Should I ask for an ablation

Hi everyone,

I don't comment much on the site but do read regularly and try keep up with a lot of the posts and good advice given by others.

I'm in persistent AF with no symptoms apart from the usual worry of it all, which I seem to have got under better control as time goes on.

My question is, even though I don't have symptoms and still swim and walk the dogs regularly and try to stay healthy, if given the option would you have an ablation?

Cheers

Adrian

14 Replies

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  • I would pursue this, because it would be worth having your situation assessed by an expert. If it is felt that you are indeed fine as you are, then you know where you stand. An ablation would only be offered if there's a good possibility that it might improve your circumstances or your long term health.

  • Thanks for your reply

    I have an appointment with the cardio nurse tomorrow.

    I will be asking for a referral to an EP specialist.

    After all we are al looking for is answers

    Cheers

  • I think the EP is best qualified to answer that question but I can offer my take. As a great fan of ablation as many will know my answer may surprise. Ablation like all treatments for AF is about improving quality of life. Since you are asymptomatic one must question the wisdom of going for a procedure which is not totally risk free. OK the risks are very small but they still exist. Against this must be weighed the rather reduced chance of success. I'm not saying it will not work but persistent AF is less likely to respond than paroxysmal.

    Provided that your AF is well controlled by drugs then I would question taking a path which may well lead to needing multiple procedures. It is all about the risk/benefit equation and only you can answer that one.

    Bob

  • Thanks Bob

    This same question has been on my mind.

    If and when I get the appointment I hope maybe, I get some answers.

    My quality of life is not really affected but at 49 and very active before I went into AF Im still finding it quite difficult to mentally adjust, but must say Iam winning that battle, albeit slowly. Lol

    Thanks again for your response.

    Adrian.

  • I too am pro ablation when it comes to improving the quality of life, but you need to think carefully. As Bob says, ablation can be more of a challenge when in persistent AF and it may expose you to a different range of issues that could be difficult to mentally adjust too...not an easy decision, but with the help of a good EP, I hope you make the right one....good luck, John

  • Thanks John.

    I understand the success rate is lower and I may be exposed to other issues, it's the other issues which are the worry.

    If I get to see an EP I would hope I will get the right guidance.

    Cheers

  • There's another angle you must consider. Yes you are asymptomatic or largely so but that does NOT mean that things will remain that way. In years to come you could become significantly symptomatic. Bi know because that's what happened to me. If that's 5 years down the line the chances of success will be much smaller than today. As you are only 49 this is even more important. See what your current EP says and then seriously consider seeing one of the leading EPs privately.

  • Hi Peter

    That is another one of the questions I was going to raise.

    Leaving as it is and waiting for it to get worse is not a good thing to do in my book.

    The private route was another thing I was going to do.

    You never seem to get very definitive answers or is it just me????

    Cheers

  • No it's not just you it's quite common I suspect.

    You need to be pointed and specific and most importantly say I want everything to be about my case (ie your case) and not generalities.

    I had cardioversion but reverted to AF just over 24 hours later. When I saw EP again I said to him that I wanted him to be honest and realistic. He said that the only realistic option was an ablation. I asked him what he thought he chances of success were in MY case. He said that in my case he would bring forward the post procedure review from 3 months to 6 weeks in the hppe that I would still be in NSR at that point so he could see the heart beating normally. However he said that he thought it would definitely take two or quite possibly three ablations for it to work and that it wouldn't work first time. I only lasted just under 72 hours in NSR.

    I was glad that he was frank.

  • My first cardio version lasted 18 months and think the stress of my job added to it jumping again. No second cardio version as they said it was pointless.

    I have a friend that lasted 3 months the first time but has gone over 5 years and is still NSR now, go figure. Lol

    They do generalise as you say.

    How are you now?

    Cheers

  • Why is the second cardioversion pointless? Mine lasted 4 months and I'm due to have another one next month. I'm similar to you in that I'm 47 and in persistent AF. Did you take any medication after your cardioversion?

    Cheers,

    Stuart

  • Hi Stuart

    Thanks for replying, I took a small dose of bisoporol after my cardioversuon. About 1.5mg.

    When did find out that had permanent AF?

    Cheers

    Adrian.

  • Hi Adrian,

    I'm in persistent AF, not permanent-big difference. I was diagnosed in May after suffering exercise intolerance. After my cardioversion I was put on Flecainide to help to keep in rhythm but I didn't get on with it. I was also taking Bisoprolol 2.5mg

    Cheers,

    Stuart

  • From what I have learnt and read on here I certainly wouldn't agree that it's pointless to have a second cardioversion - in fact quite the opposite. I would definitely push for one.

    Have you seen an EP?

    Waiting for my second ablation.

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