To Ablate or not to Ablate?

[Capri62]

Hi everyone, I have just joined this group and in am in need of advice.

I was diagnosed with Paroxysmal AF three years ago (I am now 72). I have been taking 5mg Apixaban and 100mg Flecainide twice daily, 1.25mg Bisoprolol and 40mg Valsartan once a day. Last April I had a stroke, after which they put me on 40mg Atorvastatin. Prior to the stroke I was happy to be treated with this medication as I generaly believe operations are a last resort and I had learned to live with the AF. But since the stroke I am not so sure. I tend to feel that the medication did not stop me having a stroke so perhaps I should have the Ablation as I may not be so lucky next time. I have seen two consultants one recommends I have an Ablation and one doesn't. I would love to hear of others experience and advice.

[BobD Volunteer]

You have AF therefore you have a stoke risk. Were you taking the anti-coagulant when you had the stroke? Ablation does not remove stroke risk and you should remain on anti-coagulant even after successful ablation although you may be able to reduce or even stop Flecainide post a successful ablation.

By the way ablation is not an operation it is a procedure but that is perhaps being pedantic. Read up on AF , ablation and all such matters on the main AF Association website.

[Capri62 in reply to BobD]

Hi BobD, thanks for replying. Yes I was on anticoagulants for two years prior to having the stroke, I did miss one dose a few days prior to the stroke, my Doctor thinks that was significant. I have been told that I will remain on anticoagulants for the rest of my natural.

[rosyG in reply to Capri62]

If you were on apixaban you would have been fully protected after the couple of days so not sure if one dose a few days before the stroke is relevant

Were you in AF when you had the stroke?

I think the underlying health and age factors which result in AF can also result in stroke so it's a complicated picture you almost need to ask the stroke consultant as well as the cardiologist for advice

Ablation is usually thought appropriate if your symptoms are such that your quality of life is affected by the AF but I'm sure you know that already

Hope you get some advice that helps you reach a decision

[Plantwords in reply to BobD]

Hi Bob,

In your reply you mention remaining on anti-coagulant even after a successful ablation. Did you mean for a specified period of time or indefinitely? My EP prescribed Xarelto for 3 months post-ablation only. I would be interested in any research that indicates long term use post-ablation.

Stevem

[Plantwords in reply to BobD]

Hi Bob,

In your reply you mention remaining on anti-coagulant even after a successful ablation. Did you mean for a specified period of time or indefinitely? My EP prescribed Xarelto for 3 months post-ablation only. I would be interested in any research that indicates long term use post-ablation.

Steven

[Buffafly]

Hi, I am your age and had an ablation a year ago. Up until a year before that I had no idea an ablation was an option but I wasn't keen to have one. Then I had problems with my medication and had no choice (alternative was a pacemaker) which I am now glad about as I feel much better. Really it is a decision made on your QOL and the confidence of your EP that an ablation will be successful. Perhaps you should bear in mind that your PAF could develop into Permanent AF and then there won't be a choice.

[WestSussexGuy]

I am 45, have PAF, and tried medication, it was a real pain taking so many meds - and they helped reduce but did not stop my PAF. I was offered a Cryo ablation and accepted right away. I had to wait 6 months and had the procedure in October. I am now feeling so much better. In your shoes, I would not hesitate to try the ablation. It is a very safe procedure and if your Dr thinks you will benefit, then I would go for it. I am curious, is the other Dr who doesn't think it would be helpful was also and EP? I would follow the advice and expertise of an EP on this, no other consultant is really qualified or expierenced to guide you on this.

[Capri62]

It was my regular Consultant a cardiologist that did not recommend I have the Ablation. His actual words were 'If you were my father I would not recommend it'. He did send me to see the other consultant, who is a Cardiolagist and a EP. for another opinion. It was this consultant that does recommend that I have the ablation. I guess from what I have read on here. That I should go by what the EP says.

At the time of my stroke I was not in AF. I was sitting quietly having a cup of tea. But I had had an episode of AF the previous day.