Ablation.: When are you offerd an... - Atrial Fibrillati...

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Ablation.

benmaise profile image
29 Replies

When are you offerd an ablation ? I was diagnosed 18 month ago with lone AF. I just get AF once in a while. I don't notice it much since i started with Bisoprolol. Just wondered. I suppose it is when someone has it a lot.

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benmaise
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29 Replies
jennydog profile image
jennydog

I cannot imagine that you would be offered an ablation until such time as your EP felt that you needed one and that there was a fighting chance of it improving your condition.

It's not something that you would agree to, unless AF is making your life a complete misery. I had mine 3 years ago and have no regrets. If it's recommended then go for it.

benmaise profile image
benmaise in reply tojennydog

Thanks Jennydog

It really depends on a number of different things benmaise. At the moment, it sounds as though your burden of AF is fairly low in that it does not appear to be impacting on your life. A lot depends on whether or not your current condition shows signs of getting worse. I suggest that you ask to be referred to see an EP, a cardiologist who specialises in arrhythmias. This is likely to take some time, but the EP is best placed to assess your condition and suggest a treatment plan that would be best for you and of course, this may or may not include an ablation....hope this helps....

BobD profile image
BobDVolunteer

As I say repeatedly any and all treatment for AF is only ever about improving quality of life. (QOL ) so if your QOL is pretty good then there is no point .

IanMK profile image
IanMK

Most often an ablation is offered to improve quality of life when the symptoms become troublesome. Since you say you don’t seem to experience the issue much and the tone of your message suggests that you are not greatly troubled by it when it does occur, then I wouldn’t think you would be offered one. Although it is a routine procedure, it is not entirely without some risk. It is also expensive.

Some people are asymptomatic and have AF without realising. You don’t mention if you have been prescribed any other medication. You should see your GP periodically to ensure there is no deterioration of your condition that you are unaware of. It may be worth taking the time now to research local EPs so that if you need to be referred to one in future you can make an informed decision and a specific request.

foxglove1 profile image
foxglove1

i agree with all of the above and although I am paf with no meds other than apixoban and my qol is good, my ep has offered an ablation at my last review. I am not keen unless my circumstances change and after discussion he agreed we could put me on the "watch and wait"

all the best

benmaise profile image
benmaise

Thanks for all your helpful comments.

Something else to consider benmaise, although I appreciate it may not apply to you is the effect improving lifestyle can have on reducing AF. Some medics say that controlling blood pressure, alcohol intake and weight can offer similar benefits to having an ablation.

Buffafly profile image
Buffafly

I agree with previous comments but something that hasn't been mentioned is age. Ye Olde AFers are sometimes surprised at the speed with which younger people are offered an ablation and I think this is partly because of improvements in equipment and trained personnel but also because the latest thinking is that it is better to nip AF in the bud while the procedure can be shorter, simpler and have more chance of success first time. I suspect (just my own little theory) that older people with AF are harder to treat because of the effects of maybe having had undiagnosed AF for a long time plus comorbidities - other medical conditions.

So my opinion is that if you are young and offered an ablation go for it if you feel ok about it, but if older the QOL argument still applies.

Kaz747 profile image
Kaz747 in reply toBuffafly

I’m 54 and having ablations for AF and AFlutter on Friday. My EP is very optimistic it will “cure” me because I haven’t had it for too long and it hasn’t had a chance to do too much structural damage as yet. I hope he’s right (I’ve had 2 unsuccessful SVT ablations in the last 18 months).

hock217 profile image
hock217 in reply toKaz747

Why were the two ablation for SVT unsuccessful? You have both AFib n SVT? Wishing you success this time and hope your AFib is gentle with you.

Kaz747 profile image
Kaz747 in reply tohock217

I was diagnosed with SVT after ankle surgery 2 years ago and they did the ablation under sedation 9 months later but I was very uncomfortable and despite topping me up with drugs after 4 hours they decided it was too dangerous to continue. Doctor said if he knew how easy it was going to be to trigger the arrhythmia he would have organised a general anaesthetic. They did the second one 6 months later under a general and that’s when they discovered it was Multifocal. Every time they got a rogue cell, another would pop us somewhere else so they did a lot of burning and hoped they got them all (that was over 4 hours too). They decided to keep me on medication but I had a lot of breakthrough episodes of Tachycardia where I would take extra medication to settle it. After 12 months I had a bad episode which extra meds wouldn’t settle and I was diagnosed with atrial flutter and had an electrical cardioversion which lasted 6 weeks (my meds were increased) then I had another episode of AFlutter which then morphed into AFib (meds were upped again). Hoping for a positive result after Friday.

hock217 profile image
hock217 in reply toKaz747

You have been through so much. I'm so sorry. Quite risky for you. Sending peace your way

Kaz747 profile image
Kaz747 in reply tohock217

Thank you. A few days after being hospitalised in April with atrial flutter I was also diagnosed with Shingles and then postherpetic neuralgia. I’m looking forward to New Year’s Eve and hoping 2019 is a better year 😀

in reply toBuffafly

I think there may be some substance in that argument Buffafly

Buffafly profile image
Buffafly in reply to

Too kind.....

in reply toBuffafly

I know....generous to a fault 😉

JB721 profile image
JB721

I may disagree with a few folks here, but as someone else pointed out age may be a factor. First, for you, since you aren't persistent, I think you needn't worry about an ablation quite yet. However, the moment you are persistent or the SECOND you require meds to stay in sinus rhythm, I'd get the ablation!

I'm 38 and had my ablation just over a year ago and am SO happy I did. My A-fib didn't really interfere with my life, but in the long term it's not a good situation. Higher risk of stroke, thickening of the heart muscle due to constant tachycardia, etc... plus the remodeling of the heart the longer you're in it... there is NO reason for that in this day and age! Just do the ablation and call it a day. Who wants to suck down pills for the next 40-50 year? Especially since those pills all stop working eventually anyway. Oh, and who the hell wants to be on anticoagulants for that long?

Sorry to be such a pollyanna but as you can see I'm a big fan of just dealing with it and calling it a day! ;)

Aqua_1 profile image
Aqua_1 in reply toJB721

I have to agree with you. I am in my early 50's and was diagnosed earliy this year. First round of drugs didn't work for me and i was then put on Flecainide. Its working however i hate the thought of taking drugs forever. I have seen two EPs so far and both believe that i am an excellent candidate for an ablation so i will probably go ahead with it early next year. This condition has broken me and has put my life on hold. I hope to live a normal drug free life once i have the procedure.

Terriuk profile image
Terriuk in reply toAqua_1

I’m the same as you, I’m 56 and have been in permanent AF for about 2 months although I’ve probably had episodes without realising for years. I’m having my ablation next week, nervous as hell but my EP says I’m a good candidate for it so I’m hoping it will improve my QOL and I can climb stairs again!

Aqua_1 profile image
Aqua_1 in reply toTerriuk

All the very best to you. Do let us know how you go.

hock217 profile image
hock217 in reply toJB721

So am I....completely agree.

sadie308 profile image
sadie308 in reply toJB721

Were you ever on blood thinners? I had an ablation 4 months ago for atrial flutter and have been on blood thinners (before and after). At my next visit, we are going to discuss the possibility of coming off blood thinners. I get the idea it is still "experimental" as to whether or not it is safe.

hock217 profile image
hock217 in reply tosadie308

After my ablation for SVT, I was advised to take 2 baby aspirin a day.

UScore profile image
UScore

I got offered an ablation at my first appointment with an EP, at that point I'd had 3 episodes of AF, each of them lasting about 10-12 hours, ending by themselves.

I wasn't sure if I'd go through with it, but I took the EP's advice to go on the waiting list whilst I thought about it.

Had the ablation earlier this year. It was definitely the right thing to do.

I now take no medication at all, and have been AF free since February.

I was told that the sooner you do it, the better the chance of it working and lasting. (Provided, of course, that you don't have an ablation and then return to a lifestyle of over-eating, over-boozing, etc)

hock217 profile image
hock217

No. It was because the cardiac monitor worn for a month indicated SVT and revealed an extra node where my blood would spin in a circle and not continue on creating a risk for stroke or cardiac arrest. The ablation burnt that node hopefully successfully. I worry when symptomatic that it did not work.

scienceguy02 profile image
scienceguy02

I had exercise induced PAF for many years and was told I was not a candidate for ablation. It wasn’t until the episodes became “random” and more frequent that I was able to get the ablation. In my humble opinion I think most docs prefer to use avoiding the stimulus activity over offering ablation up front

GordonS profile image
GordonS

I was put on the list for an ablation on my first visit to the EP in February (had my first ablation 7 years ago). It probably helped that I had an attack whilst in clinic and it was my third in just a couple of months. My view is that the earlier it is treated the better the outcome will be. AF begets AF in my opinion. Still waiting but trying not to let it rule my life. Managed to complete Ride London 100 mile bike ride at the weekend, hoping to raise lots of money for AFA🙂

Morzine profile image
Morzine

I’m very interested reading all this’s it’s very current in my mind this afternoon, as I’ve been to the cardiologist today, I live in France. I started afib ear,y this May on holiday in Spain. So it’s not been long, Apixaban bisoprolol and fkecanide seem to have calmed this down amazingly although side effects were horrid initially, and the last month since he upped the fkecsnide I’ve felt normal with just two tiny epsisodes. I’ve seen him three times now as the health systems pretty quick here...Today he saud I can have an ablation if I wanted which threw me somewhat as I thought it was way down the line. Cos’ im just getting used to this invading my life and making me feel awfully lost, and just calming down from being scared all the time..... He said he thinks cure is better than maintaining....obviously he also said it’s nit guaranteed....he offered to ring and get me an assessment today and done within the month....but I sajd I’m on holiday in September and I’ve come out half of me excited I may get cured( or not), and half on me thinking well you’re feeling pretty good on these tablets should you rock the boat....I see him now in October and he said he can organize it then if I want it and to balance it up in my mind....I trust him a lot, and I also appreciate hearing everyone’s views on this today .

Can anyone tell me with the ablation must you rest if so how long? What exactky happens after it?...

Sue

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