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AF Association
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Just diagnosed with afib

Hello there! Newbie here, glad to have found this site. I have been having heart rhythm issues for awhile now. I honestly thought it was my anxiety so didn’t really think into it too much. That was until I fainted at work. They sent me to a cardiologist to be checked up. I had an echo, stress test, tilt table, and Holter Monitor. Everything was good except for the holter. It showed a lot of bradycardia and some tachycardia as well as several complete pauses in my heartrate.

So I then saw an electrophysiologist and he had me get a 30 day event monitor. Only 1 1/2 weeks in he called me and said that I am going in and out of afib and I have a very slow heartrate. So he would like to do an ablation and a possible pacemaker implantation.

To say I’m scared is an understatement!! I feel that 39 is too young for this! But I would love some advice from you all.

Thank you in advance.

Sara

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Welcome to the site!! Sorry to hear you have problems at this young age. Ablation is a serious step but because you are young it is the usual thing that doctors suggest because if you took anti arrhythmic drugs for many years they , themselves, cause serious problems.

Our support group( in Epsom) have had some great talks from the head of pacing at St Georges and the modern pacemakers sound fantastic. You are monitored safely from a distance!!

Look at all the information on the AF website re ablation and pacemakers and ask any questions here as many have had ablation and many have pacemakers. The fact that you fainted means you need proper treatment to get sorted out. Good luck and let us know how you get on

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Hello Sara, of course you are scared, I remember how I felt when I was first diagnosed with AF, but as your knowledge and understanding of the condition improves, often the anxiety reduces. It sounds as though you are getting some good medical advice, but as Rosy suggests, you need to check out the AFA information which will help you determine what treatment is going to be right for you. You will pick up lots of help and suggestions from the forum too, although it might be a bit quiet until the New Year kicks in. Lifestyle will have a major impact so you may need, if necessary, to think about all those boring things like diet, alcohol and exercise etc., but it is good that you are pursuing a treatment plan with an Electrophysiologist. Best wishes, John

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I wonder if you have misunderstood. Ablation would not precede a pacemaker, as far as I am aware.

The immediate problem would be your risk from your slow heart rate. A pacemaker would be normal. The ablation sounds rather drastic. Did the EP say why he felt that necessary. More usual would be a pacemaker first and then medication for your paroxysmal atrial fibrillation.

Did he suggest anticoagulation?

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He mentioned an ablation first and then said possibly a pacemaker. I am not on any medication at all. I’m not sure I can take anticoagulants as I have a platelet disorder and I am a bleeder big time.

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Sorry Sarah, I was editing my post when you replied. Could you have this the wrong way about?

Do you have a name for your platelet disorder and do you have a recent platelet count?

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I recently had an iron infusion and that helped my platelet counts. Not sure what the count is offhand. But I have thrombocytopenia. I am sure I know what he told me. Maybe he said it backwards not sure but I know pacemaker was said last because I couldn’t believe it.

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He said since I’m so young he doesn’t want me on medication the rest of my life. He most definitely mentioned the ablation before he did pacemaker. Then said probably do them at the same time

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I think it may be me getting confused!

I assumed you were talking about an AV node ablation.

Of course he was talking about a pacemaker and a left atrial ablation, which makes sense. Sorry about that.

The procedure of pacemaker insertion is simple and done very commonly. Usually that would be done fairly quickly if you have long pauses and are fainting.

What is your main worry right now?

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I’m just scared for the procedure and the fact that I even need to have this done at this age.

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OK. I have some experience of both procedures. I had a permanent pacemaker implanted with local anaesthetic. I was alert and pain free. It took around an hour. It was straightforward.

I have had an ablation under general anaesthetic. I had no problems after coming round and went home the next day.

The combination of symptomatic bradycardia and atrial fibrillation is not unusual. In my mothers case, it was due to what was then called sick sinus syndrome.. She had a pacemaker for 30 years, and did not have an ablation. She lived a full and active life and died aged 92 of unrelated causes.

I think you will find others here who have had these procedures at your age.

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My heart rate, after ablation was going too low and I was having the most dreadful time and quite honestly thought I was on my way out, the ablation for me had been a waste of time as I was worse off after having it and, as a consequence, had to have a Pacemaker which changed my life dramatically and for the better so don't be frightened. Today they are even better, very small and compact and the tiny scar made to insert soon disappears and no visible signs of the little lifesaving gadget you have had implanted. A/F wont kill you so they say but it caused me to have a stroke and over the years had control of my life now, with my trusty Pacemaker, I am back in control. Good luck.

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I was offered a pacemaker so I could safely take meds for AF or an ablation to stop the AF with the ablation recommended. I had that two years ago, very successful until recently but now I am having episodes again so if they are too troublesome I shall have to consider a pacemaker. It is certainly worth trying the ablation first at your age.

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Sorry to query this Buffafly.

If I was fainting because of what Mrs Montgomery describes as "complete heart pauses" on the Holter, I would think a pacemaker was on the cards, unless the bradycardia was due to medication.

Of course Mrs M's EP is the only person with all the facts, and I ( that is Badger and not you 🙂 ) should and hopefully will, stop second guessing him.

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In my case my EPs letter said there was 'an element of tachybrady' because at the end of an episode of AF I was having repeated long pauses in HB (caught on my Kardia) so the assumption was that other semi blackouts were caused by the same thing. This was exacerbated by my meds (Propafenone and Diltiazem) so the thinking was that without meds I might be OK. I had a very thorough ablation for AF and Flutter and have had very few presyncope (proper term) episodes since. As Mrs M is going in and out of AF it may be that an ablation might help to put the pacemaker off for a while. As you say, her EP is the one with the facts and expertise 🤔

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Not called 'Badger' for nothing I see! 😀

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First sett to Badger? 😉

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I had a similar situation to yours. I was a little older, 52, but had never been ill enough to be in hospital in my life, when one day everything changed.

I was admitted with fast AF, 260 bpm, which took a 10 day stay in hospital to control.

I was at home for 5 days when I woke up and then blacked out after sitting on the side of the bed.

I was taken to A and E by ambulance and had 4 further blackouts with my heart pausing for 13 seconds each time. This was extremely frightening and with very little discussion the decision was made to fit a pacemaker that day.

I subsequently went on to have 3 ablations over the next 14 months to sort out the AF as I didn't tolerate the drug regime and wanted my life back.

It was a tough two years but I now feel 'normal' again an do the things I used to do.

Do I still worry that AF might return, yes sometimes, but I know that my pacemaker will keep my heart beating and for me that's the most important thing.

Good luck on your journey x

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I understand how scary is for you to hear the word “pacemaker”. This device is more commonly associated with older people, not 39 year-old’s. Actually, your fainting at work is the main concern. It appears that after undergoing many tests, they finally determined that your syncope was caused by a severe bradycardia. AF was also discovered, but this arrhythmia is not supposed to cause bradycardia, unless it’s associated with a malfunction of the Sinus node, AV node or both. This situation is fairly common in older populations. In young people can be from genetic causes. The ablation is being considered for the AF and the pacemaker for the slow heartbeat. Since control of the bradycardia is the priority, the pacemaker might be come first. The AF can be treated with medications initially.

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My doctor said he’d like to take care of both at the same time. Since I’m so young and I have a platelet disorder so blood thinners would be bad for me.

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How low are your platelets?

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Not sure as of right now. I had to have B12 and iron infusions s couple months ago. So may be better now.

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Hi,

I have had both the ablation and then pacemaker procedures this year (at 43). My EP wanted to try the ablation first in the hope that it may help the AF and the pauses. At the 3 month review the pauses were worse ( well over 6 seconds) thus I had to have the pacemaker. It is overwhelming at times, but AF won’t kill you (as my EP and many people on here have said!) There is lots of good advice and experiences shared on this site. I hope things go well for you.

Best wishes, Becky

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My daughter had a pacemaker fitted when she was doing her A levels... in her late 20's, she now swims competitively for GB Masters in European and World competitions. Pacemakers at a young age are not to be frightened of.

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My friend was told by his EP to have a pacemaker implanted. So, he went to Bordeaux, France for a second opinion and an ablation. He is now in sinus rhythm without the pacemaker.

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Sara, are you in USA? Have you been seeing a cardiologist? How lucky you to get all your testing done and to get an electrophysist My Afib was persistent. It is a whole new way of life. Sounds to me that your doctors are very on top of things. You could always get a second opinion. Please keep us posted. If In USA please let me know where. We can exchange references.

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