AF Association
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Ablation, here I come :)

Fresh back from my first appointment with my EP – Dr Bourke at the Freeman Hospital in Newcastle Upon Tyne, and it’s good news. Here’s a brief summary of what he told me:

• I shall be ablated within 3 months on the NHS.

• There is no advantage to going through BUPA, other than perhaps getting to choose morning or afternoon!

• There is a slot available the week before Xmas because it isn’t a popular week for ablation. I politely declined.

• They do 300 ablations per year.

• I have a 75-80% chance of being “cured” with 1 or more ablations.

• I will be sedated but not by general anaesthetic. I will be sleepy, but awake.

• There is a 2-4% chance of serious complication including death, but in the 17 years that they have been doing ablations, they haven’t had a single case of death by oesophagus rupture. Other complications include Stroke, heart bleed and a diaphragm / nerve problem.

The 2-4% statistic seems quite high and it does worry me... but I conclude that it’s better than the alternative - I’m only 37 and my AF isn’t getting any better.

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Congratulations Mejulie69! I believe I am on a 12 month waiting list, but have so far heard nothing about it. It's interesting that you will be seen so soon, in the North East. I'm in the North West (Lancashire). Is that just the current situation there, or do you think you have been pushed forward as a very deserving case?

Ian

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Dr Bourke said "we have to offer ablation within 3 months" - I assume this is a hospital target and they have the resources to deliver. I guess I am lucky with the postcode lottery in this instance. I don't think it had anything to do with my age or statistics.

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Well done and hope all goes well very soon.

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Excellent news Mejulie69 and very best wishes for your better future.

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Excellent news Julie, sounds very much like the stats I was told. Newcastle Freeman is an excellent centre. I took the warnings with a pinch of salt - my AF was so bothersome I would have had the ablation anyway.

At your age you should definitely check out the stuff about vagal AF, if you haven't already done so: healthunlocked.com/afassoci... I had long-term digestive problems which I am sure contributed to my AF

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Hi John, I can't work out if I am vagal or not - I have some of the symptoms but not others. My AF is triggered by exercise and stress (probably adrenaline in both cases) which I think means I am mostly the non vagal type, but perhaps one can be a bit of both (?)

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Yes, you can definitely be a bit of both. What counts is the balance between vagal and adrenergic (parasympathetic vs sympathetic) drives. Whilst vagal is well described, ditto adrenergic, this area of how the balance works is less well understood. As an example, when I used to have an AF episode onset, I could often terminate it by raising my heart rate - gently. A short run up a flight of stairs often did it. But it seemed to be that I could definitely over-do it. I've occasionally had severe gut pain which has driven my heart rate way down, 45 bpm, but that hasn't tripped me into AF.

All I'm saying is be aware of the sub-type and observe your own case. It may not be a big thing for you; if you can clearly correlate an episode with typical vagal triggers, then as they say - don't do those things ;)

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I don't know of course but I am guessing that the complication rate your EP mentioned might look different if broken down by age, complexity and length of procedure, individual EP etc.

A fit 37 year old like yourself with a good EP will be fine.

Interpreting complication rates is difficult. Units that take on the most difficult cases will presumably have higher rates. If an EP only operates on patients under 40, the rates will at a casual glance look very good.

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I did ask about this point but he was reluctant to say "you are young so you are safe". He said regardless of age their is a risk, and therefore it would be unfair to say I was safe. Even though I have a young family, I am taking the Buddhist approach on this one - if my time is up, my time is up (but hopefully not).

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Julie, if you try to pin a doctor down about risk, she or he will likely be a little defensive and perhaps overstate the risk to protect herself. I am sure your team will be very aware that you have a young family and they will all be super vigilant. You are going to a top notch unit at FH and your EP will not take any risks with a mum. He knows he can do a brilliant job on you, and would not have taken you on otherwise.

Clearly you are worried. Two suggestions, consider having a chat with the EP nurse. And maybe stop researching things that could happen - the stats show they hardly ever do, particularly with such a good candidate as yourself.

You may want to stop logging on here at some point. It may be better to forget about medical stuff for a while.

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Thanks, wise words. I'm feeling fine at the moment, hope I stay this way.

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Hello New Castle, Sounds about right. I had mine done last year just after Xmas, successfully. Coming up on 1 year with a 80-85% chance of only having to do it one time and I am 60 and in shape. * I was an outlier in that I developed a Pulmonary embolism a week after and surviving that took precedence with heavy heavy AC's for about 3 months. Good luck!

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I had the same in 2005; same warnings, sedation etc, it worked brilliantly. Best thing I ever did.

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Great news Julie.....keep us informed of progress.....

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I am 3 months post ablation and AF free at the moment. I would say I underestimated how long it would take me to recover from it. I had migraine developed tinnitus and had fatigue and sleep disturbance for a couple of months. But things are settling now and I am feeling positive. So be kind to yourself Julie and don’t try to rush your recovery like I did. I am 60 so it was always going to take longer but you are young so hopefully it will be quicker. But it’s easy to think of it as a ‘procedure’ rather than surgery but your body and in particular your heart does take a bit of a battering and needs TLC for a good while afterwards. I Hope all goes well for you.

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I had a cryoablation at Freeman 10 weeks ago. They couldn’t have looked after me better. All the staff were wonderful. Good luck with your procedure!

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Great to hear. How's your recovery going?

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Wish you the best. I know I was very nervous about my ablation which was 5 1/2 weeks ago but the procedure went well. And I am positive that yours will too.

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I had some Af the first week after the ablation but none since. I’m still on my arrhythmia drug but hoping to start cutting down soon. I go back to the Freeman in a couple of weeks for follow up.

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I had my ablation last July in the Freeman and it was the best thing I could of had done. If my af ever comes back again I wouldn't hesitate to have another ablation.

The only problem I had was my cardiologist wanted to do the ablation in 2014 but was over ruled by his boss and my af got worse over the years until it became persistent and I had to have to ablation under the "urgent" banner but as I said best thing I ever had done. Good luck x

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yes - it is usual to have ablation when you are young as a life on meds is a poor alternative. It sounds very good if they do so many a year- Think of the 98 per cent that don't have complications and you have youth on your side- some people represented by the figures will be more disposed too the complications ( not meaning to minimise the risk for you) Do let us know how you get on.

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