Do I...Don't I ?????

My GP recently sent me to see a Consultant at Musgrove Hospital Taunton. (Not an EP)

I don't really get many problems in fact since being on Flecainide for a number of years I have not had an episode. However the GP thought i was a good idea to touch base with the Consultant.

The Consultant told me that I wasn't currently in AF and no need for any Anticoagulants due to the low risk.

I also asked if I pushed myself while out cycling was bad for me and he said go as hard and fast as you like. (He likes to cycle by the sound of it)

He said he thought it was best i stay on the medication as they were working.

However he mentioned that an Ablation could be an option if I wanted to come off meds.

So my dilemma is do I stay as I am or take the Ablation option and potentially rock the boat with the AF.

17 Replies

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  • Hi

    I don't know what age you are !! This would have some influence on your decisions re coming off anti-coagulation .

    Also would be a factor re ablation as you might not want to be on meds for many years if you are young.

    Ablation decisions are often based on frequency of episodes and symptoms when you have an episode- and age,( because if you have no symptoms ,and are elderly, Af is not affecting you much, as long as you are anti-coagulated)

  • Hi I am 49 had AF since 40. I take no anticoagulants. I have seen an EP some years ago who said he would never have an ablation, To be honest I use to have a few episodes but nothing since taking meds. I am just concerned that an ablation could set me off and upset the apple cart

  • I'm interested to know who you saw? My consultant is Dr Seddon who seems to be pretty knowledgeable about arrhythmia s, he was my main contact before and after my ablation and seems to work with EPs in Harefield and Bristol.

  • Hi

    I think it was Dr Seddon. He seemed to know what he was talking about.

  • I had an ablation specifically to come off drugs which were doing my head in. I had no AF symptoms at all whilst on the drugs though. Glad I did as it worked 100% and I came off all drugs except anti-coags which I'm on for life (even though my score was 0 till I recently became 65, so now 1).

    Got a bit of AF back now after 10 years but being controlled by another drug, which isn't affecting me this time.

    But my decision was easy because the drugs I was on at the time were causing me serious problems (although they don't for other people). I could have tried other drugs in hindsight, but my EP thought that the ablation was the best route.

    Koll

  • This is still my dilemma, booked in for ablation next weds, I'm 40 and have had 3 brief episodes in last 18 months, I'm hoping the ablation gives me years free of AF, however I'm worried I'm hitting the hornets nest with a stick and make it worse and then become someone who's very symptomatic needing more and more procedures

  • Hi Chris, thanks for raising this situation, I am in the same place, a bit older at 63. Sounds like you have got a good cautious GP.

    You don't mention the amount of Flecainide you are on, which is relevant, as the lower the dose the more scope the medics have to increase it, if AF breaks through in the future - a high dose at 300mgs per day and more chance of side effects in the future and no way to go but ablation if AF returns.

    I presume you saw a consultant cardiologist. I am afraid I don't buy the advice cycle as hard as you like and see what happens. I recently turned down a similar suggestion by my cardio, who offered me a treadmill stress test. He also gave the advice if Flecainide is working well at 200mgs/day (for 2.5 years now) stick with it and don't have an ablation plus slowly increase exercise from brisk 1 mile x2 per day walks to jogs.

    Currently my decision is to postpone an ablation, as procedures will improve. In the meantime, due to implementing a host of lifestyle changes and taking some supplements e.g. Mg & CoQ10 I plan at some point to try reducing my Flec dose - just haven't got the nerve right now! Hope this helps, Good Luck.

  • Orchard worker, I recently posted that I cancelled my ablation scheduled for this week. I realize that this decision is a difficult one for many. I have been eating a very clean diet since May of this year and have been doing breathing exercises and taking supplements from Naturopath. I have been symptom free since starting these lifestyle changes. I have also reduced my 300 mgs daily of Flecanaide down to 150 Daily, I'm not a Dr so I won't medically advise you but why not slowly reduce your Flecanaide. You can always take additional dosage if you have symptoms. You made an excellent point, once at 300 mgs a day there is no where to go if an episode occurs, my feeling exactly. I will not stop anti coagulant but I do believe I've been over medicated.

  • Thanks Gracey, that's impressive cutting your Flecainide. If I may, two questions....How did you cut the Flec, gradually and over what period or just straight down to 150? Also, what supplements did your Naturopath recommend?

  • Orchardworker, I was on 300mgs so first I took evening 150mgs and cut it in half. I did that for about three weeks and all was fine. Last week I stopped morning dosage out completely. I'm feeling great, less tired and less stomach upset. I started anticoagulant last May and thought that was what was making my stomach hurt but think it was the Flecanaide. Since I've got the anticoagulant as an insurance policy I felt why not try to get off med and get to pill in pocket. This is just my theory and don't want to mislead anyone into decreasing medication. As far as supplements; vitamin D, vitamin B, magnesium and an herbal for keeping thyroid stable. My Naturopath thinks that my thyroid fluctuates between high and low even though conventional tests don't fully support. I also have sleep apnea and use a CPap machine. I'm a slight 66 year old female weighing 128 lbs so I don't meet any criteria for sleep apnea but when tested 4 years sago my symptoms were chronic,. Beyond that I have eliminated processed food and all wheat from my diet. I also drink about 4 glasses of mineral water a day which is filled with magnesium and calcium. I hope this helps and please don't be afraid to trust your body . Good luck, Gracey

  • Lots of things to weigh up. Side effects. Age. %age success of ablation. Duration of ablation success. Etc.

    I'm like you. Controlled AF with medication. (In my case 8 years). Manageable side effects. I too cycle a fair bit - but I take it easy on hills. I'm 63.

    I'm reluctant to have an ablation because I'm not sure how long it's success will last. My cousin has had three and is going to need another. The dilemma is the older you get, the less chance of a successful ablation.

    Last year I developed high blood pressure out of the blue but that's being controlled with medicine.

    Final thought - do you have a hiatus hernia? The association between hiatus hernia, vagus nerve and AF is still in debate (and not really accepted by medics in the UK). A full stomach (and or spicy foods) can push the stomach further up into the diaphragm , press against the heart, and more especially the vagus nerve, which can trigger AF. Best eat little and often and watch what you eat.

  • My AF seems to have progressed quite rapidly, and I hate/can't tolerate most of the meds I have been on. Amiodorone, sotalol, bisopralol,rivaroxaban, pradaxa, etc etc.

    So for me, at 48 with a young family and a mortgage to pay I need to do something. So an ablation is my next step. If it doesn't work then so be it, but I have to try something.

  • I agree. My AF also progressed quite rapidly so I know what you mean.

  • Similar dilemma for me. I've seen an EP at my local hospital who advised that i need an ablation for flutter & afib.

    I've previously been DC cardioverted, which kept me in NSR for 2 years.

    My concern is related to the stories on here, where people who have had ablations still require further work sometimes within a couple of years. So if i can get a couple of years from a cardioversion, why should i choose to have invasive surgery on my one & only engine.

    I know i may be lucky to get a couple of years from a cardioversion but there are less risks as i see it, and the chances of relapse exist with both procedures.

    The last time i was DC cardioverted, i was back at work the next day, and on no medication for the 2 years.

    My current episode began in July. On a day to day basis my arrhythmia does not hinder me, however it just prevents me from any aerobic exercise, which really grates me.

    I'm debating whether to go back to my GP and ask to be referred to a different EP for another opinion. Trying to communicate with my current EP since the initial consultation is nigh on impossible

  • Well if you haven't seen your EP for a couple of years you may well be off their books so to speak.

    Knowledge AF practices (diagnostics and treatment), Medicines and other aspects have changed and improved over the last few years make it even more of a good decision to see an EP to get an up to date assessment and that's in addition to the fact that things may well have changed with your heart and body. Go for it!!!

  • Also as BobD has said on many occasions (with different words) this forum will be be heavily biased towards those where it has not worked 100% because that's the way - those who have had an ablation will drift away quiet quickly as this forum is not relevant. Some pop back now and again but there are many I know of over the last couple of years who are no longer on here.

  • Thanks for the replies. I take 100 flecainide twice a day. There are times when I forget due to shift work but this never really has an effect when i miss one.

    I would definitely say mine is food related because the times I have had bad episodes are ties when I've eaten a large meal.

    It gives me something to seriously think about.

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