When to consider Ablation

Hi folks, Have had AF since 2002 and in that time have had 34 episodes . I know this is far less than some of you out there but the frequency is increasing . They last from about 6 to 8 hours and are very violent . When should I start consider asking for an Ablation and can anyone recommend a good EP in the South East to include London.

Many thanks in advance

Best regards

31 Replies

  • I can't help with the EP, but answers to the ablation question could be right now, or sooner rather than later.

  • Many thanks for your reply

  • I knew that ablation was right for me when the AF was making my life a misery. I had lost confidence, I could not make arrangements to do anything because I could not guarantee how I would be feeling. Four types of medication had not improved things. Then I was allocated a good Cardiologist who referred me to an EP. I was offered an ablation at a time when I had found this site. An ablation is a £15,000 procedure. It is not offered lightly - the patient must be considered suitable.

    Anyway, I had the ablation. I gave it my best shot. No regrets. I'll never be totally free of AF as my heart has been damaged by radiotherapy to my shoulder, 25 years ago. But I'm so much better and no AF for the past 2 months ( since I started acupuncture, but that may be coincidental) one important factor is that since the ablation my AF is mild and easily controlled by 100 flecainide

  • Many thanks for your comments

  • Best time to consider an ablation is now I'd say. Had mine in 2005 and it kept me totally clear of AF (mine was persistent and bad) for 8+ years, it was bliss. Now got something back but under control.

    But if you've had Af for 14 years I wonder why you haven't already been offered one?

  • Many thanks for your reply. My GP (now left the practice) showed little interest and had to fight tooth and nail to get onto Rivaroxaban. Will go to my new GP and see what he has to say.

  • Up to you of course but I wouldn't speak to a GP about an ablation. I'd want a referral to a specialist, an EP and nothing less. I just speak form the experience of having dealt with loads, and cardios, but only with the specialists did I get results, whether that be ablation or drugs.

    I had to insist on a referral to an EP and I paid to go private for the consultation.

  • Hi Koll yes take your point. Need to see my GP to get a referral and would like to know that the EP I will be seeing is someone who has been recommended and has a sympathetic ear to AF suffers

  • Sounds to me that you have not been getting the best treatment or advice so far and no doubt you have yet to see an electrophysiologist? AF is almost always progressive but you seem to have been luck things have not deteriorated too much so far. Get something down now before it is too late.

    Go to AF Association sire and search heart Rhythm Specialists for one near you.

  • Thank you BobD for your reply. I value all your replies to the various pots by other people. My doctor (now left the practice) took a very casual attitude to my AF and was loathed to put me on Rivaroxaban which I have now been on for 2years. Was hoping someone could recommend an EP as reading other posts there are some better than others.

    Thanks again BobD

  • I mirror the opinion to see an EP. When you have Afib, you really need a team of doctors to treat you. I have a GP and added a cardiologist When I started having irregular beats. The cardiologist approach was strictly through medicine and that was fine until I had my first Afib attack. Since medicine treats Afib but doesn't cure, I wanted more treatment options and went to see the EP. About 48 hours post ablation right now and my heart rate is so regular and calm. Really glad I went with the cryoablation.

  • Hi fredsbam thanks for your reply and glad you had a good reaction to your Ablation. Can you recommend an EP in the South East and London ?

  • Sorry, I'm in the US. Sabine Ernst is a name that pops up often on this site. If she's not available, perhaps her office could recommend others?

  • Many thanks for your reply.

  • In London I recommend Sabine Ernst, or another name that is very highly regarded is prof schilling

  • Thank you for your reply those two names are coming up a lot.

  • 2002!

  • You may have to insist your GP refers you and if you can pay privately to speed up the whole process it will be less stressful than lots of waiting; the cost in the South East will be £150-£250 per appointment plus tests. I have developed a system (easier to do these days) where I have tests on the NHS but pay the consultant's privately, which works well for me.

    The accepted route is to see a cardiologist first and they usually have a link with 'their' EP. I am pleased I spoke to a cardio first as after 9 episodes in a month, I was being railroaded into an ablation and a medium dose of Flecainide only plus lifestyle/diet/supplements has stopped it. I have a Guildford based Cardio Dr Hickman who I have found helpful and willing to listen to my views as well. I saw 'his' very well qualified London EP but got him on a very busy late clinic and wasn't impressed. If I was going to see another EP/ablation it would be at Royal Brompton but I am postponing that in the hope new non/less-invasive advancements are on the way - maybe you read here an encouraging paper given by Dr Sabine Ernst. Good luck.

  • Many thanks for your comprehensive reply and the info provided.

    No problem paying for an appointment but can you please tell me what tests you have had on the NHS.

    Best regards

  • Sorry for the delay in replying. I have had a full batch of tests, the cheaper urgent not on NHS, the ones I can remember are: sleep apnea, carotid artery, magnesium red cell, Coq10, many ECGs incl I think 24 hr, Heart MRI, stress test, thyroid. I am sure I have forgotten some but that's most of them.

  • Hi Orchardworker

    Many thanks for your reply.

    So after the tests you decided not to have an Ablation.

    There is so much to take into consideration.

    Best regards

  • The tests were good news as they showed I had no 'structural' or obstructional problems of any sort i.e. Lone PAF. I realised I had had a perfect storm of stress in 2008, Flecainide stabilised things some while later in 2014 and since then I have considerably changed my lifestyle, no more AF and as important great QOL.

    Ablation has been postponed as taking into account everything I don't like the odds of success with better QOL afterwards at present. The crunch may come when I start (date not decided) to reduce the Flecainide dose. Have a good weekend.

  • Glad you are in a good place re QOL.

    Going to Surrey ASG next Wed to ask my question and others. Very good Cardiologist and EP will be there. Have my doughts re Ablation and the after effects etc

    Best regards

  • Professor Richard Schilling carries out ablations in the London area. He is considered one of the best in the country.


    Good Luck.

  • Many thanks for your reply and video link. Dr Schilling I know is very well respected.

    Thanks again.

  • Mark O'Neill at St Thomas' gave me the choice -ablation or meds right at the start of AF journey. I opted for ablation using the logic that earlier intervention meant less damage. That was November 2013 and got life back.

  • Many thanks for you reply and glad you "Got life back"

    Best regards

  • Gather as much information on yourself, and your condition. Understand your body, and what it is telling you. With that information, get to an EP. Neither a cardio, nor a GP, can assist, other than provide a route to an EP. The GP can look after, support, and administer, your medication requirements. The EP, once you see him/her, will give you the prognosis, including the success rate of the chosen Ablation procedure. It is then your choice. One thing - take control yourself, do not think, or assume, 'the system' will look after you. It won't.

  • Many thanks for your comprehensive and positive reply.

    Best regards

  • With regard to GPs. In my experience, one over prescribed, one wrongly gradually took me off Bisoprolol whilst introducing Digoxin, which caused me to end up in A & E after I had stopped taking the last Bisoprolol 7.5 tablet, and the last one wrongly prescribed Flecainide which should be introduced in the hospital and according to wait. The ex-cardiologist GP did not prescribe according to either of these requirements. Fortunately, I decided to check on the internet and had confirmation by my EP, through a private appointment, who favoured Bisoprolol if I have any AF after the first ablation for AF. Hence, I would have been in trouble again if I acted according to the last GP who prescribed 300 mg of Flecainide which is far too much for my weight of 56 kg and too much in one go. Therefore, in my experience on take pot luck when trusting a GP with regard to AFib.

  • Many thanks for your reply.

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