Meds or Ablation?

[glenpointe]

Hi, I'm 54 year year male. I've a persistent afib for few years now, but I did not know that I have it until my doctor did an EKG few months ago. My doctor gave me three options:

1) Do nothing. leave it in persistent afib and just take blood thinner as I am currently doing.

2) take medications twice a day for life.

3) Ablation (he says, with my persistent afib, chances for success is about 60%).

I'm a type of person who prefer not to take meds every day, also meds only effective for so long. Do you think I skip the meds and get an ablation? I'm a marathon runner and just want my heart back to normal sinus rhythm. Anyone out there who had persistent afib and got back to normal sinus rhythm after the ablation?

Thanks,

Glen

[Hidden]

I had AF that had become persistent for probably 6 months or so, who knows, even when it wasn't persistent it was there most of the time! After diagnosis, I was on drugs that worked well for a few years, except gave me peculiar side-effects, so I had a PVI ablation in 2005 specifically to get off the drugs. Wow did it work. Afterwards I couldn't even feel my heart for many years and zero AF. And no drugs except anticoagulants. After 8 years my AF came back just a tiny bit. So I'm back on drugs now but my ablation is still working because I know I be a whole lot worse if it hadn't been done, that's my theory but I can't prove it of course.

One thing my EP said to me before the ablation was, that because my AF was there all the time, they would know straight away whether they had got it or not, his words.

Had mine under sedation and it was no problem at all, just had to be a bit careful for while afterwards.

If you go for it I hope yo have a good one.

Koll

PS. Anticoagulants actually don't thin your blood.

[BobD Volunteer]

Since you admit to being a marathon runner, which I am sure you will know is likely what caused the AF, there seems little point in ablation which is unlikely to be a permanent "cure" for the AF without reviewing that situation. And this from a fan of ablation . ( I had three!)

[secondtry]

There is a 4th option and probably the most important Lifestyle changes; recently the respected York Cardiology said this is probably the most important action you can take. Plenty of experiences on lifestyle detailed here.

[Mike11]

I'd vote for an ablation and giving up running. Take up mountain walking or something instead which keeps you fit and doesn't give you AF.

[RickyM]

Hi Koll,

I have had persistent af since the age of 58 and when given the choices decided against ablation

You will, i'm afraid, have to make a compromise somewhere.

My symptoms were, I decided, not bad enough to take the risks of ablation.....you will have to decide.

My guidance was that the odds of long term success through ablation were lower than you are quoting.

How bad are your symptoms?

[glenpointe in reply to RickyM]

If your atrial keep quivering all the time, isn't that weakening and enlarging your heart over time? I don't have symptoms, but persistent AF is limiting my exercise and running. Also, my feet and hands always feel cold due to lack of blood circulation.

[RickyM in reply to glenpointe]

I've never been told that persistent AF is life shortening. My mum and dad had it at 86.

I didn't know I had it until a gp spotted it when seeing him for something else.

Everybody has different symptoms. I too have the cold hands and feet thing........ Is this definitely AF related?

It sounds like you are favouring ablation.

[UScore]

It's the kind of decision only you can make, because all the risks and positives and other variables that balance out the decision can only be given weight by you.

Me, in a similar scenario to you, would be taking the ablation.

I've no idea if the amount of marathon running that you do is likely to be the cause of your AF. Nor do I know if resuming running will make it come back if ablation is successful.

DIscounting the small risk of something going wrong during the procedure, which is the same for everyone, and the risk of it not working all, there is a chance it will rid you of AF for good, or a long time, or even just a few years - which is still better than resigning yourself to it from now.

You then could keep running and maybe run the risk of it returning, although who knows. You might be fine, or you might get a few more years of running in before it comes back. Or you might decide to do shorter, less endurancey runs or take up a new hobby, if staying in NSR is the only goal. Up to you.

In any of the options, the anticoags will still be needed. But the daily medication might not be.

Good luck.

[glenpointe in reply to UScore]

A friend of mine stopped taking anticoagulants four weeks after the ablation. It has been 8 years now.