I wait until the PAF has progresses further before jumping in ?

Your comments will be appreciated.

14 Replies

  • As PAF progresses treating it becomes harder. If you traverse into persistent AF the chances of success drop quite significantly although part of that difference is covered by additional ablations. You will have seen the comment AF begets AF.

    My personal view is that if I were in your shoes I would take it now whilst it is on offer and whilst you are fit enough to have one. If you leave it a couple of years you don't know what the situation will be.

  • I like your comments on this forum. U seem very knowledgeable. My PAF started with a vengeance over a month. -Jerking heartbeats, ER three times in a week. Roughed out two bad episodes at home the next month- trying to get a grip on this afib thing. Then nothing for a month.

    My doctor suggested the ablation.5 months after first episode. I had the ablation. All was good for about 6 weeks. The last 6 weeks I have had short episodes of a few runs of afib lasting a minute or so. 10 minutes later the same thing. Always heartrate at 70-80. Maybe off and on episodes like that for a couple of hours, then two weeks of calmness. And then another short episode. I have a kardia and I am 3 months post ablation as of the 11th. I am on metoprolol and eliquis.

    Am I too anxious too soon? Like everyone else, I feel so good when not in afib, but I still hate the feeling of waiting for it to happen again.

    I am 75 pounds overweight and working on it. Otherwise healthy.if u have time time to reply about the 3 month time frame and what to expect, I would appreciate it.


  • Carol. Thanks for the compliments. Partly naturally and partly by training myself for work I have a very good memory, I am very analytical, very logical, objective and used to researching new areas and writing. I have been used to dealing with complex aspects outside of my original engineering speciality. I have just applied these and other skills into the medical environment even though I have never had any medical training whatsoever.

    At 3 months I wouldn't be too worried because many (medics and non medics including our illustrious BobD) will say 3 to 6 months. Some people on here have said it has taken them 9 to 12 months to plateau. Some EPs say 3 months because that's true for many and I suspect that they like to be optimistic and don't want to alarm or frighten people though in my view this can have the opposite for those who aren't on a plateau at 3 months.

    Being philosophical what will be will be and worrying about it will only make things worse!!! You've probably seen me quote my dad's expressions.

    Good luck.

  • Hi Peter , thank you for that. I do understand your point , as at the moment I am asymptomatic , very concerned of the out come of the ablation , being about 70% which may put me into a state that I have not experienced before . From what I read on this forum and the results of the 1st ablation, it does worry me tremendously . Please note I also have anatomical abnormalities ie my heart is on the right hand side and is twisted, this has made the EP to recommend general anaesthesia and use of TOE (Transesophageal echo ) to guide the transseptal puncture . So you can see nothing is straightforward .HA HA !!

  • Hi Bachman I totally get your dilemma if you are not symptomatic but unfortunately only you can decide on the best action for you.

    Peter makes some good points - if I were you - knowing what I know now - I think what I would do is say yes to the ablation on the basis that if you decide against further down the line you can cancel whereas if you say no it may be much harder to get back on the list - do a lot more homework on the consequences of AF longer term and treatments etc and then decide nearer the time. In 2-3 months you may have had more episodes.

  • Hard choice. All I can say is my AF went from once a year to almost continuous in 3 years, at which point I had little quality of life. Fortunately the ablation fixed it (to date - touch wood). The ablation is a relatively simple procedure taking a few hours and then a few weeks to recover so in my case it was the best move I ever made.

    But we're all different.

  • Hi Mike , thank you for your note . one question , did your AF go from once a year to continuous at once or did the episodes increase gradually ? As being a simple procedure , please see my reply to Peter .


  • It gradually increased until it was about 50% of the time, Mine was straightforward and a no-brainer to have it but sounds like you're more complicated.

  • Thank you Mike . It looks as if I have a little time to consider my options At least to a point that after the ablation to be able to recognise if it has worked or not . At the stage that I am in now, I would have to wait eight month to find out if ablation has worked.

  • Although my ablation was essential, my heart bypass was marginal so I eventually just said to the surgeon "Would you have this operation in my situation ?" and he said yes. Might be one approach worth considering.

    Good luck whatever you decide.

  • Bahman

    Mike11 had a gradual increase to around 50%. At the other end of the spectrum it can go from Paroxysmal to persistent quite quickly (same day or a few weeks or a few months. AF is unpredictable.

  • One of the problems with AF is it's rate of progression and it's level of severity is so unpredictable and so variable. From a given point in time some might take 3 years to hit persistent but for the next person 3 weeks. Many go into persistent AF without ever being diagnosed with AF and others can remain wth paroxysmal AF for years.

  • Thank you all for your postings . I think I will take the CDreamer 's guidance and book my self in the queue for ablation and see what happens when the time comes.

    Peter, I have taken your warning on board and will continue doing my research .

  • It wasn't a warning just some background advice. Nothing on the internet will give you any clue as to timings or durations because it's so individual to each person. Even if you had 5 EPs in a room you wouldn't get 5 identical answers!!!!

You may also like...