No symptoms of Afib, should I get an ablation?

[Slattery]

I do not know how long I have Afib, I was diagnosed 1 year ago. I am worried that my Afib will get worse over time, should I have an Albation procedure?

[10gingercats]

I am in a similar position to you and have more or less decided not to have an ablation.At 78 I will 'take my chances'.

[Hidden]

Do you feel adversely affected by your AF? If not you may ask yourself

if the small risks involved are worth taking.

I would quote from the AFA publication...' if there is very little to be gained, even the smallest risk may make a procedure unacceptable. When considering an ablation for AF it should be remembered that the main reason for undergoing the ablation is to improve your quality of life by reducing or eliminating symptoms that result from the AF.'

I would not rush into this. You may find yourself adequately protected with anticoagulation and beta blockers as many are.

Discuss with your cardiologist ( if you get the opportunity!)

Sandra

[RobertELee]

I partly agree with Sandra's view. If AF is not a problem to you - and only you can be honest with yourself about that - why bother with a hospital admission to end it? But you have already realised the flaw in that course of action. AF, in almost all cases, is progressive and it is likely that your episodes will appear more frequently and last longer. It may well become persistent/permanent if left over time. Ask yourself what that would mean to your quality of life then. But here's the rub - wait for a few years until that happens and ablation therapy, slowly, becomes a less viable option. A lot depends on your age of course - gingercats makes a valid comment in his/her own circumstances.

Only you can make the choice but as someone who has had a successful one-time ablation which cured my AF two years ago, I really don't understand what all the fuss is about. So, to answer your question directly.....YES!

[Jamila123]

Hi

Health professionals todate still are very unsure as to what causes PAF in a normal healthy person

Therefore its progression is alos a puzzle in the health field

Not all Af progresses look at DR Gupta on utube about the two types of AF

its quite interesting 🌺

[BobD Volunteer]

I think it well known that I am a great fan of ablation . BUT-----

Any treatment for AF up to and including ablation is about improving quality of life. In other words reducing symptoms. You can't cure it merely mask it. If you are asymptomatic, provided that your heart rate is well controlled and that your stroke risk has been dealt with by anticoagulation where appropriate then undergoing a procedure which however small carries risks does not seem that sensible.

Only you know the burden the AF causes you so I really don't think advice form any of us is warranted.

Bob

[Hidden]

Firstly a general point, there are a number of very experienced people (myself excluded) on here, so it is always worth giving a bit more information to hopefully receive some more beneficial replies.

As already said its a QOL decision; also dependent on any other comorbidities you may have and your ability to be able to try alternatives e.g. lifestyle, supplements, diet.

I am 63 with Lone PAF and good QOL being stable on Flecainide and alternative actions, so I am definitely postponing ablation. Yes I might regret not taking earlier action but equally if they develop less invasive techniques I might feel rather smug! Good luck.

[Hidden in reply to Hidden]

I see that you posted this around two years ago. If you don’t mind my asking what has been your outcome over the last couple of years? I ask because I too have PAF and am not very keen on having an ablation.

[secondtry in reply to Hidden]

The last two years has been very good with no AF. I continue to work on lifestyle issues, no complacency. I still have not reduced 200mgs/day Flecainide. My approach now is that the risk of AF is unlikely to be eliminated but if you optimise your lifestyle and cover your triggers the risk is minimised as far as is practical. I have been 5 years now without AF and whilst it has brought undeniably a number of negative issues I find these are increasingly eclipsed by the positive ones, including appreciating a healthy day much more. I hope something there helps.

[Hidden in reply to secondtry]

Thanks for the reply. Of course, everyone is different, but it’s encouraging that you have gone years without an episode.

[RoyM]

I am in persistant AF. With controlled HR and taking Apixiban. I have had numerous discussions with my EP on the risks associated with an Ablation and any benefits from an ablation. In my case my persistant AF doesn't really cause me any problems. My QOL is good I travel the world. I swim, cycle and walk. I have reached the decision NOT to take the offer of an Ablation. I am 70 and only time will tell if my decision is the right one. I think you can only make a decision based on your circumstances and your burden of AF and your attitude to risk. I do worry slightly the effect of being in persistant AF will have on the structure of my heart. My EP said he will monitor that and any changes will be picked up and dealt with. So, I will let him worry about that. This is such a difficult decision but only you can make it. Good luck.

[Mercurius]

Very difficult question. About a month ago my cardiologist friend offered mi ablation. But still I'm reluctant. I'm absolutely asymptomatic. I can do any exercise (waterpolo, road biking) without restrictions even at afib. My fortune that I'm testing a personal ECG, so I can catch every my afib episodes.

Pros for the ablation:

- I have 8-10 episodes pro month. BUT all of them is silent and no data on afib frequencies of silent afibers.

- I'm 66

- I have a cured hypertension

Cons for the ablation

- I'm in excellent physical and psychic state now. After ablation it is gambling.

- I see on my ECG that premature atrial comlexes (PACs) initiate and drive my afib. Exercise can suppress my PACs and terminate my afib.

- We found 3 years ago my afib. Until the and of last March the frequence an duration per month is not changed.

I did what I can. Changed my life style.

- I was 107 kg, now I'm 95 and continue to loose weight.

- I had sleeping disorder, now I can sleep well.

- I had hypertension, now my hypertonsion almost controlled (see later).

Positive changes: My echo is almost normalized. My left atrial dilatation reversed. All dynamic parameters (ejection fraction, speed etc) became normalized. Still my cardiac septum is thicker and according to the gadolinium enhanced MRI I have a moderate fibrosis.

The hypertension problem. I have a rare, less very well understood version, the so called orthostatic hypertension. This means a sudden increase in blood pressure when a person stands up from resting position. Orthostatic hypertension is diagnosed by a rise in systolic blood pressure of 20 mmHg or more when standing. Orthostatic diastolic hypertension is a condition in which the diastolic raises to 98 mmHg or over in response to standing. I have both. Without pill my bp is ~120/80 in bed, ~150/90 in sitting position and 190/100 if I stand up. Ramipril virtually normalized my bp. I measured my bp in every morning before and 30 min after Ramipril. After Ramipril my resting 110/60 and standing is 120/70. Recently came up that in the late afternoon my orthostatic response returns. This is anyhow issue, since I got usually afib in afternoon.

CONCLUSIONS ?

My impression that the understanding of the afib is still far from complete. Best thing what we can do that we personalize by the help of our fellow sufferers and docs as much as possible our personal case. The hope that this may help to get the optimal decision.

[cat55]

Hi, I guess there is only you knows how much it affects your life. I was first diagnosed in 2001 and have probably had less than 20 episodes since then. The nature of the episodes has changed too. At first I had a very fast heart rate and the episodes lasted many hours. Now my heart rate barely changes I just feel the irregularity. I take Apixaban and have a pill in pocket which at the moment works, so on balance I will stay as I am and wait and see. when I asked about ablation I was asked why I would take the risk when every other test on my heart showed nothing abnormal. Having said all that I have spells of what I believe are ectopics which can last days,at least I think tha'ts what they are, so I try not to worry about them, and I am an excellent worrier, and they eventually stop. When you reach a decision it will be the right one for you. Best wishes Kath

[souljacs4]

My concern about having an ablation is that more often than not it takes two to three times to get a result so its not a quick fix. and that also means you have to be prepared to face the risk two or three times and the recovery time after each procedure should also be taken into consideration. so it really should come down how you feel you are dealing with your AF on a day to day basis and how badly it affects your quality of life.

[Alemo27]

I am glad to read so many valuable answers to my question "to do or not to do" ablation. Thanks to the Internet medical and group communication site, I have learned the pros and cons of the medication treatments and precautions for AF ,PAF,etc. I have learned, that the nature of all the arrhythmias are different, and can not be defined since it is result of heart problem or other serious decease.

In my opinion when the basic prevention and choose of the medications can not stop arrhythmias, that runs for hourse, days, the ablation can be considered.

The problem is, that it is looks like " firing in the dark". And still post operation recovery with potential afib comeback and medication..

Would it prevent the stroke?

Well, is the pacemaker not better ? And anticoughalant is mandatory.?

[Slattery]

I am a 69 year old female, very active, no other health problems other then Afib. I take Diltiazem only, no other meds. My concern is progression of Afib. This is a difficult decision, thanks to everyone for your excellent advice.

[Buffafly in reply to Slattery]

I notice you don't mention anticoagulant which is the most important medication for AF unless you have extreme symptoms. Also you don't mention if you have actually been offered an ablation? If you are in the UK you don't really choose unless it is offered, don't know about other countries?

[djmnet]

BobD as usual has the most thoughtful response. Two things to remember: Ablation is not necessarily a cure; some folks on here have had multiple procedures. Second, if you can't even tell you have it, why try to "fix" it? My afib is mild -- after three years -- and has gotten milder, not worse over that time. That may change, but I'm happy to live with what I've got for now. Also, I take only anticoagulant, not any of the other typically prescribed beta blockers, etc.

[Bahman]

I posted on here two weeks ago , when I first went into AF episode . However I went back into NSR for just 12 hours , and back into AF , which is now nearly three weeks . Like yourselves I have no symptoms . Only when in gym I think I feel a little stressed, it could be psychological , only because I know I am in AF . Due to see my EP on 23rd of June , not sure if I should go to A&E and try to ask for CV . Are they obliged to put me into NSR ? or is it only if I have uncontrollable symptoms ?

[Pam296]

Difficult one, and I think it is going to be down to personal choice. I'm in the same situation. I didn't get on with the medication and decided, with cardiologists agreement, to manage my infrequent episodes without it. Just take Apixaban now. However, I know that as AF progresses, things get more complicated. I guess you just have to weigh up the risks/benefits.