Should he go for Ablation

Hi

My husband was diagnosed with AF last September and put on Meds, when we saw a consultant he said he must have an ablation as he had a couple of blips where he had not felt well as in hot and sweaty, felt he may pass out one time. But,since early November he has felt totally fine. Playing golf, a few glasses of wine which didn't have any effect, living life normally in fact.

Today his letter came to arrange an admission. You gave to confirm by phone but of course can't get through to anyone. We both feel why would you go for a procedure if you feel fine but I expect its best to get the Consultant to agree that.

We have had issues getting travel insurance for example so would need to discuss further. The chances of discussion are almost nil via NHS aren't they.?

The Consultant can be found online in many private hospitals in our area..Surrey.

Would you pay to go and ask further questions?

35 Replies

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  • If it is your only chance , yes I would. Do you have an arrythmia nurse you can phone for advice?

  • I had my cryoablation done 2 days ago. I hope it will work. If it does not I will not go for another one. I came to conclusion that AF in the healthy heart can be controlled with rate and rythm control drugs as well as with blood thinners. My readings about the current ablation tech and potential complications (event in experienced centres) made me come to this conclusion. This is strcitly my perosnal opinion as everyone has diffferent circumstances that may require AF ablation.

  • giitus I understand and appreciate your views. I do think that too many people rush into ablation s before trying, for example, lifestyle changes.

    However there are many for whom drug treatment doesn't work and ablation is the only route available.

    Sandra

  • Hi I'm due to have mine 4/7, I'm concerned with the risks associated, and the groin discomfort, how was it for u.

  • piece of cake! You have no experience of the procedure, and the small incisions in your leg are no bother. I was scared to death of the amiodarone.

  • Hi how are you doing. What has made you say you won't do it again..the whole experience of this one?. I have a mixed bag of replies . My husband now feeling he won't have it at this stage. Lots would disagree I know but interested in why no. Number 2 for you if needed. Most are saying it gets worse with time but others 4 hasn't done the trick. Hard to know what's best.

  • I am just afraid of potential complications however low the risk is. This is very individual . My PAF is more likely caused due to some extra weight and digestive problems. If i resolve them I maybe better control the future occurrences.

  • How was your crayo ablation?did you recover quickly? My father has been recommended for one and we are trying to understand more about the procedure and potential complications, recovery times etc.

    I wish you a healthy recovery:)

  • Thanks for your replies. We are thinking our best bet is to pay and get a conversation with the Consultant. Not looking forward to that as he was so abrupt and dismissive before but seems the best thing to do. I personally would not want to have this procedure if I felt well every day, but it's not my body.

  • If you're paying for the consultation why not seek a second opinion?

  • I agree. My EP, Dr Todd, is lovely but unfortunately for you he is in Liverpool. I'm sure someone on here could recommend a good EP to see.

    Good luck with your decision.

  • I am in the same situation as your husband but don't drink so I don't know if that would affect me.The consultant I saw (I live in wales) was very abrupt and as I was only with him for about ten minutes I am not going to make a decision about something as important as an ablation in that time.I have decided to pay to see another EP and get a second opinion

  • Try dr Barry at morriston, a very understanding and thorough professional

  • Hi is doctor Barry your consultant

  • Yes he was until I went to London to have ablation with Sabine Ernst, but the meetings I had with him he was very thorough and approachable

  • Thanks for the info. yes I remember now your ablation was a new procedure with Sabine Ernst I hope all is well.

  • Exactly. We feel the same. We were so taken aback by his attitude and didn't ask enough questions as we felt he decides and that's that!

    It didn't help my husband hadn't felt great a couple of times around the appointment time. If he had been ok since going on Meds maybe he would have said see how things are in a year. Good luck to you with your follow up hope you get the info you need

  • Can the ablation happen at a later time if the Af returns? If your husband has vagal AF, ablations may not be that effective. This is not a minor operation and the results are not guaranteed as you will see if you read lots of posts on this site.

  • Definitely more questions. I pay to see a Surrey cardiologist twice a year and I think it helps to determine what's best and mentally is a reassurance, both important if you have Vagally mediated AF.

  • Don't hesitate - I would go for it!

    AF can be progressive, just because it isn't present at the moment doesn't mean it won't come back. Cutting out alcohol period may help if it is known to trigger an episode.

    How do you or he know he hasn't had an episode? Many episodes are silent and asymptomatic so just because you don't have symptoms doesn't mean you don't have AF.

    The sooner ablation is performed the higher the chance of success. Having an effective EP is far more important than his bedside manner but yes it may be a good idea to investigate your options and to check out his credentials, training and success rate - all easily done. And yes if you have concerns, ask for another appointment or pay for a private one but when you go ask clear, pertinent, factual questions - match his style.

    Learn all you can about the procedure and become expert (AFA website) - you will then have better understanding of AF & ablation and able to ask informed questions and therefor better able to assess as to whether or not to go ahead a but keep the appointment slot as you may not get another easily - you can always cancel nearer the date.

    Best wishes CD

  • You don't say if your husband's consultant is a cardiologist or an EP but Richard75 has made a good point and many people on the forum have made the comment that paying for a consultation has been money well spent. You don't become a private patient but just slot back into the NHS system.

    Personally I haven't found the chances of discussion in the NHS to be virtually nil. Appointments may be subject to a long wait however and much depends upon the charm of the consultant.

    One may have AF and feel fine but it means living on a bit of a knife edge and progression is likely. There's a choice between medication or ablation. Opinions on the forum vary and those who are hesitant about the benefits of ablation tend to be those who have not had one.

    Are you aware that there's a support group in Surrey who have regular meetings? rosyG has details.

  • I suffer with AF unfortunately medication doesn't work for me. I had an ablation done in Liverpool last July, felt great for 6 months but AF came back with vengeance. A repair ablation was suggested was fitted in as an urgent case unfortunately things went wrong and it had to be abandoned as had a bleed in heart. This has not put me off they are going to try again in a months time.

    so if you have the opportunity to go for an ablation take it.

  • I was diagnosed with AF over 8 years ago ( I'm now 50 ) which got progressively worse so I was prescribed flecanide & tildiem. Wonderful, my life returned to normal for many years until I got to the limit of my drugs. So ablation was on the agenda. I did a lot of research at the time via numerous websites and decided to wait a bit longer. However the drugs were becoming less and less effective ( which is normal) so I felt the only option was ablation. Fearful of the op I put it off on two occasions but eventually after a very long wait (1 year) I decided to have the Op at the RSCH: that was August 2016. Pretty straightforward procedure. AF free for a days post op then it returned which is entirely normal so I went back onto the drugs. I kept in contact with my EP nurse via e mail which was reassuring. I am now off all my drugs ( including blood thinners) and have had no episodes of AF since - I am so pleased that I decided to have the procedure as it has changed my life for the better. I wish that I had done it sooner. No more hot sweaty nights, breathlessness and the anxiety I used to get when a spontaneous episode used to occur in the middle of the day. Due to my age I was told by the consultant that chances were that it would be successful first time round but I am prepared to go back and have another procedure if the AF returned.

    Like your husband I used to have long periods of time feeling fine so I thought do I really need a op then when it suddenly returned I knew that I had to. I could have kept on waiting thinking it would get better but the reality is it didn't , it was getting worse. Seeing a consultant was a challenge but I kept on at my doctor and it was arranged. I also managed to see the EP nurse so my confidence was high in having the op. Look, I am not a doctor just someone who has had the op and is pleased he did so. If I were you I would accept the admission date: you can always cancel nearer the time as there will always be somebody on the waiting list (like me).

    Good luck

    Julian

  • How long did you take flecainde? What was your dosage? How old were you when you started the drug? Were the side effects the reason you stopped taking them or were they ineffective? I started Flecainide in Dec of last year.

  • dosage was 150mg twice a day so 300mg in total, the max that is recommended although at times I had to over dose to calm my AF hence the need for the ablation op. I was also prescribed Tildiem - 2 x 90mgtablets per day. Must have been 42 / 43 ish when I started the drugs. They worked really well for me until after a period of time ( some 2 to 3 years ago ) they became less effective so hence the over dosing. It was time for the op although I had put it off several times. I did a load of research and spoke to some friends of mine who were doctors, one who had AF also. He went onto to have the Op so I thought well if its good enough for a doctor then it will be good enough for me. Side effects - nothing that I could really say that was related to flecanide as the the drug worked well for me. So pleased I had it done - now drug & AF free. Love the gym and cycling so can embark on these activities with pleasure once again. For me leaving it longer and longer was not an option as the AF episodes had become a lot worse even on the drugs and also I didn't want to have the Op later in life as it is less likely to be successful. Hope that helps?

  • How long did you take drugs for your afib?

  • Well about 8 years in total

  • When I could not get through to the cardiologists secretary about an admission I phoned the cardiology ward and asked the ward clerk to pass on my message.

  • Hi, I had a similar issue regatding contacting my cardiologist so I wrote to to him, i sent the letter by recorded mail. I received a phone call two days later from him. It might be worth you writing before you spend out any money. If you find it diffucult to talk to your cardiologist ask to be seen by a different one, I recently had a implantable loop recorder fitted and the cardiologist who carried out the procedure was amazing so I ask to see him instead, the hospital were absolutely fine about this and this has not impacted on my treatment. Good luck

  • I was diagnosed with Afib last May, symptomatic off and on since sept 15. It took a while to diagnose. I didn't get it a lot but when I did I hated it. Was put on blood thinners and a calcium channel blocker. It began to occur with more frequency, so my doc wanted to put me on Flecainide. I went to two other doctors for opinions because I really didn't want to go down the medication road. From what I learned from the doctor I settled on was that he thought I was an excellent candidate for ablation, and that he didn't think anti-arithmyia drugs like Flec were good for me. He thought it would slow my already low resting heart rate down too much and I'd feel pretty crappy. He said they work for a while, but then one must change drugs or go to higher dosages and then eventually end up with an ablation anyway, and at that point the heart can remodel itself to the arrhythmia and then the ablation is less likely to be successful. So he told me the sooner the better as I was at the point where the chance for success was highest, even tho 20% still need a touch up afterwards. I didn't want to go down the medication road for years, so I went for it. I had my ablation three weeks ago and am doing well. A few jumps here and there but basically quiet. Doc says that if anything happens within 3months it's just part of the healing process. After three months they will see where I'm at. So I'm happy since I didn't want to go on anti-arrhythmic for years. I do understand your concern about the procedure, as there are risks with any procedure, but it was much easier than I thought and I was fortunate not to have any complications. In hospital overnight, was home by next early afternoon, and was walking the dog by Monday. Took a week and a half off from work, and am back to doing mostly everything I normally do, except for exercising, which I will wait to resume until after my follow-up visit with my EP the end of March. Good luck and do what you feel is right for you, but get informed by researching, reading and talking to a qualified and may I add, concerned and sympathetic EP to make the best decision.

  • We have simillar experience as you. My husband obtained letter with invitation to "investigations" but from enclosed paper become clear that "investigation was actually ablation". Without any discussion with him or with us. As he became totaly symptomfree we decided to wait with ablation, research everything available concerning ablation, continue with medicine (Sotalol 80 mg x2 and xarelto) and during time start with aggressive adaptation of life style. He lost 21 kg, has now normal blood pressure, blood glucoce close to normal. May be that there will come time for ablation but at that time we would know what are we doing. I would not reccomend anybody ablation without research and consultation with Cardiologist whom I would trust. People has right to be informed about alternatives, their concequences and than make decission what seems to be right for each of tham at given time. Good luck!!!

  • Do look at our website - google SurreyASG- and come to our meetings where you can learn a lot from the doctors who give talks- first Wed of each month at Epsom Hospital. You can ask our medical director ( who does ablations every week at St Georges) about ablation

  • Hello Rosy

    Thank you we will do that. Is the Dr 's name Kaba. Ours operates at St Georges too.

  • no It's Dr Bajpai take care

  • I don't know but maybe some of the posts are from people who are younger and understandable don't want to be on medication for years. maybe as we get older the choice of an ablation becomes harder to make.

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