Well its been 7 months since i last wrote and i have finally, today, been offered the chance to have an ablation. The cardiologist made the risks of the op very clear to me and also suggested i could try a different combination of medication, instead of the operation. He said i had a 70 per cent chance of success if i have the operation, but should consider the different medication option also.
I currently take 5mg biosrapol and 50mg flecanide twice daily. CHAD score 1, female, no heart problems. I am aged 49.
The cardiologist wants me to take 100mg flecanide twice daily. 3.75 biosropol, then if i have an attack of AF to take another 200mg flecanide. I asked about the risks, taking all this flecanide. He said my heart is fine and i would not have any long term damage to health by taking this. I currently have an AF attack once a month, lasting for around 2 hours. The cardiologist also said they usually offer the operation when a patient has tried all options and they come in with hands in the air saying enough is enough.
I know they probably see lots of patients much worse than me, but living with AF at my age is restricting my every day life. Do i go with the meds or take the leap and gave the operatio?
Thanks
Mandy
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I have ablation on Tuesday. Been out of breath for 2months now. On tabs which help but think my arteries might be furred so having the dye on the 18th. Just want to feel normal oh and I'm 60. Good luck. Hope you get sorted xx
If you ask my opinion go for the ablation BUT do remember that any and all treatment for AF is only about improving quality of life (QOL) and that ablation is part of that and may need to be repeated in the future. At your age do you really want to be on drugs for the rest of you life if there is 70% chance of not having to? Do also understand that regardless of your Chadsvasc score you will need to be anticoagulated for some months before the procedure.
Read all you can about ablation on AF Association website and make your choice from a position of good knowledge
Hi there ... I had an ablation 3 weeks ago and I'm 54 live in the UK. I didn't want to have one of course, who does but my symptoms just got worse and worse over the past year. I went from monthly attacks to weekly and AF will normally get worse over time so my theory was to have the ablation now while I'm young-ish and fit enough.
It was done in 3 hours and I was home the same day so I'm pleased it is behind me now.
It's worrying leading up to the day but it's not a big procedure as far as the medical profession is concerned.
If I had to have another ablation I would no problem, the only thing I would change is I would have a general anesthetic, mine was done under sedation and was not a very pleasant experience. Saying that everyone is different so you might think it's a breeze.
Best of luck whatever your decision ... Regards Dave.
Thank you for your reply djbgatekeeper. I hope you make a full recovery. Keep in touch.
The only question i have is did you have a choice to be put to sleep? Not sure i could go through it awake.
Having to return early to a job, children at home, a stressful life and being prone to anxiety are all factors which decrease the chance of a successful ablation. One ablation is not generally sufficient, two seems the norm and some have more.
You don’t seem to have much of an AF burden, though I don’t have a sense of how symptomatic you are?
carneuny recently wrote an excellent post on how lifestyle changes have meant he no longer has AF episodes and has not had an ablation. Definitely worth reading.
Reading your old posts, I wondered how much you have used anxiety management strategies with your AF. CDreamer is the expert on this.
You seem concerned about side effects from Flecainide. Have you had any?
In short, I’m not convinced you need ablation yet. If you go ahead, set aside several stress free months afterwards.
I am lucky. My children live with me, but are now working. My job is stressful, working in Education, but after 18 years service, i would not feel guilty to taking time off, full paid, up to 6 months. I have never had time off, apart from early AF days, just over 2 years ago.
AF hit me, just over 2 years ago and since then my life has changed. Yes anxiety has hit in also. Having an AF attack whilst ' just out and about' is not pleasant, we all know that. Been at work, with children and having a pre attack, doessnt help with your job concentrarion. Having an attack and having to go to A and E , then calling work to say. I cannot come in today. Work then interviewing you when you get back, saying, you have had x ammounts of days off. This does all add to stress and anxiety.
Side effects from flecanine. I have put on a lot of weight, a full dress size in 9 months. That is the only, big side effect. I know this could be worse.
I do thank you for your in put and caring to reply. I too am worried about an ablation, this is why i have asked. Just to say, 2 years ago, before i had this. I did not take any medication, at all. I even stopped taking the concrecptive pill, because i needed to take control of my own body. Blooming heck. Look at me now.
Thank you again for taking the time to reply. Will keep you posted.
"Hands in the air" is my story. Early on with my a-fib diagnosis when I could still go in and out of normal sinus rhythm quite a few med combos were tried. The side effects were so bothersome with whatever was tried I literally said to my EP during a visit that I was tired of this approach and all its 'ups and downs' and asked what else we could do. He offered me a pace and ablate which I accepted and have done well ever since with no cardiac medications.
I am so pleased to for you, that all has eventuly worked out well. Can i ask, if you dont mind, how long did you ' put up with this' and after reading my post, was you at the same level as me or do you think i should ' keep taking the medicine'
First let me start by saying I can't advise anyone how long they should put up with their prescribed treatment before asking for different options. We are all different and have different levels of tolerance for whatever comes our way. I believe you will know when the treatment you are getting becomes too difficult to continue without giving something new a chance.
For me part of my decision was because different drugs that were tried-starting with one called Multaq (don't even think it is still used but it was touted at the time as being the latest wonder drug for rhythm control,) then cardizem, then adding digoxin. None ever were effective for very long and they all had bad side effects. I never felt well on any of them. Everyday I had problems with my pulse being too slow, then too fast, calling the doctor for dosage changes, trips to the Emergency Room (A&E), and so on. Not to mention constant anxiety because nothing was making me feel better.
So here is my timeline for my a-fib journey:
2011: Had my first episode of AFib which I didn't even feel. It was picked up accidentally on a routine EKG. I was otherwise healthy and asymptomatic so was not hospitalized.
My regular doctor had me seen by an Electrophysiologist who did several things: Ordered a test for sleep apnea which resulted in my starting a C-PAP machine, started me on the anticoagulant Pradaxa in case the AF continued so I would be ready for an outpatient cardioversion. I was monitored for about 5-6 weeks, the AF continued, though without symptoms.
After I'd been on Pradaxa about 5 weeks I was still in Afib. A cardioversion (with the machine as opposed to medications) was done and was successful. I stayed AF-free for 3 years. After about 2 months was still on the Pradaxa (horrible G.I. symptoms,) I tripped one night on a broken sidewalk walking my dog. I cut my eyebrow and it bled so badly I had to go to the ER for sutures. If I had not been on Pradaxa I could have handled the cut at home; cleaned it up,dressed it and no problems. So I said I wanted to stop the Pradaxa.
So until 2014 I was Afib-free, medication-free and thought I was home-free and it wouldn't return.
2014: Visiting family in Florida and out of the blue the AF came back-this time with symptoms. Was in the hospital in Orlando and stabilized. I didn't want to start with new doctors so when I was discharged my brother and I drove back to Atlanta. I was in AF all the way and short of breath. I went right to the ER when we arrived. I drove as my brother was starting to be forgetful. I made him comfortable in the back seat with his portable DVD movies and the dogs. What a trip!
2014-2016. My AF continued and I never went back into normal sinus rhythm except once briefly . For almost 2 years I went back and forth between various medicines, started coumadin (my anticoagulant choice so I could manage my own INR's and dosages) with meds working for a short time then requiring dose or med changes. Meanwhile I never felt good, was anxious all the time and was hospitalized several times for heart failure as meds caused my pulse to jump between normal, too fast, and too slow. During this time I went back into sinus rhythm once for a few days. When I went back in Afib I had a second cardioversion which didn't work.
My life was revolving around Dr visits, trips to the ER, hospital stays, and feeling anxious most of the time.
October 2016: I asked for other options and had my Pace and Ablate in November. Started right away to feel better and still doing well.
Dec 2017: Tired of the Coumadin, felt it was a harsh drug and I wanted off. I was concerned as I got older about small, missed, mini-bleeds from the coumadin and possible higher risk of dementia from long-term anticoagulants. My brother, meanwhile had died in 2015 from colon cancer and he had early dementia. We shared a home and I was his caregiver.
January 2018: Requested and had a Left Atrial Appendage Occlusion with a Watchman device inserted. Doing well, spend much less time thinking about and dealing with AF problems.
Glad I did it. I had just reached a point where, for me, enough was enough. So we each have to decide in life situations how much we will tolerate and when it's time to change gears.
One more thing which factors in medical care for most of us is cost. Prior to the P and A I spent a lot of money on new prescriptions changed midstream, Doctor's visit co-pays, Hospital balances not covered by insurance. Money shouldn't be part of the equation but it is.
And as BobD has pointed out more than once on this site Quality of Life (QOL) is very important-we all have to come up with our own definition. For me before my surgeries I didn't go a day without worrying and wondering what might be next. Now I don't think about Afib every day. I'm more concerned with my thyroid and my knees now. LOL.
A big part of my own QOL definition is staying out of assisted living and nursing homes. I am not impressed with any I've seen in the US and when I finally leave this planet I want my mind and my body to leave together.
Hope this helps, Mandy. I know you are facing some hard decisions. Take care. irina
I would certainly do it again and I have an 80% success rate according to my EP. Drugs are bad in the long run to many with side affects that even more drugs are needed !! I know DRUGS can do harm of their own. It is all risk management. Use intuition and your Doc's advice. I have a lot of anxiety to deal with and lifestyle and perspective change has helped
I like that you mentioned using our intuition. I believe we all have it and listening to ourselves when all is said an done can often be our strongest ally.
For me, my intuition. (the Universe/God helps with thoughts that pop into my head in the early morning hours before I'm fully awake and my conscious brain gets in my way.
I find if I fight these subconscious ideas things don't always turn out well but when I'm too tired to 'be the boss' and listen (get out of my own way) I make a better decision that serves me well.
If I were you, I would definitely have the ablation. I’m 53 and had one just over a year ago and so far, so good. I feel like I have my life and confidence back. The unpredictability of attacks was making my life really stressful. I was afraid to be alone, reluctant to travel for work and hesitant to make social plans. And as many people here point out, AF is often progressive. Whatever you decide, good luck and I hope the ablation or drugs help alleviate your symptoms.
I have only had this since May , it’s upturned my life and confidence .like you anxiety and stress kicks in..... I’m in France and was advised by the cardio days after this started I could have an ablation, but I started off in tablets, Flecainade has been my saviour ince that was sorted dose wise,150, plus other tablets.....but with the side effects of these tablets and it seems by the general consensus on this forum that this beast gets worse with time, it didn’t take me long to wY up the ablation V tablets.....the chance to be free of this at odds 70 per cent ...it’s a no brainer......the chance to find my way back to the old me that’s been lost in this thick fog of the unknown......it’s a no brainer.......I feel this is a chance .....if I were you after 2 years of this I’d go for it.....I think there are a lot on this forum right now, just been done or waiting to be done, we all share that same bond of hoping to get our lives back.....the months wizz by so quick as we get older, these years ahead are precious.
You sound like you have a good cardiologist who treats you like an adult and discusses options and risks. I think the significant part of your post is that you feel that PAF is having a negative effect on your quality of life. In this context a 70% chance of success sounds pretty good to me. I've had 2 ablations and while they are not a miracle cure my physical and mental health has definitely improved and I have been able to reduce or eliminate medication
Well . . . you asked for opinions. I am on a waiting list for an ablation after having had only three instances of AF in two years. I too don't know whether to go through with it, and I'm 69 in three weeks time, retired. I'm only taking 1.25mg Bisoprolol and Apixaban. When it happens to me, I go to bed and ignore it until it stops. It has stopped me doing certain things in my life, but the impact is quite small.
As BobD said, the treatment is all about improving quality of life, so in your position I would definately take the jump in the dark. The chance of getting off the drug regime (although you might still need anti-coagulation) and not having attacks so frequently as you do, even if only short ones (mine last 8-10 hours) would settle the matter for me.
Life is all about chances, and what you can do to influence them for the better.
Whatever you decide, good luck with it, and I hope you can choose whichever settles your mind on the issue.
My EP gave me the option at very first appointment - meds or ablation. My episodes were frequent - 4 or 5 per week lasting 5 or 6 hours.
He was of the opinion that if I chose ablation the earlier the better. I decided On ablation. That was 2013 and after 5 months of various arrhythmias bumps etc all settled down and no more AF.
So my choice - ablation. Difficult decision I know.
Depends how you view the risks. I was on 2× 50 flecainide + 200mg diltiazem per day rate control. Side effects we brain fog cumulativly getting worse ,tiredness, exercise intolerance - max hr 137 ish making it painful to even run slowly . I took the ablation!
I was 57 and thought I was fairly fit before last July when I had to go onto the above drugs . I did not have AF attacks very often : 12 in 20 months prior to July 17, and then only one after the drugs listed above but I had a very bad 8 days in july 2017. High for over a week.
"Af begets AF", the more you have it the more you will get it, so eventually it gets worse. In my case that was demonstrated. QAL going South owing to the drugs and lack of exercise, and I could wait longer for an ablation but then when I have the ablation I would be older, weaker,less fit so do it would be even more of a risk later ( in my estimation).
ABLATION was the only thing that offered the chance to ditch the drugs and get more normal, so the 65 to 70% seemed to be a good idea despite the risks.
I had issues post ablation, in that I developed reentrant atrial flutter which kept me in the house/ in bed for 3 weeks and I then had a second ablation for that. The flutter may have been a side effect of the flecainide.
I have not had AF since January, nor flutter since February and have not taken a drug since may 15th I would not say I am as well as I was pre AF, but I am an awful lot better than I was post July 2017 and I do not have brain fog, excessive tiredness or anywhere like the exercise intolerance I had previously.
In short it's brill and I am Cured (for now anyway!). If AF returns one day, then I will have another ablation the day after to keep away from the drugs and keep my marbles and QAL.
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