First appointment with EP

Hello all! Finally saw EP (at UCLH) yesterday. I'd never heard of EP's until I joined this wonderful support group - and by the way, when I mentioned I'd joined, he was very approving. As usual, I can't remember half of his comments. I'd listed questions, but didn't like to hold things up taking notes. Any advice on this?

I was puzzled that he seemed very dismissive of CV - 'rarely works for any length of time' - yet also seemed to be putting me off Ablation, as it's such a complicated intervention. I wondered if it was my age, (75), but he assured me they operate on far older patients. He wants me off Warfarin and on one of the 'new' tablets.

Curiously, by the end , he suggested I have a CV and once I'm in sinus rhythm again, however briefly, I can decide whether the improved QoL would make it worth an Ablation. I'm really confused. I don't want any operations, if poss. and I wonder whether the deterioration in my QoL is due to my meds, rather than the Afib itself.

I'm so grateful to be able to share this with people who know what I'm obsessing about!

Pat.

12 Replies

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  • Hi Pat, for a few, a cardio version can put someone into sinus rhythm and that is it they don't revert however, for most there was a trigger so as soon as it happens again you are back in AF. Some people live happily in AF without symptoms some get lots of symptoms. A CV is a very simple procedure - in and out in a day and under GA for ten minutes. I think your cardiologist wants to try and get you in sinus (even though you will probably revert back) so you can see how you feel in it. If it makes a huge difference then it is worth trying procedures like an ablation. If you don't feel much better drugs to control may be better. As for remembering everything, I have the same issue so I now take someone with me and between us we remember more!

  • Thanks, Richard! I have several dear friends who would be willing to come with me, but we're all having similar problems with memory. I'll have to persuade a niece or nephew next time.

    Pat.

  • I guess you could try taking someone with you whose sole role during the appointment is to take notes (if the consultant permits)? It might help too if you had a prepared list of questions (with space below each one for notes) and if you, your friend and the consultant each had the same list. I do that if I go to the GP (on my own) and have lots of questions. She reads the list first and then we work steadily through them. She says it's helpful to her too and it keeps us both on track. Worth a try?

    Carole

  • HI Pat, CV back into normal sinus rhythm seems to be a stop gap thing for most of us. That and meds. You can go thru CV and be back in AF hours or months later. We all know that. Having the Ablation is a sooner or later thing for most of us. I've gone both months and years tween AF events. I just had mine. Hope to be one and done. Good luck.

  • Thanks, RotS! I think I'll try to stay without intervention as long as possible.

    Really hope your Ablation works.

    All the best,

    Pat.

  • The thing about having a CV before offering an ablation is that if you can be converted by CV - even for a few mins/hours/days then the chance of an ablation working is higher.

    Best to try intervention sooner rather than later as AF progresses it becomes much harder to convert back into NSR.

  • There is no substitute for having another with you at important appointments....to listen and/or, for preference take notes. I also permit my husband to ask questions at the end of the session if he notices i have forgotten to ask something we had discussed at home earlier.As for being worried about taking up time. This is your opportunity to find out all you can about your health so make the most of it.

  • Yes, you're right - I'm sure my docs would be happy to answer my questions. It's astonishing how long one's upbringing lasts - strongly encouraged to consider other people first - especially if a girl! Totally inappropriate in this situation.

    Many thanks.

    Pat

  • There is a video posted this morning about the 'new' AC's = NOACs (New Oral Anti-Coagulants) posted by Dr Sanjay Gupta - I have been on Apixaban since September.

  • Thanks, CD. I'm going to chat with my GP, as I have several health conditions which need their treatments knitted together. Good to hear Dr. Gupta has a video on NOACS.

    Love

    Pat.

  • It might just be me but given the choice between a cardioversion (huge electric shock but over quickly) and an ablation (far gentler but goes on for hours), I'd choose the ablation anyway.

    But anyway cardioversion just deals with the here and now, whereas an ablation can be a long term fix.

  • Thanks, Mike. I think my EP was saying that once the CV puts me in sinus, however briefly, I could decide whether it would be worth going for an ablation. I have to say, I'm much more averse to the ablation - it's a much bigger undertaking.

    Pat

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