Dual ablation for flutter and afib - anyone had this?

[ijan]

After seven glorious years free of afib, and drugs , thanks to a successful PVI ablation I woke to find my heart racing and knew my arrythmia was back with avengence.

This time it started as atrial flutter then moved on to afib. The main difference from previous episodes was the duration, six days of racing/irregular HB was disconcerting!

My island GP was fabulous and saw me every day while experimenting with drug combinations to bring me back into sinus rhythm. He also made a referral to the EP who did my original ablation who said it could be an isolated episode and advised on pill in pocket meds and suggested going drug free, once I was back in sinus rhythm, to see what happened next.

Three months later, back on the mainland, the rapid regular heartbeat came back with avengence. The local GP advised me to go to A&E and I was admitted for four days while attempts were made to bring me back into sinus rhythm. Eventually I was discharged, still in NSR. I wasn't happy with the meds prescribed and reverted to the dosage which had worked previously (fewer drugs at a lower dosage), I slipped back into sinus rhythm and waited for my EP appointment which was only a few weeks away.

ECGs showed that I had experienced episodes of both flutter and fibrillation- each episoded started with a rapid, regular pulse and my EP offered me the choice of a combined proceedure or Radio Freequency Ablation for the flutter knowing that the afib was likely to return.

If the proceedure is sucessful I should be able to drop the bisoprolol and possibly the aniticoagulant because of my low CHADSVASC score. As 1.25mg of bisoprol makes me very tired I've opted to go ahead and now have a date in mid March.

Typically, I haven't noticed any episodes since my EP appointment and wonder if any one here has any thoughts or had a similar proceedure. I think My EP plans to use cryo ablation to touch up the original PVI and RF to adress the flutter which originateson the right side.

I guess I'm looking for reassurance that I've made the right decision to have another ablation, and in particular to have both proceedures done at the same time. My last proceedure changed my life and I'm hoping the second will too!

Cheers

[pottypete1]

Yes In addition to ablations for AF I have had an ablation for Flutter. On one occasion it was a combination of both but not with cryo ablation but a radio frequency ablation. They ablate the right atrium for flutter and the left atrium for AF.

You won’t know much about it so I think you should not worry unduly.

If it is at UHS you will be in good hands.

Best wishes

Pete

[ijan in reply to pottypete1]

Thanks PP1, Its at Glenfield and I have great faith in Dr Stafford - he did my previous ablation and that transformed my life for many years.

[Hidden]

As far as reassurance is conerned ijan, I think your opening sentence goes a long way to answer that one! Clearly you have confidence in your EP, so be guided by him in doing the best he can for you. I was interested that he plans to touch up the original ablation with a cryoablation. As I understand it, the balloon used in a cryoablation is designed to scar to the entire pulminary vein but often it does not cover the full surface of the vein and the touch up, if required later, is normally performed using RF . I think they can also use a "wand" with cryo, so maybe that's what is planned. Hope all goes well with you.....John

[ijan in reply to Hidden]

Thanks John,

There was a lot to take in during my consultation so I may have misunderstood the finer details of the cryo.

Will post again with an update.

[Hidden in reply to ijan]

Probably a bit for you now Ijan, but for the benefit of others, it is always a good idea to have someone with you on appointments. Preferably, someone with a good memory!

[ijan in reply to Hidden]

So right Flapjack. The person I took with me was pretty good but got lost in the technicalities. She did remember some things I missed and asked some pertinent questions.

With hindsight she would have been better able to support if I'd briefed her better before the appointment.

[wilsond]

I cant comment on ablation as i havent had one yet.However my EP is suggesting that we go down that route of both sides done at once,for flutter brought 0n by flecanide and fibrillation which was there before .He said it was less invasive to doboth proceeedures at once,and so i shall probably go with this if he offers itmin April when I see him.hope all goes well for you.

[ijan in reply to wilsond]

Good luck with the proceedure!

[Dodie117]

I had ablation for both af and flutter in November 2013 and all fine since. Procedure was fine but had lots of arrhythmias after which took 5 months to recede. Then bliss!! I stopped bisoprolol on day of procedure.

[ijan in reply to Dodie117]

Brilliant! Thanks for sharing; I'm desperate to get off Bisoprolol as even a very small dose saps my energy.

[Dodie117 in reply to ijan]

I know a lot of people on here stay on it for some time after but my EP was happy for me to go cold turkey on the day. So you may need to discuss options with your EP. Good luck 🍀

[jondeanp]

I was first diagnosed with AFib. I was cardioverted and when the arrythmia returned it was diagnosed as Flutter.

My EP offered me the two procedures at the same time, however i opted to have the Flutter treated alone. My engineering background, i believe drove me to think that it would be best to eliminate one problem as part of the diagnosis. Also i was more concerned of the more riskier Afib ablation.

The benefits of having the both done together obviously means only one visit to the operating theatre.

[ijan in reply to jondeanp]

Sound engineer thinking- you make a good point, and I did consider having the flutter treated first but decided to get it over with in one go as there was a strong chance I'd need a further proceedure for the Afib.

[jondeanp in reply to ijan]

These decisions are not the easiest to make. I was on a waiting list for over 12 months so had a long time to mull & dwell on it.

You've experienced an ablation already so maybe a little easier for you too

[ijan in reply to jondeanp]

You're right about the wait introducing time for doubt to creep in. If I could have been ablated soon after one of the episodes I would have jumped at the chance.

While my first ablation was uncomfortable, even painful at times, it made a huge difference to my quality of life and allowed me to enjoy many of the outdoor activities I'd had to shelve because of the risks of an AF attack in a remote location.

The difference this time is that the attacks are less frequent but much, much, longer, days rather than minutes/hours.

I wanted to avoid two periods of convalescence so balanced this against the increased risk of adding the Afib to the flutter proceedure.

I'm not about to wimp out but am gathering info so i'm an informed patient

[tinhouse]

I had them both done in Oct. I had cryo on the right side for flutter and radio frequency on the left for AFIB. The bruising on the right groin was much worse than the left, but as of today, 2/19/2018, I am still in normal sinus rhythm.

[ijan]

Thanks tinhouse, good to hear you're still in sinus rhythm. Were you in overnight?

Are you "back to normal" or still in recovery after the proceedures?