Hybrid ablation getting closer

I posted on monday about being selected for a hybrid ablation clinical trial at the northern general, Sheffield, to start in 6 - 8 weeks. Thanks to all who responded/DM'ed and I will post on progress.

I have just received a call inviting me to a pre-assessment next tuesday. Surely this should take place within a couple of weeks of the op? Does this mean I have been moved forward? I asked the secretary, but she wasn't able to comment.

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  • Please explain hybrid ablation. Thanks.

  • I've had an ablation for flutter, and am still on meds for fibrillation, that's known as hybrid therapy.

  • Thanks

  • It may be a term used for other things too, of course.....

  • Two ablations 3 months apart, first done by a cardiothoracic surgeon on the outside of the heart accesed from the left of the chest (mini-maze). The second a catheter ablation done by an ep, accessed by femoral vein.

  • Hi johnMiosh - good luck with upcoming first stage of hybrid ablation. I had the first stage 4 months ago. The pre op appointments were pretty close to the op day, including a CT scan squeezed in 2 days prior to going into hospital. There were a few of us on the ward having the same first stage op, including one lady who had been booked into the ward for the op 3 times, and 3 times it had to be cancelled due to various reasons such as an emergency case. I have a total phobia of hospitals, operations and needles but can say that the cardiology staff were pretty understanding and amazing. I awoke without any pain or discomfort - obviously the morphine helped - and as the dosage was lowered and discontinued, still no pain or discomfort! As you have described, they make 3 tiny incisions on the right side of the chest whilst you are laid on your left side - it is such minimal invasion. They then scar the outside of the heart by heat or freezing. They allow time for these scars to heal. And once the scars are healed they carry out the second stage of scarring the inside of the chamber where the signals are going astray. I had the first stage op on the Monday and was told I could go home the Wednesday morning. After speaking with others on this site, and despite my phobias, I am now chasing up the second stage as it appears to have been delayed due to bed shortage and operating theatre space.

    I am definitely interested to hear about your experience and how you feel afterwards.

  • Hi Ktomoph, thanks. I have no fear of hospitals, but i did have a reaction to the invitation yesterday; part exitement and anticipation, part nervousness.

    I will continue to update the forum. As this is a clinical trial, i will be followed up for at least three years, so will have a reminder to post even if "cured".

  • I notice on previous posts, and not just yours johnMiosh, that you are reacting to the medication prescribed, such as the bisoprolol. Have you described your reactions to your doctor/cardiologist and asked if you can have an alternative?

    I reacted to bisoprolol, and also along the way, other medication prescribed, but felt strongly that these should not make me feel worse than I did. Fortunately, at the time, I was registered with an amazing doctor who not only understood, but immediately investigated and prescribed an alternative, Digoxin.

    Prior to the first stage op I was also on rivaroxaban(blood thinner) and I was told to stop taking this 3 days before the op. Post op I was given dabigatron in place of the rivaroxaban - it was explained that this worked quicker post op - which gives dreadful heartburn/indegestion as a side effect. After 3 days of horrible discomfort, I contacted the cardiology team to ask if I could change back to rivaroxaban. I was told to take gaviscon at regular intervals throughout the day. Rather taken aback at being told to take medication to help cure the effects of medication, I disagreed and asked why I could not return to a medication that my body coped with. They spoke to the cardiologist who said of course it was OK to return to rivaroxaban.

    There are alternatives which are worth trying. I know some, or perhaps most surgeries have an 'allotted favourite' drug prescribed for many years, but feeling better as opposed to feeling worse is something worth consideration, as my previous doctor made me aware of.

    After many many years of being fit and finding alternative measures to fighting colds other than taking medication, taking notice of what may be making me feel discomfort and changing my diet accordingly, it is with a mixed feeling of defeat and relief that I take the 5 different medications that I know are helping me to stay alive........

  • When my af became persistant and therefore diagnosable I was put on Rivaroxaban, which was fine, although it caused itchiness on my arms and neck; this is now pretty much back to normal.

    I was given bisoprolol for rate control. Immediately, it magnified my symptoms; real breathlessness after minimal effort, brain fog that was affecting my work and a general listlessness. Also my resting HR dropped from 57 to 49. On the plus side, it did restrict my HR, a gentle walk could send it racing to 200 BPM as soon as I hit a gradient, on Bisoprolol it could not go above 160. Requests for a change of medication were dismissed on the basis that alternatives would have similar effects, so I continued with bisoprolol. I still have all the side effects. My cycling now involves a general potter along canal paths rather than racing around the peak district.

    I have just finished reading "The Haywire Heart" by Cash, Mandrola and Zinn, about AF in athletes. It seems that Beta blockers affect the aerobic capacity of athletes particularly badly and cardiologists are not good at understanding this reaction.

    My pre-assessment clinic is tuesday, and so assume i will be admitted reasonably quickly afterwards. I assume i will then be off bisoprolol and on amiodarone, i am sure that both together would result in serious bradycardia.

    I am actually looking forward to it; finally something concrete appears to be happening.

  • Not been so good for past few days so have only just looked to see new postings. Am interested in the the book mentioned - will send for a copy today. I try to read as much info as possible to understand what is happening. I admit that I find it difficult to remember all the terminology, but I do understand what is being discussed.....it does make amusing (probably irritating for doctor) conversation when I refer to heart 'thingy' etc.

    I have an xray today - after contacting the cardiologist by email last week stating how abysmal my quality of life is at the moment - to see how heart has healed after first stage of hybrid ablation. Hopefully(?!) this means I will shortly have the second stage which is long overdue.

    It is true what you say, that cardiologist do not really understand the reactions - I was just grateful that my doctor at that time really DID understand what was happening.

    Good luck with your procedure.

  • Best of luck with the procedure John.

    Interesting to hear your comments about reduced cycling. Similar with me. I have also just read Haywire Heart, interesting book.

  • I have come down from 3000miles/year averaging 78 ft/mile at 16mph to 1675 miles, 14mph and 31ft/mile last year. I live in Chesterfield, so can't avoid the hills unless I ride around the canal banks and on the rollers.

  • I managed to keep my mileage at about 6,000 miles last year but like you avoid tough hills. More disappointingly I do not go out with Stocksbridge Cycling Club on Sundays. I need to get a slower group together.

  • Equally difficult to avoid hills in stocksbridge. I am normally out with Bolsover, but my particular groupalways heads west, so theres no chance for me in the near future.

    Meadfoot has invited me to the next group. I will be there if not in recovery.

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