AF Association
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What is Quality of Life?

It may sound like a silly question but I’ve always argued against having an ablation as my quality of life is fairly good in my opinion.

I am on medication but it doesn’t give me any negative effects. I still exercise but differently to pre AF. My home and work life are good. I’ve recently turned 49 years old (a youngster I know) and have two young boys and a loving wife.

However when I queried having an ablation with the EP and subsequent arrhythmia nurses, my quality of life arguments were not really taken into consideration. For them it just seemed to be wrong to want to continue with an AF heart and on meds when they could offer a chance of getting it “fixed”. I think they see quality of life as being off meds and not being at the risk of stroke

As it turned out I went along with the experts decision and I am due to have the procedure in one weeks time.

I just hope it turns out to be the right decision

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Mmmmm...... an interesting comment. I suspect it is because of your age that ablation was recommended in your case as long term use of meds will inevitably cause some effect as you age.

I also hope you find it to be the right call.

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Hi JD,

AF occurrence may worsen with time. Also, stroke is not the only potential risk, if at all. According to Mayo Clinic, the longer is the condition left, the more problematic is a subsequent remedy.

I, for one, am pleased with the results of my (maze) procedure. You may well find a positive change in the quality of life - a little unexpected bonus. I am assured by my doctors that being in a normal heart rhythm also betters my chances of keeping a healthy heart.

The die is cast, go with it and best wishes

J (-:

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Interesting, best wishes. It would have been good to be able to have a more in-depth discussion on their reasoning though. When I was a child it was fashionable to have your tonsils and adenoids removed (apparently because Prince Charles had it done). My father refused the operation for me on principle, same with antibiotics, but at 18 with tonsils covered in abscesses I had them out! When my daughter had repeated bouts of tonsillitis and an operation was suggested the argument was that she might temporarily overcome the infection but it would return just when she was sitting important exams later so I quickly gave permission and she has hardly ever been ill since. These decisions are difficult if not based on personal experience. I didn't realise how much my life was affected by AF and medication until they were gone.

I hope all goes well and look forward to your report later.

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Best wishes for a heart healthy future. If you are happy with your medics advice and feel you have made an informed decision then perhaps this is pre procedure nerves. All the very best.

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Hi jondeanp,

I can’t help wondering what your motives were for writing this post. Possibly to seek some re-assurance that you have come to the right decision and who are we to challenge that decision. I share CD’s comments.......

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Hi jondeanp :-) good luck with your procedure.

If I were your age and not 20 years older and faced with many years of medication I would opt for an ablation.

As it is I would be unlikely to be offered one at my age when my P-AF is under control with medication as decreed in the NICE guidelines.

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Age is no barrier to ablation but any other conditions need to be evaluated. And I think the NICE guidelines changed on that some time ago?

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CD :-) it is in my neck of the woods where seeing a Cardiologist or EP at all is only for those who can't be reasonably well controlled by medication, the thought of my 'in special measures' HA spending money on an Ablation for someone my age reasonably controlled by medication is out of the question.

Ablations here if they are lucky enough to be offered to one are are for those who have only recently started to have episodes of AF, the young who face years on medication and those for whom medication does not work.

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Oh dear! Our area there was a moratorium on ablations because of the winter crisis and there is a long waiting list, but at least it is a possibility. This post code lottery is very divisive.

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I hope all goes well- there are lots of co-morbidites caused by AF which hopefully you will avoid by having an ablation- I would also look for any causes and make sure you rectify these if possible- weight, dietary insufficiency ( potassium, magnesium) sleep apnoea, high blood pressure, over training in sport ( heart muscle enlarges along with other muscles so errant signals get going) so that the ablation has the best chance of lasting as long as possible

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I genuinely think that at your age at least trying the ablation route is the right way to go. You have a lot of life ahead on drugs otherwise.

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Before I was diagnosed with AF, most people would have thought that my QoL was good and my fitness levels excellent. I was a keen cyclist, but starting to find it difficult to keep up with my friends. Everyone was telling me that I was simply getting older.

Over a couple of years what I now know as AF attacks extended from seconds to minutes, but even then I was only affected during hill climbing. Eventually my AF became persistent in 2016 and I was diagnosed. I stopped all exercise other than walking and started beta blockers and rivaroxaban. At this point I was still active, I had not needed to go to A&E and compared to the average 52 year old I was at a level of fitness above average.

From this point it took eighteen months to complete my treatment.

There were several times during this period where I had told people that I was feeling better: particularly after my cardioversion, after recovery from first ablation (mini maze) and immediately after the second ablation. However, I now realise these were small incremental improvements.

My second ablation was completed in October, and in November I came off all the meds. Only now, two months later, I feel that I am back to normal; all the brain fog and lethargy is gone. I am still off coffee and alcohol (apart from a spell at Xmas). There are a couple of issues: I have a few more ectopics than I’d like and I will not be able to return to competitive bike riding. But I am extremely happy with my progress compared to what I expected.

I would say to jondeanp that your QoL is probably compromised more than you realise and may be slowly getting worse (AF is a progressive disease). In your position, I would go for the ablation and hope for a serious improvement in a couple of months time.

Best of luck.

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For me personally, I would stay away from any surgical intervention until it was in fact necessary, providing your A/F is being controlled and you are enjoying a good quality of life, as from my experience not all ablations are successful.

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I'm with you here opal. If I could be sure that a single ablation would work, I might consider it though my qol is not compromised at the moment (I'm in my 70s) But most of the people I know have had to have more than one ablation and have experienced periods of discomfort and emotional distress between the procedures so while the Propafenone works, I'm happy to stick with it!

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I agree,

I’m 60 years young. I had an Ablation last November, it did not fully work. I am worse now than ever health wise. Always short of breath.

Only go out in a wheel chair or on a scooter.

Awaiting to have another Ablation.

Also from June last year 2017 , I had 5 Cardioversions , one a month. Because AF returned after 2 to 3 weeks .

Also I now have Obstructive Sleep Apnea. I have researched the later and it can and often is tied in with AF

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I had a bad experience and ended up with a Pacemaker which has returned my quality of life, I too am in my 70's and pleased to be here.

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Get the ablation- you are young and it’s much more likely to succeed the sooner you get it. The disease will progress- and flec is not a drug you want to be on for the next 40 years if you can avoid it. I was in the same spot you were last weekend at 44- I had my ablation on Monday and am glad I did- best of luck!

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Very happy I hadmy 'pace and ablate' surgery Nov 2016. Am 73 and my EP told me last week my afib and overall cardiac condition is much better than it was 3-4 years ago. Hope yours follows the same path. BTW I grew up in a household where taking medicine was not done unless truly needed. I believe the less meds, the better. Especially over the long haul. This is my own personal bias but here in the US I have less and less trust in new 'miracle'drugs. Including how the research is carried out. Just my opinion.

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Simply put, Afib is very complex. Yes it can be treated with medication but for how long. AF will only get worse over time because it enlarges your atrium due to the flow of blood not getting thru the heart properly. The larger your atrium the harder it is to treat AF. Especially with an ablation. If AF is caught early on in Paroxysmal stage then Ablation of your pulmonary veins is only neccessary. These have a greater success rate. Best of luck to you and know that having the procedure will likely lead to better quality of life. Always do your homework and know of all your choices of procedures out there that pertain to your condition.

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Hi

I think you are probably doing the right thing having the ablation. I am 57 and have had a fib the last 2.3 years. It was an inconvenience for 20 months with little medication but that took a turn for the worse 8 to 9 months ago and have been on diltiazem and flecainide since which is a lot more intrusive but although I have only had 1 Afib episode since then, tiredness, excercise intolerance, and brain fog of the drugs means it is not me anymore as I felt even 10 months ago. The effects of these meds seems to have got worse even over the short period I have been on them . I also expect A FIb will evolve and get worse in future, (as it has the last 2 years) and as I understand "A fib begets Afib" I decided to have a cardioversion even though I think I am currently a lot better off in terms of QOL than a lot of people who have afib. I have also realised over the last 10 months how much having a fib means you spend a lot of time thinking about it, probably worrying about it. getting worse, researching it, etc . Etc and realised that it would be so much simpler if I did not have it!

If you have two kids you probably have enough to worry about without AFib

My ablation is on Monday - hopefully it will work!

Good luck for yours .

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Essentially, quality of life means what life style you are happy to accept. I don't think other people, nurses, doctors, whoever, can tell you. Whatever the problem, whether AF or some other condition, I feel that a proactive approach will sort out what you can reject or live without and what you feel needs addressing to fill or cure what's missing from your life. It's important to work on accepting things that can't be changed and and appreciate that what's left can be enjoyed within any restrictions.

Sorry if this may sound a little like a Lifestyle Counsellor.....I'm not! Simply, I have a few conditions I can't change and have learnt to put these aside, work round them and I've become quite a happy bunny! I really hope that this part of your journey works out for you and that you carry on with a smile! Good luck.

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Thanks all for your helpful responses. Just to clarify I was really posting to discuss the differing views on quality of life from the viewpoint of the patient and the healthcare professionals

It may have ended up being a post for reassurance also, probably made worse due to the length of time I’ve been on the waiting list. A long time to mull things over

As it happens I did listen to the professionals (in conjunction with the feedback on this and other posts on this site) and am currently typing this while waiting to be discharged after a successful ablation

Fingers crossed

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Mine was four months ago, and I’ve no regrets. I’m 58 and really didn’t like the thought of 20 + years of medication. Now off ramipril and reducing Angitil, (would be off that as well if this recent virus hadn’t sent me a bit wobbly?). As always, it’s your own decision, but fir me, the less medication the better!! Remember, don’t lift anything bigger than the tv remote for at least two weeks!!!

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Oh well done Jondeanp :-) I wish you a speedy recovery..

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