How soon is ablation for flutter appropriate ?

[allserene]

Over the last 2 years, I had what I thought were palpitations after heavy gardening with insufficient water in 90 degrees F.... 3 weeks ago I got a 150 beats flutter and ended up in emergency.. They gave me cardizem drip AND metopropol at the same time and stopped my heart for 5 seconds each time and 5 times over.. Scared me as I watched the EKG trace and sank into oblivion! A few days ago and after no more flutter, I decided to get myself off meto..Instead of doing in carefully by step and over 6 weeks, I tried to do it down from 25mg in 3 days.... Got a 170 blood pressurize followed by another flutter at 150 beats... Lesson learned; dont mess with Meto ! Don't ! Seeing the electro physiology guy in July. Fashion seems to be to go for ablation earlier in the process rather than later... Should I push for ablation after only 2 flutters ? They say this stuff is progressive..first to afib then worse and worse ? Here in the US, my annual max costs for 2019 are already within sight, so money is no object... What's the NHS policy on doing ablation early ?

[BobD Volunteer]

Waiting lists here in UK are anything from 6 months to a year for NHS treatment. This is not the main criterion though.

It must be clearly understood that any and all treatment is only for quality of life (QOL) so there are things that need to be assessed. If drug therapy is sufficient to maintain good QOL and rate is well controlled then many people elect not to take the risk of ablation. At the same time, again here in UK, the private cost of an ablation is around £20,000 whilst we had a report last week of a US ablation being billed at $143,000! From this side of the pond the reason is obvious! I do wonder how independent advice given may be in such circumstances.

All that said I am a great advocate of ablation having had three for AF and awaiting one for paroxysmal atrial tachycardia and know that for me early intervention was important. There are many EPs who also think that rather than be a back stop, ablation should be a first line of attack.

One must make one's own mind up I'm afraid and assess how badly your QOL is affected by your condition and act accordingly.

[Cookie24 in reply to BobD]

My recent Atypical aflutter ablation cost $130,000. There were two attending EPs in the OR. My personal EP, who had done my first PVI ablation for afib, was there. He assisted a colleague who was more skilled to handle complex atypical flutter. My EP was pleased that his PVI ablation was intact and the flutter was coming from other regions.

[allserene in reply to Cookie24]

Wow... I am atypical flutter too... My max out of pocket is 5k so hopefully that would be my max so long as its all in 1 insurance year... I feel really settled just now on my water and magnesium diet (lol), but everyone seems to think that it ALWAYS comes back eventually without ablation, so I always carry metoprolol and eliquis on vacation... .......

[Hidden]

I agree with BobD, the sooner the better if you meet the criteria.

I started with AF in December 2015 and it took until April 2017 to get my ablation.

I had several cardioversions and different medications during this time, as well as holter monitors, ECG's, heart scans , sleep studies etc etc.

I wouldn't call it a fashion, If you need an ablation and are suitable, you will get one as you see from BobD's post, they are expensive

[Bob002]

If the Doctor says your a good candidate I would get it done. I had a ablation 4 years ago and it does help. not perfect but make the afib controllable for me. Life was hell before the procedure. The procedure its self is very easy (but scary if you don't know) but very simple and recovery was very fast for me anyway. Feel for you I know what your feeling I have been there afib is very scary if not controlled, does the Doctor have you on something to prevent blood pooling and clotting which can cause a stroke. This is what I would be concerned about the most,

[allserene]

Thanks guys... Here in the US I am on United Medicare which has an annual max of $5,900 'out-of-pocket'.. I must have blown 3k of that already (haven't got the bills yet), so I might as well get the TEE and ablation and MRI and everything I can get before the year end... When I had Cyberknife for prostate cancer, it was initially billed at $222,000 but reduced to around $25,000, and again I paid $5,900 annual max... My mother in England (age 92) got a hysterectomy at 2 days wait and it was great job and totally free to her.... So both systems have their pros and cons...