Persistent AF

Hi everyone,

I saw my consultant today after going back into AF 8 days after cardioversion. I am currently taking Dronedarone. He said there are two options for me, 1 - to leave me in AF with rate control as I am asymptomatic 2- Ablation. The arrhythmic drugs just are not working for me.

So, I've decided to go for option 1 and to stay in AF with rate control along with regular check ups. My AF doesn't really bother me that much and with the ablation option I may need 2 or more and then there were no guarantees of success.

I know there are others on this forum who are in persistent AF and appear to be doing fine. My intention is to maintain a healthy life style and just see how it goes.

I hope I have made the right decision.

thanks,

Stuart

11 Replies

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  • Hi Stuart,

    The forum is full of posts from people who have had to make difficult decisions about what is the best route forward. Something tells me that whilst you have made your decision, you are not totally sure it is right and you are expecting, possibly even hoping, folk will either agree with you, or get you to consider alternatives. I wouldn't be that bold, but the good thing is, you can always reconsider your position at a later date, bearing in mind many would say ablation is best undertaken as soon as possible.

    Is your Consultant an EP or a Cardiologist with some knowledge of arrythmia? The fact that you stayed in NSR, albeit for 8 days after your cardioversion, may provide an EP with valuable information about the effectiveness of an ablation. Also, a lot depends on the overall condition of the heart as this will be important. Generally, if an EP is prepared to carry out an ablation, then they are reasonably confident that their efforts will not be in vain. If you have not seen an EP, then maybe it would be worth pursuing, just to be sure. I have only had one ablation and I would not hesitate in having another if it was necessary, but I totally understand and respect that others may not share that view. Age is important too.

    I know of many who have permanent AF and their general condition has remained consistant for some time and they lead relatively normal and active lives. The important issue that is probably influencing your decision is that you are assymptomatic. An EP's will take this into account in their assessment, so I really think you should talk to one (if you havent already). The best of luck......John

  • Hi John, thanks for your perceptive reply. Your right, although I have made my decision, it is a case of "What ifs". If I feel in the near future I will go back and see the cardiologist; we have a 6 month review planned anyway. He is cardio with an interest in arrhythmia (he does pacemakers) but is not an EP. He is more than willing to refer me I that is the route I want to take.

    I want to get on with my life and not have this hanging over me, so for the time being I'm going to see how it goes.

  • I know exactly where you are coming from Stuart. My turning point was when my cardiologist, who was also not an EP and had a "conservative" view on ablation said to me, "if I were you, I would have a cryoablation". I followed his advice and thus far, have absolutely no regrets. The only thing I would suggest is that you should consider seeing an EP as soon as possible, as I am sure his/her considered opinion will be invaluable. I get the impression you will not be easily influenced, but you will have then done virtually everything possible to make that "final" decision when the time is right!!!

    Best of luck......John

  • John makes some useful comments but my only addition is that the right decision is what is right for you at the time. Everybody knows how much a fan of ablation I am but I am also aware that any treatment for AF is only about improving quality of life. It follows that if that quality is good then there is little point in taking unnecessary risks. All I will say is keep an open mind as nothing ever stays the same. .

  • As they say, the only constant is change....

  • Like you, I can say that my AF doesn't really bother me that much. I've been offered a fourth ablation and have not accepted it and am currently sitting on the fence. As you say, there are no guarantees of success, but there's success and improvement and ablation has, for me, most certainly provided the latter.

  • I would ask myself, did I feel any better in NSR than in AF? (I'd be interested to know your answer actually - I am in permanent AFand have never been offered any interventions) But as BobD says we're all different

  • The consultant asked me that exact question and the answer is not much difference. In AF I can can sometime feel my heart bouncing about and I have lost some exercise tolerance and do miss a normal pulse. But I can walk, cycle, go the gym without any major issues. My question to him was of the future as I'm only 47 and how could things be in 10 years time.

  • $64 million question!!.....but by then, they may have invented an app that cures AF!!!

    Did he give you a slightly more sensible answer?

  • LOL - not as specific, more around the state of my heart health, not having high BP or diabetes etc are all positives.

  • it all depends on how you feel, if you feel ok why risk a procedure ? - for most people that go the ablation route life has become difficult due to the recurring afib which affects them badly - if I didnt notice it I would leave but its a personal choice.

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