Ablation...yes or no

[claudesf]

Hi, I'm Claude, 56, and have been diagnosed with AF since 2015. Currently on Propaffenone and am considering ablation. I'm eager to hear results from others.

Thanks

[UScore]

There are so many factors in this decision that you need to provide more information really if you want people to put themselves in your shoes. Is it permanent AF? Is it debilitating?

I'm still agonising over the decision myself. My PAF is so infrequent, and so mild, that I still can't justify putting myself through it yet, particularly with young children. But I'm pretty sure I will have one sooner or later.

[Beta44 in reply to UScore]

I put off having an ablation for years as I could cope with AF with the help of drugs. In retrospect I am glad that I did because techniques improved in the mean time. However, I am glad that I did as it was successful and I am now free of AF.

Peter

[Hidden]

I had a PVI ablation for AF that had become just about persistent in 2005 (age 55). It just worked straight away and I couldn't even feel my heart at all for a few years. I stopped all drugs except anticoagulants before the procedure and never went back on them. I was also on propafenone.

Mine was done under sedation and it was no problem at all. Time flew by and I felt very relaxed.

8-9 years later my AF came back just a tiny bit, as predicted by my EP. They tried another ablation but had to abort for other reasons. So I'm back on drugs (another one this time) but with no side effects. I feel sure that the drugs I'm on could not possibly control what my AF would now have developed into without the ablation. So, in effect, I personally reckon my 2005 ablation is still working.

Koll

[RiderontheStorm]

I would not be in a hurry for ablation until you get a risk ratio from an very qualified EP on how successful it may or may not be. I decided to and would again after finding the drugs could not absolutely control my PAF. It never gets better but it is a managed risk of how long until it gets very worse. My ablation nearly killed me with a major PE that was caused by the ablation procedure. 90 days of blood thinners and I was back to normal again with a normal resting heart rate 6 months later. I am in great shape with no other medical issues and went 9 months until 1 AF episode last week which was fixed with a massive dose of flecinide(?) an arrhythmia drug. NO other meds for 9 months or since. Hoping NSR lasts the rest of my natural life. EP gave me an 85% chance of having to only do it once. Choose well.

[Barry24]

Hi Claude,

I’ve had three ablations, and wish l could turn the clock back.

Have you tried to improve your lifestyle yet?

[Dave1961]

I would definitely encourage you to at least get an EP study done to see if ablation would be right for you.

I have had AF (and the occasional 250 bpm SVT) since 2012.

I have been in and out of hospital. Mine is not permanent it comes and goes. And when it comes it HITS ME and stays for hours. I am basically completely out of action and even on an amiodarone drip it can last for up to 10 hours. It's crippling and I am unable to do anything when I am in the middle of it.

Last Thursday week I went into SVT which is unusual for me as AF is usually my problem. The ambo's moved me to put me in the ambulance and the SVT slowed right down.

I had had intermittent left arm pain so they decided to do an angiogram through my wrist to check for blockages. All clear which was a relief for me as I had been a little worried.

Friday night after the angio I went into SVT alternating with AF - party time in my heart! Within seconds a "medalert" was called and I had what looked like the entire cast of Greys Anatomy in my room, milling round.

Pumped lots of drugs into my, I was almost unconscious then slowed. Had another two medalerts within an hour and was cardioverted and drowned in meds to try and slow me down.

fortunately this activity confirmed what the medical staff could only assume and I was schedule for an ablation the next Friday.

I had an ablation for flutter (what was original thought to be SVT) but I can not be ablated for AF until I lose some weight.

I know its only been two days but I am now waking up feeling refreshed instead of lethargic, I am not having these massive 4 p.m. dips which meant I could hardly stay awake and my heart feels strong and stable.

I think there are always lots of negative ablation stories because people tend to talk about the negative - its in our nature - but so far so good for me.

I feel great 48 hours after leaving the Cath Lab.

It doesn't mean I won't have problems in the future but for now it feels fantastic. I feel very lucky. I think I found the right electrophysiologist for me.

The point I was slowly getting was I wish I had done it sooner. The longer you wait for an ablation the more difficult it can be to stop the AF. Maybe I am wrong about that but I am sure I read that or heard it somewhere.

I think of it like a river. When all is good the electrical currents flow through your heart like a river and your heart beats beautifully.

When that current "overflows" it can find a new path to travel until things calm down and the flood is gone. The next time that new path is a little easier for it to find and so on - I kind of think that each time you get AFib it makes it easier for the next event to occur.

I'd encourage to explore your options and not do what I did for 5 years - ignored it and just hoped medication would fix it forever.

[Pam296]

Hi Claude. I have PAF which doesn't cause me too many issues at present. I only take Apixaban, no rate control drugs or beta blockers. I know the time will come when the AF progresses and at that stage, I will definitely consider an ablation if it is offered.

[Ldr1980]

Hi all

I'm 37,and I was diagnosed with SVT in April/May of this year. The first time it happened I was terrified, as I had absolutely no idea what was happening. That first occurrence lasted about an hour, then I eventually managed to fall asleep.

Since then, I have had episodes of SVT approx 3 times a week, always late at night, and always happening very suddenly.

I'm booked in for an ablation on 31st October, and if I'm honest, I'm very nervous about it. Unlike most people (from what I've seen and heard anyway) mine is being done under GA, as sedation literally does nothing for me.

Do most people feel generally better afterwards? Have you had many palpitations since the ablation? Anything else that would be useful to know before I go in?

Many thanks in advance for any information/help

[Dodie117 in reply to Ldr1980]

I had first and only ablation in November 2013. For 5 months I had a lot of arrhythmias and bumps by they gradually reduced. Then stopped. That was 4 years ago and I am af free since then. Bliss! I am med free but continue with anticoagulant - apixaban.

[Kiwi2 in reply to Ldr1980]

Hi LDR1980, I am having my second ablation on the 30th October under GA too. The first helped enormously but due to it being a cryo ablation they couldn't get to everything. It did help straight away. Like you I was having 2 or 3 episodes a week and then 4 the first and second year and 7 episodes this year so far. If you want any more info feel free to PM me. Where are you having it done? All the best Bella

[Sam72- in reply to Ldr1980]

Hi , I have had undiagnosed SVT since my early 20s . Only came on every few years but got worse as I got older . It’s a horrible feeling and I sympathize with you . I went in for my EP study 7 weeks ago and the SVT came out before the AF and they ablated it and then froze the AF ! Apparently the SVT has a very high success rate and is less complicated than an AF ablation . But I had both done at the same time and I have had a few ectopic beats going on and off up to now but I think it all depends on how much they have to burn. Some people are fine after an SVT ablation and never have problems after wards . Good luck with everything 👍🏼❤️

Best wishes

Sam 💕

[Dave1961 in reply to Ldr1980]

Hi LDR, I had my ablation last Friday (20th) and was sent home the next day. Mine was under sedation not GA but I have to admit at times I had wished I was under GA as the heating of the wires to do the burn can be really really uncomfortable across your chest.

I feel better than I have in years.

I don't know if its the ablation or the tweaking of my meds but I am sleeping soundly and waking up feeling much fresher than I have in forever.

Of course its only been 3 days so my experience doesn't count for much so far.

I had a run of AF yesterday for no more than 30 seconds - came and went in a flash.

Usually I can expect it to stick with me for hours so that was a definitely positive result.

Wish you the best for your ablation - the earlier the better in my books.

[MJ17 in reply to Ldr1980]

Be prepared to give yourself time to rest and heal. I felt much worse than I was prepared to feel. It is a big deal on your body and heart. I am going on a month now since my ablation and am just now feeling back to normal. Good news is that my heart does feel much better!

Best of luck.

[clarence16 in reply to Ldr1980]

Hi - I had my first ablation this past September 29th for PAF. I was under GA and it took five hours to complete. I had it done at Brigham & Women's Hospital in Boston, Massachusetts (USA) a highly rated hospital by a very experienced EP. I have to say I was beyond nervous to have it done, but am very glad that I did. I think the big thing here is it is your heart and that the ablation may not work the first time. I once told someone that if I was having surgery done on my big toe that would be different, but this is my heart. So far so good for me. I have had minimal palpitations off and on which I am told is very normal while your heart adjusts. I was quite tired for the first two weeks after the ablation and slept/rested a lot. Feeling better now, but still listen to my body when it tells me to slow down. Bottom line for me having it done was I didn't want to be on all the meds, especially the antiarrhythmic drugs (horrible side effects for me) for the rest of my life. Since the ablation, I am on a blood thinner, which I will always be on, and a bp med. Of course, I am hoping it works, but I think it would be easier for me to have a second one now that I have had the first. I understand your anxiety/concern. Good luck!

[Zozzy]

You have to make your own judgment of course. All I can tell you is how I made my decision to go for an ablation sooner than later.

Because a) I read that AF just gets worse over time, and my paroxysmal AF was already starting to get worse, b) I didn't want to lose too much of the fitness that my more frequent AF was starting to impact, and c) I wanted to go ahead while my health a fitness were good enough to cope well and recover quickly from the effects of the op.

The are risk, of course. Inevitably you read more about the failures than the success - most of the latter are silent.

I place a high value on the benefits that experience brings to any line of work. There are no guarantees, and I'm not sure you'll find comparative stats, but I'm willing to bet that the failure rate of a consultant who does a few per year is higher that that of one who does a few per week. So I did since research on consultants and went to one consultant who does a LOT of them.

Steve

[dabend36]

Hi Claude, I hope by reading the replies you are seeing that there are a lot of factors that go into the decision and what's right for some is not right for others. For me, I got my first ablation in July and as of now, I am 'fixed'. I was diagnosed last December with AFIB. After two cardioversions, it was determined I had persistent AFIB and was put on Flecainide. I would still go in and out of AFIB every few weeks so my cardiologist recommended Ablation. I got that done in late July of this year.

The procedure went smoothly. Not only was I back to work (from home) in 2 days, I was more focused mentally than I had been in years. (I learned at this time that this is not uncommon) In 2 weeks I was back to a mild exercise regiment and feeling no after effects of the procedure. In 3.5 weeks, I met with my EP for a follow-up and was told that I had no restrictions. In other words, I could eat or drink whatever I wanted and exercise as much as I wanted. After 2 months, I was taken off the flecainide. After 2.5 months, I was taken off my beta blocker (Diltiazem). I am now only on Xarelto which is more because I also had a DVT last December.

I just returned last weekend from a 4 day backpack trip in the White Mountains of New Hampshire carrying a 35 pound pack on a 32 mile hike that included 10,000 feet of total vertical. And through it all, I have not had one irregular beat.

In February, I the plan is to take me off the Xarelto and monitor my clot rate in hopes of being drug free. So when you ask, Ablation, yes or no? I answer a resounding YES. I know it doesn't work for everyone, but to have the chance to be 'cured' rather than on drugs the rest of your life seems like an easy choice for me. Especially at your age. And with a procedure that is so non-invasive. My advice, go for it!

David

[songbird74]

it is a really difficult decision - I too am trying to make it but at the AF Patients day recently a study was cited that for people with BMI of 27 (which is me) or over losing >10% body weight is as effective as ablation and even if you have an ablation results for those who have lost weight and got fitter with exercise do better re recurrence so I am now committed to doing the lifestyle stuff while I decide on the ablation. The trials were done in Australia and I got copies from the AF Association.

[Sam72-]

I only found out I had PAF last November and had my first experience of it , I had a fast one . But had I not gone for my EP study 7 weeks ago ? I would have probably not known I had 2 other conditions. SVT was another one. I wish my cardiologist had listened and sent me to an EP years ago .

But it’s your choice and all I can say is that I got told the sooner you try and ablate it the better as the condition has 3 stages . However the technology is getting better and me personally would have another one done if my one this time hasn’t worked . Also make sure you look into your EP and what kind of mapping technology they use as I think this is so important because if your like me and had more than one problem area? You want them to find it first time. Hope this helps ❤️

Best wishes

Sam 💕

[secondtry]

Hi Claude, you don't give us much to go on but the short answer is if you are asking this question your QOL can't be too bad and therefore provided you are prepared to make some lifestyle changes, I would say postpone.

[Emsysy]

My understanding is that the longer you put up with untreated AF the less likely an ablation would be successful. I had 2 in my 60's and both failed long term along with a cardioversion.

I wish I had been ablated when I first experienced episodes (paroxysmal) of AF in my 40's.

I was basically told to go away and get on with it !

Talk to your cardio because we are all different and it's horses for courses but if an ablation is recommended, go for it.

[Paper65]

I had mine done on July 6th this year and really glad I did.

[Beulah87]

Yes