Now I’m in a quandary - just watched Dr Gupta’s YouTube video “To have an ablation or not - that is the question” He seems to be quite negative against it & more or less saying unless your quality of life is really affected (which mine is not) then don’t have it, as it is invasive & they still don’t know the long term effects & you can still have AF & ectopics, along with the fact it only has up to a 70% success rate.
I would be interested to know your thoughts, as I am waiting for my ablation date after pre op last week.
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Hi HM managing AF for me is about improving and maintaining the quality of life. The first course of action as laid down in NICE is to attempt to control AF with the use of medication. If this fails ablation is then considered.
Lifestyle can also help to control AF so weight loss/health diet/ regular exercise/avoiding stress .
I think this is the approach Dr Gupta takes and one I am pursuing.
Thanks for your response- the thing with me is I am not on any medication (yet) to control my AF. PIP
in case, which I have only had to resort to twice in over 4 years. Also Apixaban. I lead a healthy lifestyle & go to the gym. I do drink wine & G & T, but not in excess. I am 66 & retired now, so work stress has been lifted. I think that had a big factor 4 years ago when it first kicked in.
I just feel I could tweak my lifestyle even more & hold back the ‘beast’ & not go through such an invasive procedure unless it’s totally needed.
It can be a quandary and the motivation for having an ablation has to be driven by improving quality of life. The problem is that AF is a condition that generally, but not always, gets worse. This is probably more important if you are younger, generally fit and very reluctant to rely on very potent medication to control the condition for the rest of your life. We also come into contact with many folk with persistent AF who are happy to take their pills and wonder what all the fuss is about as they lead fairly active and relatively normal lives. Then we hear from medics who say that early intervention is best because it prevents the heart deteriorating and developing other heart conditions so yes, we all understand where you are coming from.
This is why it has to be a decision made based on an EP’s assessment of your own personal circumstances. The only thing I would say is that 1000’s of procedures take place every week all over the world and it is very rare to hear anyone on this forum say that they regret having an ablation.
Then I think I would probably hold off from having an ablation now. Two reasons, one, the overall condition of your heart is unlikely deteriorate from AF unless episodes become more regular and two, ablation techniques could well improve in time. It will be interesting to hear what you decide to do.....every good wish...John
Any and all treatment for AF is only ever about improving quality of life as there is no absolute cure for this condition. There is growing evidence that life style especially being over weight, drinking too much or doing excess exercise can be a factor in AF and changing these can reduce AF burden. Reduced reliance on meat and processed food has also been shown to help.
There are of course plenty of vegan racing snakes out there with AF so nothing is consistent.
One does need to do everything possible to reduce one's risk factors but there will always be some of us who steadily decline as our AF progresses regardless of any changes we make and thank heavens there is ablation for us . If you have managed your symptoms well then I can see why people are reluctant to go the ablation route but AF is almost always progressive and sooner is usually better in these circumstances.
As I say many times the only right answer is what is right for you right now. Just don't look back and say I wish whatever happens.
Not eating meat, dairy, eggs or processed foods may not prevent/cure irregular heart rhythms, however, evidence would show that the chances of stroke would be reduced.
Long-term sustained weight loss is associated with significant reduction of AF burden and maintenance of sinus rhythm. (Long-Term Effect of Goal directed weight management on Atrial Fibrillation Cohort: A 5 Year follow-up study [LEGACY Study]; ACTRN12614001123639). ]
Thanks for this doodle68. So it would appear that not consuming meat, dairy, eggs or processed foods not only reduces the chances of having a stroke, but is also likely to reduce the AF burden.
Hi Pete I do eat a bit of dairy, some eggs but very little meat and no highly processed food . After 18 months on my healthy eating programme and having lost 1.5 stone slowly, my episodes of P-AF haven't got any worse, I am fitter and my body should be in better shape to cope with AF .
Why the mantra ‘there is no cure’? Several of us have been free of the condition for years, after undergoing the Maze procedure, some also after ablation. An electrophysiological problem can be remedied, albeit not in every case.
I feel that such a blank (probably incorrect) statement may deter some from exploring all the available options. Look for answers and you likely find one.
Any and all treatment for AF is only ever about improving quality of life. How can you cure something that you do not know the reason for? Cures are for diseases and AF is a condition. Symptoms are easy to understadn but reasons not so.
Yes many of us are AF free for many years but are we cured.? After over ten years mine seems to be returning or at least some kind of arrhythmia. Is ablation worth it? Absolutely!
Will I have another ablation? You betcha.
I am guided by some of the top EPs in Europe by the way.
2 years post Ablation and I am not sure I did the right thing either but relied on what my Cardio doc's said about it being progressive, no other comorbidities and my P AF was getting worse as I aged into it in my 50's while very fit, still am. I eat healthy, exercise and don't smoke. Drink very little alcohol. STRESS was what brings it to me even today.. Only time will tell if I did the right thing when looking back. The ablation caused and also almost killed me with delivering a powerful Pulmonary Embolism approx 9 days later landing me in the ER. I'm finally off all meds including blood thinners except for carrying 300 MG of Flecanide in my pocket always, just in case. Generalizing we know it gets worse not better. If you wait too long, which is what motivated me, the heart damage may be too far gone for ablation to help very much. I took the leap.
Thanks for your reply. Sounds like you had a bit of a bumpy ride with yours, but have come out well the other side. I was a bit older when my AF kicked in 4 years ago, at 62 & it hasn’t progressed any more (touch wood) since then. If anything since I retired & adjusted my lifestyle it seems I have kept it at bay. This is why I am very reluctant to go down the ablation route at present.
After taking medication route and healthy lifestyle my PAF progressed until it was likely to become permanent. Ablation then seemed to be the obvious choice, which I have not regretted for a moment. Three and a half years later no signs of AF no drugs, BP back to normal. Never give a AF a thought except when reading through this forum. I was symptomatic when in AF so my life is very much improved. Ablation results for PAF can be 80% first time success and 90% after more than one ablation. I suspect that if the patient has and maintains a healthy lifestyle, weight, diet alcohol and so on, then they are very likely to fall into the success group.
Thanks for your reply Peter. I am not on a medication route & my AF is not progressing (touch wood). I only have PIP just in case, which I have only had to take once this year. I just feel I am not at the stage which warrants an ablation at present & carries itself some risks.
It was great for me, no real problems and improved my quality of life massively. However if you are experiencing paroxysmal AF that does not impact in a really negative way on your life then I would agree with the doctors opinion, not to be in a rush to have the ablation but keep an eye out any worsening symptoms.
That’s exactly what I thought. But when I saw the consultant last week he said that I have a slightly enlarged area of the heart which would get worse if not addressed by ablation. I would then start to get breathlessness which would “ruin my life”. As I am still “young” (I’m 63 and have not been described as young for a very long time) I should have the procedure. I don’t know if it could be deferred for a year or so or not.
I would like to ask if it could be deferred for a year too
I’m going to be faced with a similar decision shortly as I have been referred for an assessment for ablation. I guess you could simply ask the EP for his views on Sanjay Guptas video (make sure you have a detailed and accurate account of what SJ says in case he is unfamiliar with it). According to Wikepedia one study shows the success rate is only 28%. Of course, there is variation according to the type of arrhythmia you have. A very difficult decision. I also plan to ask what are the likely consequences if I *dont* have the procedure or postpone it.
Good advice. I’ve never had an assessment for ablation - I just saw a cardiologist 14 months ago & because I’d had a couple of AF episodes he put me on the list. But since then I have only had a couple of episodes, which responded to PIP.
Had my pre-op last week & now waiting for procedure date, which is why I am in a quandary as to whether to go ahead with it, but if I decline then I will be placed back on the list to have to wait again for over a year. I know everyone says it gets worse, but since I retired 2 years ago (less stress) I feel I have it under control. Agghhhh what to do!!
I think just ask him what the probability of it progressing to permanent over one year is (in which case it would be much more difficult to ablate) *or* of it causing breathlessness or becoming debilitating over one year. He should be able to give some sort of estimate- you could ask him to get back to you on a few days if he cannot product one immediately.
I believe that in many cases AF could be avoided or symptoms lessened by addressing a number of common causes; See link below and look at ;
"Possible causes of atrial fibrillation". There is a possibility that AF could be eliminated by lifestyle changes. In some cases nothing but medication and/or ablation will help. Enlarged hearts can improve if things like high blood pressure are addressed, perhaps a delay may be in order, with the agreement of your consultant if you are going to address certain problems.
Hi , when I had paf it was every now and then , I was told by ep it would progress but I choose the healthy lifestyle option and declined the ablation, but 2 years later it went permanent , neeedless to say I was back at the ep’s clinic and consequently an ablation which was 14 months ago and no af since . Incidentally I had a surgical ablation , I suffer epotopics daily for which I take magnesium which helps
That’s lucky for you. I have read that when it becomes permanent it is not usually successful. But that gives me hope if I decide to put it on hold for a while.
Check out "Cabana trial" or " ablation versus drugs". Both provide plenty of information though unfortunately nothing really conclusive. Statistics are all well and good but very difficult to be totally random and can be skewed by data manipulation. In the U.S. Ablation is a massive revenue earner which may be a factor in its favour. Personally if I'm symptom free then maintain the status quo and follow the guidance of the professionals.
Funnily enough my cardiologist asked me 14 months ago if I would like to take part in a similar trial, which I agreed to, but then I had a letter saying that the professor/team were no longer going ahead with it & I was automatically put on the ablation waiting list.
Hi there, I'm in much the same situation, and in fact when I received the call last week about my ablation date (after 8 months on the waiting list) I declined and told them to please remove me from the list. I got the impression that they were not best pleased but hey, it's my heart and I'm pretty sure there are folks suffering greatly with their AF that need that date much more than I do. I have had two cardioversions and since my last one in April this year I am still in NSR. I still get thumps and weird pauses and stuff but it doesn't affect me and doesn't go into AF.
Dr Gupta's video was only one of the factors I took into account when making the decision.
I know how you feel. I think I have come to the decision not to go ahead with it at this moment in time, as my quality of life is not affected & I am not on any medication (yet - fingers crossed) except Apixaban & PIP if needed. I just don’t think it’s going to change anything - I can count on one hand how many episodes I have had in 4 years. I know this can change & probably will. I think I will watch my lifestyle & pray it doesn’t progress any worse.
I either accept permanent Afib or an ablation. At the moment my hr doesn’t go above 80 in an episode and EP has prescribed Dronedarone as Flecainide doesn’t work, but think I will go down the permanent route.
Hi. Well that’s a coincidence because I just had my ablation yesterday but since I couldn’t sleep during the night, I came across that same video. After watching it, I literally dialed the medical center three times to cancel but hung up. I was thinking and thinking and driving myself crazy. I kept thinking how the doctor left me a five hour window for the ablation and now he was going to have nothing to do the next morning LOL. I finally decided to just go to sleep for a few hours and go through with the procedure. I’m glad I did that. I have a feeling I’m going to be in very good shape. I really do feel for you because I went through the same thing. I also do not have life changing events happening because of a-fib. I do hate being on medication for anti-arrhythmia and feel it was worth it to me if I can get off of that.
I had my first Ablation in September 2017 aged 50 for AF which was present on and off during the day and triggered during the night. I am a slim healthy female who doesn’t drink or smoke. I was advised possibly caused by a genetic predisposition and environmental factors. The latter I suspect stress and emotional grief of loosing my dear Mum.
I was AF free for 7 months.
I had several large episodes of Nocturnal AF. I went to surgery yesterday for my second Ablation to thankfully find all veins successfully isolated last time. However I now have AF it the other Atria nearby the sinus node. Unfortunately this could not be Ablated due to location risk. My AF appears to be triggered by resting heart rate dropping; vagally induced.
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managing AF for me is about improving and maintaining the quality of life. The first course of action as laid down in NICE is to attempt to control AF with the use of medication. If this fails ablation is then considered.
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