EP study and possible ablation set for next week

[jodb]

Hi everyone

I am a newbie here - I hope you won't mind me asking a question - just looking for some views. The back story is that I have had palpitations for around four years, very intermittent, maybe every couple of months, and lasting less than a minute. I had them checked out several times but of course very difficult to assess when they are not actually happening. Then, at the start of October, I had a more powerful series of palpitations when driving my young son. I felt very odd so tried to stop the car, but passed out for around 30 seconds. A trip in to A&E (just for heart - luckily my super hero ten year old stopped the car safely) and quick visit to the cardio ward, then referred for a cardio memo and consultant visit. That showed a lot of arrhythmia - around 30 episodes over a week, most of which I wasn't aware of. Got a referral to a wonderful consultant, and I am now scheduled for an EP with potential ablation next week. Precise procedure not yet known until they get in there, but strong suggestion that it is AF. My question (got there eventually) is whether any of you had a similar experience? I'm keen to get the problem resolved, mainly because I am not able to drive until it is fixed. However, many of you seem to have gone the meds route first. I realize that this is a very vague question but would be really grateful for any thoughts you have on whether I am jumping the gun a bit here. Very many thanks indeed.

[rosyG]

I haven't had an ablation but many on here who have will advise you. Its seems yourAF was very symptomatic for you to pass out- also guessing you are young as have a young son- this is relevant as the alternatives to ablation are meds which can have strong side effects so not good to take for many years.

Also you had 30 episodes in a week. I think you will find people advise you to go ahead- main thing is to look up all risks involved with ablation and make an informed decision. Lots of younger people do very well after ablation- you do have to be prepared for shorter follow ups procedures which are sometimes needed

Good luck !!

[Rellim296]

I was diagnosed with tachycardia (which I'd had occasionally for about 20 years) and had a 7 day monitor which revealed nothing at all but normal rhythm and an echocardiogram which revealed slight enlargement of the left atrium. I was referred for an EP study and possible ablation before any medication had been suggested, although I was already on a beta blocker (atenolol) for high blood pressure control. The favourite drug for AF seems to be, initially, bisoprolol. I'm happy with the way things went, although a lot of people seem to be channelled down the 'ablation is not the first line of attack' route.

[BobD Volunteer]

Like most people there have been times when I was close to passing out with my AF and it is not unknown. Whatever is wrong, the EP will find out and treat so you are on the right road. I don't have AF any more since my ablations and believe me it is better to get it sorted early before it progresses since AF is almost always progressive.

Go To AF Association main website and read all you can so that you are able to talk with your EP from a position of knowledge.

[Finvola]

Hello and welcome to the forum. You have had a relatively good passage to a consultation with an EP and the offer of an ablation for what sounds like a very unpleasant arrhythmia - and it is a joy to have good consultants.

I am also assuming that you are young but your arrhythmia has progressed to interfere significantly with your life. Were I in what I think is your position, I would seriously consider ablation, provided your EP advises it. I have opted for the drug route but I am 72, have had AF for about 10 years and, so far, my EP is advising me to continue on drugs and to wait.

Knowledge is your best tool in deciding how to go forward and be able to discuss your options with your EP. Do ask anything you need to know - someone will be able to help. Well done your little 10-year old!!!

[MarkS]

I would definitely go for the EP study at least. You need to get to the bottom of what caused you to black out. You won't be able to drive for 6 months now, and that could be permanent if it isn't sorted.

In my experience it's very unusual to pass out for 30 secs from AF when sitting down. What were you exact symptoms? It is possible you had a TIA, was that ever considered at A&E? You may need to be on anti-coagulants.

[BobD Volunteer in reply to MarkS]

Very good point Mark.

[scool in reply to MarkS]

I have had several episodes where I have passed out - though can't discount the possibility of small TIAs on each occasion as I was eventually diagnosed as having one about two years after my first episode of passing out [while sitting down].

[jodb]

Hello all. Very much appreciate your replies - thank you. It's good to know there's such a knowledgeable and supportive community out there I'm 42 and the prospect of meds long term feels less than ideal. I'm off driving for at least six months but even once that time has elapsed, I don't think I would feel confident back behind the wheel until someone can tell me I am 'fixed' - which does seem to be a bit of a moving target if this does turn out to be AF, without ablation(s). . I guess I'll know more after the EP (and possible ablation) next week. MarkS - each doctor / cardio I have seen has pointed out that the blackout is unusual considering I was sitting down. TIA has been considered and rejected so it's all a bit of a mystery....

Once again thank you for your replies and advice and I will let you know how it goes. All best,. Jo

[Buffafly]

Agree with all previous comments but regarding the blackout, some people have a 'pause' in HB when their heart reverts from AF to sinus rhythm. This is the point where AF gets serious and may be what happened to you. In that case you cannot take meds for AF so your only options (quoting my excellent Cardiologist) are pacemaker or ablation and obviously the ablation would be the preferred option for you.

Best wishes for your procedure and congratulations to your son, up for an award I should hope!

[jodb in reply to Buffafly]

Thanks Buffafly - this pause between rhythms has been mentioned as a possibility so will be good to find out more. Thanks for your good wishes and yes, my son has had lots of praise (and I've had a lot of ribbing that he can park better than me!!!).

[Dodie117]

I was given choice - meds or ablation. My EP said if i was thinking ablation, the earlier the better. I opted for ablation. That was November 2013 and fine since then. Sounds like that is the best option for you too. Be guided by your EP but read lots too so you make an informed deciusion.

Good luck 🍀

[jodb in reply to Dodie117]

Thanks for your reply. And yes - all the guidance seems to be to read as much as possible so that's what I'll do! I'm glad your ablation worked out. All best

[expences]

I think you need to find out what the rhythm was first. I had a series of episodes of palpitations bad enough to take me to A&E but it was always sinus tachycardia, my BP went up very high too, made me feel quite unwell. Long story short, it turned out to be a caffeine supersensitivity. Never had another problem after giving up all forms of caffeine and went onto decaf, until got given the real stuff by mistake and had my first and only (so far) episode of AF.

Good luck, you are so young!

Brenda

[jodb in reply to expences]

Thanks Brenda. I have tried over several years to identify whether the palpitations / arrhythmia are linked to anything obvious (alcohol, caffeine, food, stress, lack of sleep and so on) and nothing springs to mind. My husband is an osteopath and he thinks there could be something linked to position - I spend far too much time crunched over a computer at work and seemingly some of the upper back influences the heart (horribly inadequate explanation!). Haven't managed to link that really, beyond noting that I seem to get fewer episodes when I am on holiday. I'll go ahead with the EP and will update on anything interesting. I do appreciate your reply (and especially the comment about being so young!!!).

All best to you.

Jo

[jodb]

Hi all. Just wanted to thank you again for your advice and support. I had the EP study today with prof Schilling and a TOE with ben O'Brien. Their investigations revealed AF in top left with some pulmonary involvement (I think - was still a bit woozy). They were able to cause and stop the palpitations exactly as if described them, so they are very confident that they were in the right spot. I had the ablation and will be on an anti-coag beginning with 'r' for the next three months. I'm feeling really good now - a little dizzy on standing but think that's the general anaesthetic rather than the procedure. The care has been wonderful and I can't speak highly enough of professor schilling and his team - they've been so approacable throughout. Feeling very humbled and thankful to have got to the bottom of this slightly mysterious one. I wish all of you here the best and thank you once again for repjting to my original question. Jo