Deciding when to have a 2nd Albation?

[kitenski]

I'm just past 3 months ablation, things have been improving (as can be seen from the red/green in my chart attached). I've been using my Kardia 3 times a day, Red is an A Fib reading, green is normal.

I'm also on Flecanide 2x 50mg a day. Just come back from seeing my consultant. He was quite surprised by how big the improvement was since last seeing him. With his ok and guidance I've been exercising, whilst keeping my HR low, and slowly building up.

The current plan is to reduce flecanide to 1x50mg a day until Monday then stopping altogether to see what happens. If afib comes back straight away I'll go back on it and book a 2nd operation.

He kind of thinks he may need to do a 2nd operation, but also said the heart likes being in A Fib so does need retraining so time may also help.

For those who've had 2nd ablations, did you have it done quickly after the 1st one or wait?

[BobD Volunteer]

No in my opinion not a good idea. We find people improving nine months or more after their ablations. I waited a year between each of my three to be sure.

[pottypete1 in reply to BobD]

It is now over 18 months since my last ablation and things continue to improve.

Clearly we are all different and so are the results of each individual ablation but I agree with you Bob I think kitenski should wait a while longer before accepting another ablation.

Pete

[kitenski in reply to pottypete1]

pottypete1 BobD thanks for the replies, what prompted you to wait, and also what then made you make the decision to have the 2nd (or indeed 3rd) ablation?

Did you stay on anticoagulants all the time in between?

[BobD Volunteer in reply to kitenski]

Absolutely If you have AF you need anticoagulation. I'll never stop taking warfarin.

Since it takes at least six months to see if things improve there is no point in going too soon and with waiting lists around six months that is about what it takes. To be honest after my third it took me nine months to come off my antiarrhythmic drugs and I know that it was only really after a year or so that I started to feel comfortable about it having gone and life returned to normal whatever that is.

[kitenski in reply to BobD]

There are folk I know who had a succesful ablation and are no longer on anticoagulants.

[dmac4646 in reply to kitenski]

Presumably they are happy with the stroke risk against all the evidence that makes clear that successful ablation does not reduce the need for anti-coagulation ?

[BobD Volunteer in reply to kitenski]

IF your Chadsvasc score was zero and you only went on anticoagulatants for the purpose of ablation and recovery then there is an argument that since you did not need it before then you don't afterwards.

I do not necessarily subscribe to that argument as it has been shown that ablation itself increases stroke risk due to changes in the internal surface of the heart promoting eddy currents. Your choice of course but how do you know you no longer have AF. Many people are not aware they have it until the stroke hits them.

[kitenski in reply to BobD]

yes good point, I'm keen to get off them as I want to keep playing field hockey!

[Kaz747]

I had 6 1/2 months between my last 2 ablations. My last one was 6 weeks ago and I now feel amazing. I had an extreme reaction after the September ablation. I was back in hospital within 2 weeks with almost constant AF with a rapid heartrate. I had chronic inflammation, pericarditis and gastritis. Even a combination of strong drugs (including Amiodarone) couldn’t control things. I had no option really except to head back to the cath lab. Had I been feeling okay with occasional episodes I wouldn’t have been back so quickly. I wanted to hug my EP when I saw him earlier this week. I finally feel like I have my life back.

[Kaz747]

I had 6 1/2 months between my last 2 ablations. My last one was 6 weeks ago and I now feel amazing. I had an extreme reaction after the September ablation. I was back in hospital within 2 weeks with almost constant AF with a rapid heartrate. I had chronic inflammation, pericarditis and gastritis. Even a combination of strong drugs (including Amiodarone) couldn’t control things. I had no option really except to head back to the cath lab. Had I been feeling okay with occasional episodes I wouldn’t have been back so quickly. I wanted to hug my EP when I saw him earlier this week. I finally feel like I have my life back.

[jeanjeannie50]

I waited 2 years after my first ablation and 3 years after the second. So have had three ablations in total.

[kitenski in reply to jeanjeannie50]

jeanjeannie50 thanks for the repy, what prompted you to wait, and also what then made you make the decision to have the 2nd and 3rd ablation?

Did you stay on anticoagulants all the time in between?

[jeanjeannie50]

For a short while I thought the first ablation had worked, my heart didn't bang in my chest so much when I walked up hills. I had thought everyone's did the same. Then, very quickly, my AF attacks started happening more often. My EP decided another ablation could cure it, but it didn't. I was then told I wouldn't be suitable for any more, but afterwards my heart episodes grew worse and a copy was sent to my EP, he called me in suddenly for the third one. I think I had a telephone call on the Friday to go in on the following Wednesday. After that one I did feel better immediately, I still have AF but nowhere near as bad as it was. Once again I've been told I'm not suitable for any more and that I'm just one of those people not helped by ablations.

Yes, from what I can remember, I stayed on anticoagulants from before the first ablation to this day.

Jean