Appointment for assessment for ablation.

My appointment for an assessment for an ablation has now arrived- it is on the 30th January. I have just read on the AF association website that the procedure is carried out shortly after the “pre-operative assessment”. Does my initial assessment fit this description and indicate that they will want to do the procedure shortly afterwards? Or is there usually another pre-assessment when the procedure is immament, after around 6 months? I must say that I hope it is the latter. The hospital is St Bartholomew's. The more I read about the procedure the more alarming it sounds.

[Fazerboy]

Hi, I assume others will post with better advice regarding the timescales but I would ask you to step back a bit. You mention "they want to do the procedure" etc. It is your decision not anyone else's. You need to consider why they are recommending an ablation. How is your quality of life at the moment? There are risks with any procedure but you need to balance the risk against the potential better quality of life after the procedure. If you think the risks are too high then don't have it. You could always have it later if your condition worsens.

I'm on a waiting list for an ablation at the moment because I was getting symptoms of SVT (not AF or I don't think it is). I'm wary of the ablation as I don't need to take any meds and it doesn't really affect my lifestyle so I'll probably decide against the ablation. Others though who were suffering seem to be saying that the ablation improved their quality of life. It really depends where you are on this at the moment. It is your decision though and there is no right or wrong answer. Good luck.

[Hidden in reply to Fazerboy]

You have correctly identified the dilemma re ablation: the procedure carries *immediate* risk while most of the risk from AF comes in the future. I have PAF- at the moment I don’t get breathlessness etc. but I have been told by a consultant that my heart will enlarge and then I will develop other symptoms. He didn’t give a time-scale for these. The idea is to intervene early and, perhaps, stop this trajectory.

[wilsond in reply to Hidden]

I am exactly the same!on the horns of this dilemma myself.I feel I can cope with my quality of life at the moment as af and aflutter symptoms are pretty well controlled with medication,and effect of leaving stressful job

.Will I feel significantly better after the double ablation? Will my stroke risk be reduced? (Not proven yet if ever)

will the scar tissue attract possible blood clots?

Have asked for a clinic appointment with my EP Dr Osman to discuss it all.When he advised me ref ablation,it was in April 2018 and to be honest,I didnt know much about ablation until I read up on it here and elsewhere.Have been talking to Dave,who says he felt a lot better afterwards,but Im still pomdering!

I have had several major operations,its not the thought of surgery as such,but whether such an invasive proceedure in my heart is justified.

Now I have questions! Brought it to a head as I too had an appointment at the cardio clinic sent through for Dec 13th,which when I rang up to ask what it was,was for pre op.

I was told proceedure follows within 3 weeks usually,so have asked to speak to Dr a.s.a.p. The consultant doesnt work there on the day of my clinic,and although the arrythmia nurse is very helpful,I feel i need to speak to the main man!

Sorry for long post about myself,cant really help but wanted to let you know you are not alone! PM if you want.

Best wishes

[Cat04 in reply to wilsond]

I have trouble getting past the telephone gate keepers (I call them the Rottweilers,unkind I know, they are only doing their job) but the person who answers and deflects my calls from the arrhymia nurse and Eps secretary does send emails to the relevant people. There is a 3 month waiting list to speak to my EP but his secretary does put my issues before him, gets a reply and then rings me back.

[Hidden in reply to wilsond]

My understanding is that ablation doesn’t reduce stroke risk.

[Alessa69 in reply to Fazerboy]

Interesting post. Like you, I had, what had eventually been recorded on ECG as bouts of SVT, which Cardiologist had said, we can treat this, we can book you in for EP studies with a view to an Ablation. I had developed a patient relationship with said Cardiologist over an 18 Year period of deteriorating health that stage, and whilst I trusted him totally, with no fear of Angiograms etc, but I struggled to get my head around the Ablation idea. I used to be very fit, and did a job which put my heart under great stress, over exercise and life stress had taken its toll. I was in the fortunate position of having insurance, so at least I had a reasonable amount of choice re timing etc. I kept on dragging my heels, as at that stage , my GP had advised caution& to take a wait & see approach.So , I dragged my heels, went back to see Cardiologist/EP a couple of times, asked more questions & still struggled to get my head around it all....then this summer, another SVT episode kicked off late at night, which concentrated my mind somewhat. I eventually motivated myself &reluctantly booked in for EPstudies/Ablation......Thankful that I did.Well dear reader, turns out it was not benign SVT as shown on ECG but AF... they had to re-start me 3 times to get me back into rhythm! Am now on Rivaroxaban , Flecaneide if needed as PIP. I had explained my fears to Cardiologist/EP and they gave me sedation. The overwhelming relief to have got through that and now actually know what I’m up against is fantastic. If I had left it, my stroke risk would have been high.I am thankful it’s done , and I can get on my life , reducing my risks as much as I can. We are all so different, I’m grateful to have found this site, wish that I had had all this info a few years ago, I would not have wasted so much time! Good Luck, stay cheerful and keep a positive view on Life, it’s really important!

[djbgatekeeper]

Hiya, I went for my assessment on a Thursday and had the ablation the following Friday so 8 days later. That said I was asked not told, because I was sick to the back teeth of the AF keeping me awake at night and disrupting my life completely I could have hugged the EP when he said next week.

When I got home that day I did have the jitters but when your QOL is so poor it tends to be Hobsons choice really. As it was the ablation went well and I'm feeling much better so glad I went ahead. The choice is and always will be yours so chill out and have a think what's best for you 👍

[Hidden in reply to djbgatekeeper]

Well, I will certainly go to the assessment and have a long chat with the EP to see what he thinks. I may be jumping the gun a bit.

[BobD Volunteer in reply to Hidden]

There is an old saying "When the pupil is ready the teacher will come". It is thus with ablation. The only proviso is that delays can mean less chance of success so think long and hard.

[Fazerboy in reply to Hidden]

Exactly. Long chat. Write all your questions down over the next week or so and then you can come out of the meeting with a clearer understanding of all the issues. I would take someone with you as well so that they can also listen to what is said, if you are too involved you don't always take it all in at the time.

[Hidden]

First, the EP will advise a treatment plan. If this is to include an ablation, you will go on a waiting list if you are on the NHS. Then you get dates for a pre-op assessment which is followed by the ablation a week or so later. Waiting times seem to range from 4 to 12 months.

[Hidden in reply to Hidden]

Ok thanks.

[Cat04]

I waited 9 weeks on the NHS waiting list, had one weeks notice by phone of the ablation appointment, no pre-op appt, was told on the phone which drugs to stop 5 and 3 days prior to admission. Into hosp 8am and climbing up the step ladder to the table in the cath lab at 9am. No time for nerves, everything happened so fast!

[wilsond in reply to Cat04]

And how bad were your symptoms and how are you now please? Hope you are well xx

[Cat04 in reply to wilsond]

My symptoms were well under control on Sotalol only getting AF for a couple of hours 3-4 times in a year, plus daily skipped/extra beats etc. My ablation was 7 weeks ago and have been in NSR since. I had pericarditis and oesphagitis after the ablation (readmitted for 6 days) which was not pleasant and still have pain in my chest from it although all echos and scans are good now.

Getting there slowly is a good description of my recovery ☺.

[Hidden in reply to Cat04]

Which hospital was this if you don’t mind me asking?

[dmack4646]

I assume you have tried any drugs and they don’t work ?

[Hidden in reply to dmack4646]

I am on Sotalol, which has suppressed but not eliminated symptoms.

[dmac4646 in reply to Hidden]

That’s a shame

[Hidden in reply to dmac4646]

I’m not really sure how many times I would have to get PAF per year to warrant a referral for an ablation.

[dmac4646 in reply to Hidden]

Think it is how troublesome it is that will make the call - how it affect your QOL - there is no cure but if nothing else works and you are suffering a lot that will make uo your mind..

[Hidden in reply to dmac4646]

Yes that’s true Thanks to you and everyone who has replied to this. I have not replied to very many posts because of the O2 outage today.

[Paige70]

I had an cryo ablation at Barts in January 2017. I had put it off for several years and during that time procedures had improved. In the end my quality of life had deteriorated and meds weren’t working. I had several appointments over the years with an EP where I asked lots of questions. After I decided to have it done about 3 months later I had a pre- op assessment with a nurse where bloods and swabs were done and we had a discussion about it and they then said I would have it done within 6 weeks otherwise I would have to go back for the tests again. I had the ablation about 5 weeks later but it was probably delayed because of Christmas. I felt quite tired and a bit rough and really wasn’t up to doing much for at least 3 weeks and it took a while to feel better but I had bronchitis during this time.? I am much better now tho still have occasional episodes of a few minutes/ seconds. I would say I was still improving after 6 months, and I am glad I had it done. The Arrhymia nurses are helpful for more info, tho you have to leave a message and they will phone you back.

I hope this helps and all goes well for you.

[Hidden in reply to Paige70]

Thanks. Were you happy with all aspects of the treatment at Barts?

[Paige70 in reply to Hidden]

I thought the medical care I received was good and the Arrhymia nurses were helpful during the recovery period.

I hope all goes well for you.