PAF and decision of drugs or ablation after... - AF Association

AF Association

20,257 members24,789 posts

PAF and decision of drugs or ablation after only 2 episodes


Hi I was diagnosed with PAF last September , I have only had 2 episodes of it and was very symptomatic. I was put on beta blockers but wasn't able to tolerate them as made my heart rate too low. Not been on meds since, just have pill in pocket incase.

I asked my cardiac nurse to refer me to an EP who I saw a couple of weeks ago, he thinks I either need to go on Fleconaide or have a cryoablation,. This seems very extreme to me as I have only had 2 episodes of AFA although I do get palpitations from time to time. He assures me my AF will get worse.

I would appreciate your views on this as I am struggling to make a decision. Thanks

10 Replies

Hello there Dawnstorm. Think of AF as a pathway through the grassland of your heart. It's there now, ready to be used and it will get wandered down now and then and will in time become a wider, well trodden pathway in constant use.

Flecainide is a traffic warden, turning away all who would wander along that path. But are there other routes? You bet there could be and they can get discovered and used and you soon or eventually will need either extra traffic wardens or policemen instead to turn away the throng.

Ablation hides the inviting pathways and hopefully the grass will grow again.

The better used they are, the harder it is to obliterate them.

Well, it's no doubt not much like that at all, but you get the picture.

Buffafly in reply to Rellim296

I would have gone with Maasai warriors in the grassland myself but love the idea 😀


AF is a progressive condition best dealt with in the early days. Rellim's flowery prose explains quite well actually. Only you can decide but please don't leave it too long or it may be far more difficult to deal with.

Rellim296 in reply to BobD

So succinct Bob


Hi I'd love to hear more about the symptoms. Were you very breathless? Light headed? If you dare, and you are being offered, the ablation is possibly going to be a longer fix than the medication. Symptoms can suddenly worsen - which I doubted - but when it happened to me I regret not listening and acting sooner through my fear. But then I wasn't to predict my problems further down the line. Maybe think of your desired outcome - and remember - medication for a while whilst you make your mind up is also a solution.

Dawnstorm in reply to Hidden

Yes thanks for all your replies, I was breathless, could feel my heartbeat in my throat and in my diaphragm, and felt like I had no blood in my legs, couldn't walk any distance and felt like I would pass out. Also very panicky feeling.

Hidden in reply to Dawnstorm

I also couldn't tolerate beta blockers - but I now have a pacemaker as I was also bradycardic so I can take them for AF as I await a 2nd ablation. It's very scary and confusing and all sorts of other feelings to suddenly be thrust into the world of AF decision making. The EP appointment was wise. His job is advising you of the treatment options. The decision making is hardest. Have you had a 72 hr monitor - as you say you only had 2 episodes - did he actually offer you an ablation already? I would have thought an echo test and a 72 hr monitor would at least be offered to check you out by further investigation. You don't sound clear in your mind regarding the minimal amount of episodes versus the treatment. Can you call his secretary and ask for further clarification or another appmnt to chat things through?

Dawnstorm in reply to Hidden

Yes I have another appointment in 3 months so wil ask about those tests.

Dawnstorm in reply to Hidden

Hi I was offered ablation after only 2 episodes as I asked to be referred to an EP.

Not had a 72 hour monitor, I will ask about that, I did have a heart scan not sure if that is an echo?


Maybe your EP can see something in your ECG's that you cannot feel? My EP's sidekick says he can see my arrhythmia even though I'm on drugs which take away all the symptoms.

We tend to describe AF as symptomatic or asymtomatic but I know from my experience it can be both, at least in my case.

I was given a 2nd ablation when I had only a tiny bit of AF return 8 years after a successful ablation, which wasn't bothering at all, just felt like a little muscle spasm. EP said nip it in the bud before it develops with another ablation.

Only problem is that when I had the 2nd ablation, he couldn't get the AF to perform even with stimulation, so had to abort! He seemed very surprised when we discussed it afterwards, so guess this is unusual. No way would he have gone ahead if he'd have thought that would have happened. But might be worth asking about that maybe?


You may also like...