husband just diagnosed with Proxsymal AF

[NJM7658]

We just learned 10 days ago that my husband has PAF. He is scheduled to see an EP this week. We are ranchers, around animals, rough tumble lifestyle so we are hoping to have a possible ablation. My question: after a successful ablation will he be on anticoagulants for life? Will he need to be on antiarrythmia drugs for life? The possibility of having a bleed from the anticoagulants is very scary because of our lifestyle. Neither of us want to give up our life as we love what we are living.

[djbgatekeeper]

Hi there, After my ablation for PAF last year I was told to stop all medication when I felt ok to do so. I never took anticoagulants apart from in 2013 pre and post cardioversion. Everyone is different of course and your medical team will advise you but if you have a successful ablation and stay in NSR then I would expect a medication free life there after. Best wishes and I hope you stay well.

[NJM7658 in reply to djbgatekeeper]

Thank you

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As a general rule, the need for anticoagulation after a diagnosis of AFib depends on calculated stroke risk and bleed risk, rather than amount of AFib. Search CHADS2VASC and HASBLED.

[NJM7658 in reply to Hidden]

Thank you for the information

[Wittycjt]

The ablation should fix the problem. It should reroute the hearts conduction rhythm/ pathway by burning out its current inappropriate pathway🤞🏻Best of intentions, Cindy in Delaware

[CDreamer]

Hi and welcome.

First thing to note is that advice from different EPs differs - hugely.

Second - as this is predominantly a UK forum - the advice in Europe and US also differs. In UK the advice leans toward anti-coagulant for life because of the risk of stroke which in most cases will be higher than risk of major bleeds, however, it is an individual decision and you will find very different advice.

Just because you have an ablation does not mean you will never have another AF episode as many episodes are silent so unless you are continually monitored - you wouldn’t know - therefore the risk may continue.

The anti-arrythmic drugs are a different story. Most will take these pre and post ablation for up to 3 months but providing there are no unusual rhythms they are normally stopped.

May I suggest you visit the US version of the AFA - Atrial Fibrillation Association - heartrhythmalliance.org/afa/us for all information on AF and it’s management and treatments.

It may also help, as it has a lot of us, to research ablation by putting the word in the search box and reading the threads as experiences and outcomes also vary. Although ablation helps many people, it doesn’t work for everyone. I had 2 ablations and still have AF although the second gave me 3 years free of it.

Keep reading - you will learn so much from this fantastic group of informed and supportive people.

Best wishes CD.

[NJM7658 in reply to CDreamer]

Thank you for the link and advice!

[BobD Volunteer]

If your husband has a stroke risk due to AF at present, then current knowledge says that ablation does not remove that risk so anticoagulation may be lifelong. if on the other hand he is only put on anticoagulation for the purpose and duration of the ablation then it is possible for it to be stopped after the recovery period. It must be understood that there is no cure for AF and that any and all treatment is only for quality of life and that it may return at any time. Life style modification is important as many have found but doubtless with your occupation you will not want to accept that reducing meat intake and a move to a more plant based diet has helped so many people to reduce their AF burden. Maintaining a healthy BMI (25 or less) avoiding NSAIDs such as ibuprofen, artificial sweeteners such as aspartame and avoiding processed foods and of course no alcohol all benefit we AF brigade.

[Txellen in reply to BobD]

Can you tell me where I can get more information about the reduced meat and plant based diet to control fib? I would be very grateful!

[BobD Volunteer in reply to Txellen]

Start by looking up Legacy Trials and use search box top right. There are a number of doctors who have been promoting weight loss and diet as a means of reducing AF burden so there should be plenty out there.

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The latest view is that an ablation does not necessarily lower stroke risk (it was formerly supposed that it did) and so it’s quite likely that he would be asked to continue with anticoagulants after the procedure. However this might depend on his CHADS -VASc risk. If it was 1, it might not be absolutely necessary (although most doctors, in the UK at least, seem to argue for it even with CHADS- VASc1). Also, he would probably be put on anticoagulants for some months before the procedure. I have PAF and its an absolute pain in the neck.