Another Cardioversion or Ablation?

I am considering having an ablation rather then another cardioversion. I had a cardioversion 2 weeks ago it was successful for only a week. I've had persistent AF for a week now. I am quite certain I'll be offered another cardioversion but reading how others have had several I just don't see the point? Does anyone agree or been in a similar situation?

11 Replies

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  • If you are offered an ablation, a £15,000 procedure, then go for it. Do not live with regrets. You are not going to be offered one unless they consider there is a fighting chance of you showing an improvement.

  • You usually have to wait for quite a few months before you have an ablation, my first wait was about 6 months. So I'd go for both if I were you, otherwise you could be in AF constantly for the next 6 months.

    Jean

  • Cardioversion is not a cure for AF but it can signpost to other treatments like ablation. If CV can put you back into NSR and you feel better for it even for a short while then ablation should be the next consideration If you can not be put into NSR even for a few minutes then ablation is likely a waste of time and would not be offered.

    There are times when CV is appropriate such as atrial tachycardia which is not unknown after ablation. I too often wonder why people have multiple CVs rather than ablation unless the latter has failed several times or is not advisable for other medical reasons..

  • Evening Bob - If I had a choice of staying in constant and disabling AF for 6 months while waiting for an ablation or having cardioversions while waiting for the ablation day to come, I always appreciate the cardioversions which have never failed to revert me back to sinus rhythm and a normal life with the first attempt. Sometimes they last days weeks, months, years, there's no telling. If I end up being admitted to my local hospital where they don't do ablations, they email my EP for advice and I guess if all else fails he suggests a cardioversion. I can't choose to have a cardioversion, it's the hospitals or consultants recommendation. I guess we all speak on here from the personal experience we have had.

    We are all so very different, especially in our symptoms and what does and doesn't work.

    Jean

  • If I were you I would go for the ablation. I did and I am very happy to be AF free.

    All the best

    Carole

  • My cardiologist has put me on bisoprolol after cv, without it I have reverted to af, with it stay in sinus. He has described ablation to me as potentially dangerous.. Personally I would try cv again with a beta blocker just to see before opting for ablation. The ablation fans here may not agree.

  • Cardioversion can carry just as much risk as ablation. Just look at the things you are signing for when you fill in the consent form! Rare maybe but then so are most of the ablation "risks". NOTHING is risk free.

  • Hi Tony, you are 78 and I am 74, so I am wondering whether age greatly impacts the interpretation of AF for some cardiologists. I have read that a 90 year old has had an AF ablation. It appears that both your cardiologist and my one visit cardiologist , for me, are fear mongering. My cardiologist questioned why I would want wires up my body (ablation) or rhythm drugs that do havoc to all the organs of my body. I found his approach mind-boggling negative. And, he added that lots of people go on to lead a good life in AF implying, I guess, just to stay on rate control. Bisoprolol is a beta blocker rate control.

    I have read on more than one site that the complication rate of catheter ablation is 1% - 3%. In the 2014 Boston AF Symposium, Dr. David Keane gave a presentation entitled " Complications Associated with Catheter Ablation for Af -- Overview 2014."

  • Hi Tony, I pressed the wrong button and sent too early. Cardiologists are not the expert on the electrical impulses of the heart -- the electrophysiologists are. I would suggest that you get an evaluation from an electrophysiologist who would not term an ablation as

    "potentially dangerous" unless you have some other heart issues.

  • GO for it! Glad I did even thought I had bad side effects for a while I have not had one issue and take no more meds - and even survived a PE caused by the dual catheters.. Sometimes the longer you wait the worse it will be.

  • Wow thanks for all the replies guys !!I

    I am on bisoprolol 5mg and rivaroxaban 20mg I have been since I was diagnosed last November. I have been in constant AF since then maybe longer I'm not sure as I never had symptoms until that time. I am only 36 so the cardiologist I see wasn't keen on an ablation but he did say it's a possibility if cardioversion wasn't successful. Maybe another cardioversion could be successful I'll just have to wait and see what the cardiologist thinks on my follow up appointment. The reason I ask is mainly due to the constant time off work for blood test plus my cardioversion being cancelled 3 times by the NHS. I have lost jobs and being the sole bread winner with a family of 3 the financial impact it has had has been very stressful, plus the whole cardioversion being a waste of time frankly I would rather take the risk of ablation if I stand a chance of living a normal life even just for a while.

    I really appreciate your responses guys it really helps.

    Sorry for late reply.

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