Ablation

[atrialfib]

Hi everyone,went to see professor schillings team on Friday to talk about possible ablation,they said they only do it to help symptoms, not for the stroke factor,Also he said once you have AF you always have it,ablation or no ablation,can anyone explain.

[BobD Volunteer]

All treatment for AF is only ever about improving quality of life. Ablation does not remove stroke risk.

The underlying reasons for your AF will not be cured by ablation although if successful the symptoms will be stopped and QOL improved. There is no real cure for it as such. Having said that, much of my understanding has come from conversations or correspondence with the Prof anyway.

[atrialfib in reply to BobD]

But if they stop AF happening then that stops stroke risk.doesnt it?

[BobD Volunteer in reply to atrialfib]

No there is no evidence to that effect. AF and even ablation causes changes inside the atrium which make eddies more likely and thus risk of clots forming. If you have the necessary other co morbidities (CHADSVASC+2) then the risk continues.

[MarkS]

AF is believed to be a symptom of inflammation in the heart, so the AF can be stopped but the inflammation will still be there with the stroke risk. That is unless you can do something about the root cause of the inflammation. There is some evidence of a reduction in stroke risk following a successful ablation but that might just be because it's a wake-up call to do something about the risk factors.

Prof Schilling carried out my ablation and a very good job he made of it too.

[Globe-J]

Hello,

I am sorry but some of this makes no sense to me.

If ablation, or any other procedure prevents AF, then the (additional) chance of a blood clot forming (because of AF) is eliminated. This ought to decrease the overall chance of a blood clot induced stroke. Naturally, other health risks may be unrelated, thus unchanged.

Sydney J

[MarkS in reply to Globe-J]

The process is believed to be as follows:

Clots form on the inside surface of an inflamed heart. AF is caused by an inflamed heart sending irregular electrical signals to the left atrium. An ablation interrupts the irregular signals, but the heart is still inflamed, and consequently will continue to produce clots.

[PaulaCH in reply to MarkS]

I've never heard of af being a result of an inflamed heart. Mine certainly isn't inflamed. It's normal size and healthy. My AF is so far a lone episode, though the rhythm has never felt completely normal since, it has shown to be in sinus when tested

[MarkS in reply to PaulaCH]

Your heart can still be normal size but still imlammed. See links below for connection between inflammation, AF and stroke.

[PaulaCH in reply to Globe-J]

If you're not in AF then your stroke chance is reduced. As described by Lynnels, the clots form because the AF stops the heart from pumping efficiently, and clots are formed because some of the blood pools as a result of not being pumped through to the next chamber.

[atrialfib]

Every so often my worry gets worst,I seek advise,and learn something else and worry more.

[Sam72- in reply to atrialfib]

You sound so like me 🙈 I look into things then find myself deeper in it and panic more , but I hate that saying about AFib won't kill you !! Maybe not but a stroke will and can cause serious problems for a person physically, mentally, and so in my eyes AFib can kill us . Sorry for being so negative but it's just how it all feels to me . Plus you ask one cardiologist one thing and another one another question and get a different outcome, so confusing for us all especially when your a worried person.

[Jemapo in reply to Sam72-]

We all have negative thoughts sometimes,I am 74 and have left sided heart failure so it's inevitable that I'm past my shelf life but on the plus side I kicked cancer 30 yrs ago so had more life than I thought .I take dabig at ran ,bisoprolol,furosemide and a whole load of supplements ,my 80 yr old friend also has afib had 3 strokes is still doing ok we go out ,theatre, movies church,meals not that any of this is practical advice but just to cheer you up

[atrialfib in reply to Sam72-]

I think it's best to try to push it to the back of our minds,all this input is confusing

[Lynnels]

As I understand it basically because you are in AF the heart is beating too fast to do a good job of moving the blood from one chamber to another therefore some blood can accumulate and cause a clot. The clot can move and block off the blood circulation to the brain - hence the risk of a stroke. That is why you are given anti coagulants, to stop the blood from forming a clot. So when you are not in AF your clot chances are less.

[PaulaCH in reply to Lynnels]

Completely agree.

[atrialfib in reply to Lynnels]

No I was told even when your not in AD a clot can hang around and affect you later

[atrialfib in reply to atrialfib]

Af

[Lynnels in reply to atrialfib]

I don't think so if you're on anticoagulants. That's why you take them for at least a month before your ablation and are advised to keep on them for a month after your ablation

[atrialfib in reply to Lynnels]

But they are saying ablation doesnt stop risk of stroke,I am now going mad.i give up I think I must be thick I cannot process this

[Lynnels in reply to atrialfib]

I'm not sure of the context of that. AF/SVT is an additional risk to the percentage of people having a stroke. If you take that away then you could still be at risk from other things going on like high blood pressure, obesity, diabetes etc so maybe that's where it comes from. I've actually read it does lower your chances but like with everything there are varying views around.

[seasider18 in reply to Lynnels]

As Doctor Gupta says it is not always AF that causes the stroke but the company it keeps.

[atrialfib]

Now I am learning that everyone with AF has inflammation of the heart that can't be true does he mean enlarged heart

[dmac4646 in reply to atrialfib]

Inflammation is regarded as an important aspect and why people who follow a diet that has at least 20ml of olive oil appear to be less likely to get AFIB in the first place.

[atrialfib]

So as I now see it,even after ablation you still need blood thinners for ever

[Lynnels in reply to atrialfib]

No once you get rid of the AF /flutter/ SVT then you only need them for a month as any clot will have dissolved. It's the non efficient pumping of the heart whilst in AF that can cause a clot

[dmac4646 in reply to atrialfib]

yes , once you have it you have it - all you can do is alleviate the symptoms and try not to have a stroke.

[MarkS]

The latest thinking is that inflammation is a significant factor in AF and strokes. Also that it is not the pooling of blood due to AF that causes strokes. See:

ncbi.nlm.nih.gov/pmc/articl...

"... inflammation may contribute to both the occurrence/maintenance of AF and its thromboembolic complications"

Also this article by Mellanie TrueHills: Is It AFib That Causes Strokes, Or Maybe Something Else?

myafibexperience.org/blogs/...

"... I have picked up on an emerging theme.

It started with research findings within the past year showing a lack of correlation between afib and the onset of stroke in many with implanted devices. It was confusing and perplexing that many strokes in those with afib were actually not correlated with their afib episodes. In fact, often the afib and stroke did not occur in the same 30-day period; in some cases, they occurred as much as a year apart. How could that be?..."

[atrialfib in reply to MarkS]

That's very interesting in fact amazing

[seasider18 in reply to MarkS]

Interesting first article but so many causes of inflammation and so many other factors involved and so many differing opinions. Should AF patients now be taking a statin. I've noted on the Forum that many who take NOAC's are anti statin.

My AF started after I had my aortic valve replaced.

I read an article in a San Francisco news paper over 25 years ago on the links between inflammation a heart disease and research into drugs being developed to combat it. I kept the page for years without ever linking the article to anything apart from statins.

Another new and expensive drug with even more dangerous side effects than statins.

bbc.co.uk/news/health-41071954

Interesting that True-Hills like me minus her LAA thinks that perhaps she does need a NOAC after all.

[MarkS in reply to seasider18]

You're right - there are so many causes of inflammation. I think mine was caused by over-exercising, though my father and mother also had AF.

Before my ablation I had very regular bouts of AF - one day with AF then two off. I tried Atorvastatin but it made no difference.

After my ablation I reduced my exercise somewhat and also got rid of some gum disease (known to cause heart inflammation and AF) by scrupulously using an electric toothbrush, inter-dental brushes and floss picks. Touch wood, I've been fine since. But I still have the warfarin.

[seasider18 in reply to MarkS]

I took Atorvastatin for two periods of several months but each time it caused muscle pain. I've never had any gum disease.

Unfortunately there is no single test for the many types of inflammation and like other silent killers we are not aware of it nor is there really much we can do to prevent it.

thesurvivaldoctor.com/2013/...

[Lynnels in reply to MarkS]

Very interesting reading. I have been saying for sure my AF is related to inflammation. It started around the same time as I was diagnosed with Rheumatoid disease. As it took 4 years to find the appropriate treatment for that ( now on Biologic IV medication) I was on steroids and my previous Cardiologist ( now retired) said that whilst on the prednisolone I wouldn't be that troubled with the AF. And he was completely right. One attack a year. I came off the steroids 18 months ago and that's when bit by bit the attacks of AF increased and in the last 6 weeks got uncontrollable as I added Atrial Flutter to my rhythms. Hence the recent Flutter Ablation. I was, and still am, debating whether going back on Prednisolone would be beneficial to my quality of life both from the AF point of view as well as the additional Muscular Skeletal problems/pain the now controlled, for the time being, Rheumatoid has brought to the game.

[seasider18 in reply to Lynnels]

Is Biologic IV medication a new thing ?. I met someone who was asked by his specialist if he would go on to a trial although it may have been a new form of the drug, He was to go for infusions once a month and at that time had been for two and felt much improved. He was then surprised that he was to be paid £35 expenses for each session he attended.

[souljacs4]

I don't think there has been enough research into this subject, there was a post on here in the last week or so saying that there has been a change of direction for woman who are over sixty five and have two points on chads vasc score as to weather or not we should be taking anticoagulant. I think there needs to be far more research into anticoagulant and AF