Or ... when PAF was actually atypical persistent AFL with variable block in the first place. And “ sinus rhythm”, rate 60, was AFL with 5:1 block 😳
So I saw EP yesterday. Turns out that recent probs were not as I thought due to PAF, but persistent AFL. And when I had been feeling good with what I assumed was NSR, it was still persistent AFL, but wth a high level of block.
So actually in AFlutter for 2 months 24/7
It was Amiodarone or RF touch up......no brainer really.
So I assume you got the RD touchup..hope all is well.
Thanks etheral
Because of advice from the good folk here, I knew I should be wary of Amio
Naff news, but glad it's been caught and is going to be sorted. Hope you enjoy being touched up.
Any idea how long you'll have to wait for it?
Thanks UScore
That'll be the day ☠
? 6-8 weeks hopefully.
How do you feel about it? Have you had ablation(s?) before?
I am in a mild state of panic as I've just found out I've been given a date of Feb 13th for what will be my first.
UScore
Very relaxed.
I'm second time round and the first was a breeze. I had a GA and the only problem was a mild sore throat from the tube. That apart, in the days, weeks and months that followed, I would never have known that I had had an ablation, if not for unwisely reading my bank statement. It gave me 4 largely AF free years after I had become a 20 hours a week man.
My only regret is that I was too afraid to have it earlier.
From what I have read here, one of the main things if you have sedation rather than a GA, is to not be shy about saying when and if it hurts, so that you can have more pain relief. This is particularly important because a restless patient makes the EP's job more difficult.
One of the major plusses (?) with sedation is that recollection of any discomfort is often abolished. And IV midazolam or similar is a wonderfully relaxing drug.
Why don't you start a thread so that others can offer more experiential advice? I'm guessing it's the being awake thing that bothers you?
It's not the procedure itself, or even the months of recovery, although those things scare me.
My main nagging worry is that I'm doing this too soon. My AF burden is quite low, really. Months apart and then ended within a few hours by pills. I've already started threads about this, including one where I banged on about why I was postponing ablation for a few years.
I changed my mind after my last AF visit, and because of the suggestion that early intervention improves the odds of success. I'm expecting to have one anyway at some point, so why not get it sooner rather than later. There aren't many lifestyle changes I can make, I'm already pretty healthy, so if I'm lucky then ablation could make AF go away, if not forever then for a long time.
I don't need to start a new thread on this, I've already gone over it many times on this forum! I know most of the arguments for and against, I just need to apply them to my personal circumstances.
It's possibly because there are good arguments for and against, and it's such an evenly balanced decision, that whatever I chose I'm going to worry about.
UScore
Yes I can see this has been a difficult decision for you.
30 years ago, at your age, I was terminally indecisive. It usually took me 6 months to decide the make, model and specification of my new car. Then a series of crushing life events gave me a different perspective.
When you have looked death in the face several times, most decisions of a personal nature become fairly trivial. All I worry about now is my kids and how they will cope in the future.
I ran scared when ablation was suggested 8 years ago. Now that I more or less cope with my anxiety, I am more phlegmatic.
I do my research and then largely ignore it. The only thing I learned from my own trivial research effort was that most research is deeply flawed because of poor statistics.
I know that I will never know a smidgen of what my EP knows. I looked him in the eye, listened to what he had to say, and instinctively trusted him. Particularly when he did not gild the lily about my chance of long term improvement. I believed that and also when he said my AFl would not get worse because of the procedure.
I know it is a toss of the coin issue for me. And I recognise that there are other things that will affect my AFl load.
How I handle my stress levels, my kid's health, the unpredictable life events....
Ultimately nobody knows, and I rather think BobD has it right, and I paraphrase, when there is no front runner, toss a coin and move on.
I haven't a clue, but I don't think there is a right answer or a wrong answer. I like my EP, he's experienced, I trust him and I am going with his advice.
Your decision seems more clear cut to me, I think ablation is the sensible option for you.
Even my EP said mine was close to 50/50, although she came down on the recommending it side (carpet salespersons...)
I think I have to go for it now, because if I don't then every time I get AF I'll be annoyed I hadn't tried to sort it out. I missed out on a friend's 40th birthday night out a couple of months ago because AF happened the day before.
Are you symptomatic right now? Does the permanent AFL affect you much?
Sorry UScore, I missed your reply.
Yes I am symptomatic, with uncomfortable ectopics and reduced exercise tolerance.
But something I did not expect, I am strangely calm now that I am no longer flipping between NSR and flutter.
I am also starting to come to terms with the prospect of long term persistent AFlutter. If millions of others can live with permanent AF, I'm sure I can too. And it seems that it won't be as bad as I thought.
That's how I feel.Iresearched it had an EP I trusted; did it; feel better; and now the rest is up to God/my higher power/the universe-whatever term works for me. For me, there is a good feeling about finally making a decision. Going back and forth drives me up a wall and sends my anxiety through the roof. Now it's done. I can live with the decision and whatever else comes I will handle it.
That's exactly how my ablation and pacemaker went. On the table I said "I don't want pain and I don't want to remember anything,+And that's exactly how it went. Anesthesia (there for standby also let me wear my C-PAP machine during the procedure so when my -awareness- returned after procedure was done I just continued resting/sleeping comfortably without fuss. BTW this was all arranged at my pre-op visit and I was told to bring my own machine. I had no post-op pain and the hardest part was staying still and not moving my legs for 4 hours after.
Go for the RF you know it makes sense
Absolutely. So many bad news stories here about Amiodarone that I didn't hesitate!
definitely not plus'es for me. Plusses or pluses are acceptable, I prefer plusses.
Although Chrome spellcheck has accepted pluses but not plusses. It has been red underlined.
For UScore
There might be an argument that if we just can't make up our minds about whether to have that ablation, then we are more likely to worry ourselves in to more AF and need to have one sooner rather than later anyway.
My advice, work on the anxiety angle and you won't need one for long enough for new tech to arrive which doesn't chew up your left atrium.
There's a reason why success rates in ablation have improved down the years.
And why BobD 's ablations have worked: he comes across as decisive and laid back, you don't get to be a formula 2 (?) race engineer by dithering around, fretting.
I feel a lot more sanguine, calmer, now that the decision is made to go ahead, about the prospect that the odds of it working aren't great. You can't make a silk purse out of my gnarled left atrium, chewed up by too many years of endurance exercise, hypertension, PAF, burning and freezing.
And I am surprised that permanent AF/AFL doesn't feel like it would be the end of life as we(I) know it.
Oh the bolding? Now I can see what the hell I'm doing!
There's a gamble either way on waiting, sure new Tech might come along but on the other hand, will the NHS still be here in the form we know it? Will ablation still covered by it?
For all my dithering and posting on here, I'm not a very anxious person. I don't think it is much of a factor in my AF. My last AF visit came when I was forced to wait somewhere, on a very comfortable sofa, with nothing else to do but watch films and doze for a few hours. I had literally never felt more relaxed and then BAM!
Don't you think overthinking this is a possible pointer to raised cortisols? No offence mind.
Do you have a handle on any AF predisposing factors for you?
I am overthinking it at the moment. But then I haven't had AF for ages so overthinking doesn't seem to bring it on.
I'm yet to find a strong correlation with any triggers really. Dehydration is probably the most common thing that jumps out.
My dad had it, but his health and lifestyle were very different to mine. I drank a fair bit when I was younger, but that was 10+ years ago now. I did a few years of quite intense physical training, but again, the peak of that was 5+ years ago and it's been much more moderate since then.
I've got to go through with it now anyway, as the wife's bought an expensive new sofa bed so that I can sleep somewhere without the risk of the kids jumping on me in the middle of the night!
I'm booked in for a flutter ablation on Feb 2nd. My AFl is persistent, but doesn't really affect my quality of life apart from reduced exercise.
When this thing first appeared it was diagnosed as AFib. My lifestyle at the time was littered with caffeine, lack of sleep (young child) and stressful job. Not sure if these brought on the Afib in the first place, but in general they have been eliminated now.
As you probably know from previous posts i've been in the same dilemma of not knowing whether the ablation is right for me.
Now, after my pre-op chat with the AF nurse a few days ago, i've accepted the decision of the experts. The way i'm looking at the condition is that as the electric signals have found another pathway to cause AFl, then without an ablation they are always going to be looking for that pathway again, even during the times of NSR.
That might be way off the mark of what's really happening, but it works for me
jonndeanp
With you being persistent, aren't they going to stay on that particular pathway until it is zapped.
And why no coffee while you are still persistent? You could surely enjoy the odd cup of the real stuff without getting hooked again, until you have your ablation.
Badger, although I self cardioverted last March (collecting my winnings after a casino win), I stayed in NSR for 6 months. Until an over exuberant weekend at the Munich Oktoberfest knocked me back again.
What i was trying to say is that even though i self cardioverted, or even if i was to request a DC or chemical cardioversion the electrics will still be looking for that pathway.
Regarding the coffee, i did try a few recently in an odd attempt to jumpstart my heart. When i self cardioverted last year i was on a cruise and had been drinking one or two "real" coffees each day and i did wonder whether the extra caffeine helped at the casino. I was trying to replicate the conditions a little. Unfortunately my recent caffeine test just made my HR feel a lot more out of synch.
I do still drink coffee, but the decaf version. I don't notice much difference in taste to be honest
jondeanp
Now I understand.
Best advice would seem to be to move to Las Vegas for regular self cardioversions.
Badger25 How aboutplus+ ? irina1975
Let's move 0n!!!!
Heart rate tracker anomalies 
Cardioversion - rhythm
Aflutter Ablation -- Blanking Period or No Blanking Period?
Persistent/ permanent AF episode and exercise 
A very Up and Down Day
