Post Ablation

[bradl36]

Hi, I am a active 52 year old male who had my first ablation in December. Prior to the ablation I was on 2 x150ml flecanide and 2 x 120 ml verapmil per day. I have been able to get down to 2 x50ml flecanide and 2 x 40ml verapmil per day. Any lower I am getting severe Af. The cardiologist considers this to be a success. My question is.Should I be happy with this and concentrate on triggers and further weight loss or should I be pushing for a second ablation?

[fnurd]

If that is a success I wonder what he calls a failure ...

More seriously, I would be looking for (and so far have achieved) zero AF with zero medications.

[dedeottie]

Before I had my ablation I was going for broke........no AF with No rhythm meds 100% of the time. The reality is that so far I have had 2 years with no AF but this is on a reduced amount of flecanide. When on no meds I did still get AF so now I am staying on the reduced amount so that no new electrical pathways are found. However, on a very positive note, I find I am actually very happy with this. My quality of life is amazingly good so I will take that for now.

This was bought home to me last weekend when I sang in a performance of Fauries requiem with a second half of celtic folk songs. I sang through a 3 hour rehearsal with an hours rest before a 2 hour performance. Before my ablation I used to have to duck out of the rehearsal as the extra breath required made me feel faint. In the concerts I had to sit on the end incase I needed to get out quickly. Not now, I am just going relatively normal choir member!

If it takes the help of a small amount of medication, so be it.

Some lucky people find complete success but I am not one of those. X

[bradl36 in reply to dedeottie]

Thank you both for your replies. He even said it was not a problem to go back up onto 2x 100 flecanide. If I get breakouts. I can cope with the symptoms but my rate control is not good. Hopefully I can start getting back into the things I enjoy without going up over 200 bpm.

[Steve_]

I would say wait. It's still early days. People here will say it can take up to six months+ to settle following an ablation. From my experience this was true. 3 months after my ablation, (the EP's declared "blanking" period) I thought I was ok, but now 9 months later I can see that I still was nowhere back to normal and it just took longer.

So, I would say give it 6-9 months and you may find you can then (with your EP's agreement) reduce your dosage further and maybe come off the drugs completely. Just take your time coming off them as they are strong drugs.

[mwcf]

Who did your ablation Brad?

[bradl36]

I am a Aussie. It was done at Royal North Shore in Sydney.

[Coco51]

Hi Bradl36. I'd say give it a few more months before you make decisions about whether the ablation has been a success. Its been 7 months since my ablation (I've had 2 now ) and the first 4 months were rough with bouts of AF in spite of Flecainide and Bisoprolol. The last 3 months things seem to have settled and I feel much better. I keep wondering if it'll start again but I'm keeping positive.

As for pushing for a second ablation...it depends a lot on what was done during the first. If it was simply PVI, and if you've had AF a long time, it could be that other areas of the atria have created different pathways to go into fibrillation. So it could well be worth pushing for another more comprehensive ablation if things don't settle. I am now feeling glad I had the 2nd ablation and would go for a third if necessary. Yes I am on meds, but at least they seem to be working better now than they did before.

This is quite technical, but someone in this forum forwarded it to me and it explains about different parts of the heart implicated in long standing AF.

afsymposium.com/february-2014

Good luck.

[bradl36]

Hi Janet,

I was told that it was just pvs I asked about it being on other parts of my heart but was told that was unlikely. I had few symptoms and only picked it up from wearing a HRM while jogging. I believe I had it for at least 3 years before being diagnosed. The cardiologist believes that ablation is not the silver bullet because it creates scar tissue on the heart and scar tissue causes af long term. Because I’m asymptotic I now just to put up with the meds. I’ll give 6 months and see how it goes