Very confused about ablation - Atrial Fibrillati...

Atrial Fibrillation Support

31,217 members36,864 posts

Very confused about ablation

Euve profile image
Euve
20 Replies

I am now talking to different doctors about getting an ablation they all agree that I need an ablation but all of them say the same thing I am doing it for quality of life and my heart is strong I've had A-fib since 2014 and it has gotten progressively worse I get it every few days I take tenormin flecainide and a blood thinner they say I am low risk but yet they recommend ablation because I am feeling the afib it's been very Troublesome to feel it the episodes it can last anywhere from 2 hours to 26 hours when I asked them about heart failure they said that is not in the cards I don't understand the correlation between afib and heart failure and if you don't get the ablation can you get heart failure later on, do higher heart rates during the episode make a difference if you are having an episode and your afib is at 90 or a hundred is it the same as being a 170 or 180 the doctors tell me to get the ablation but then they said if I did not feel the a fib it would not be necessary and I'm concerned about getting progressively worse or getting persistent afib Which is less successful for an ablation can someone please educate me on these points and especially possibly getting heart failure if I did not do the ablation very much appreciate it I'm glad I found this group thank you

Written by
Euve profile image
Euve
To view profiles and participate in discussions please or .
Read more about...
20 Replies
Globe-J profile image
Globe-J

Hello Euve

This summary may be of some benefit: virginiaheart.com/areas-of-.... I am sure, you'd be glad to find a drug-free solution.

While ablation may not fix the problem, give it a try. If not, there are more invasive, possible, solutions.

My best wishes

J (-:

CDreamer profile image
CDreamer

Hi and welcome. What your doctors have told you seems perfectly reasonable so I’m not at all sure what it is you are confused about?

You seem to have picked up from somewhere (?) that AF is progressive and can result in persistent or permanent AF which will then = heart failure which is not at all my understanding. Yes, some people with AF go on to develop heart failure which is the failure of the heart to pump blood effectively throughout the body but that it often because of other malfunctions of the heart, not simply because of the AF.

My understanding is that it is the rate rather than the rhythm which causes concern and that is why if you were to be in persistent fast AF (a rate permanently over 120) which would be undesirable. I have been in tachycardia (fast HR) with or without AF for days and been able to function, not well, but function.

Ablation is often offered to younger people with AF (under 50) as a first line treatment as an alternative to a lifetime of taking drugs such as Flecainide which is not a drug most people would want to take permanently and indeed, for some people, often fails to be effective at stopping AF in the longer term.

At the end of the day, it is your choice - are the AF episodes so troublesome to you that you find everyday life difficult? If the answer is yes then ablation is a possible route to take.

Many people have found that lifestyle changes have made a huge difference to reducing what is called ‘the AF burden’ ie: how much it interferes with your life. Lifestyle changes = managing stress, getting enough quality sleep, eating well and not too much and getting enough exercise.

I wondered if you had been given any advice on this and how to achieve this as many doctors now believe that Lifestyle changes can be as affective as ablation at reducing or eliminating AF.

Best wishes CD.

Euve profile image
Euve in reply to CDreamer

Thank you for getting back to me I guess my question is can I live with afib long-term effects on my heart?

CDreamer profile image
CDreamer in reply to Euve

How long is a piece of string? I’ve had AF for more than 11 years now, had 2 ablations which gave me 3/12 AF free for which I was grateful, I now have a pacemaker and never felt better since AF started.

Everyone’s AF journey is very individual and dependent upon age, other health issues such as diabetes or cardio-vascular disease, fitness levels, alcohol consumption, stress and how you cope with stress etc, etc.

Read through the posts and you will see the youngest poster is 18 and the eldest would be into their 90’s. Many have lived with AF in either Paroxymal or Persistent or Permanent for more than 30 years and still work, travel and live a reasonably normal life although some need to make adaptations to their life as they are unable to do all the things they used to.

Treatment to treat the AF is purely for QOL so take note of Bob’s post because he’s been around longer than most of us and has a lot of knowledge and experience. The important bits are anti-coagulation and after that rate control - but know that a normal heart rate is considered 60-120 so it’s really only when people get very high or very low sustained heart rates that there is cause for concern. You will read posts of people with AF having HR of 200+ OR the low 40’s - it that case I think we would all be saying perhaps you need to see a doctor or go to A&E.

I don’t worry until mine is +180 and has been for more than 5-6 hours but I can usually get it to settle by doing slow breathing and relaxation techniques.

Anxiety is our biggest enemy so finding ways to manage that is absolutely crucial.

Best wishes CD

Joybel profile image
Joybel in reply to CDreamer

Heart failure, which occurs when the heart can't pump enough blood to the rest of the body, is one of the most common complications associated with atrial fibrillation. Once patients with atrial fibrillation develop heart failure, their risk of death significantly increases.Aug 23, 2017

CDreamer profile image
CDreamer in reply to Joybel

However, most do not progress to heart failure when AF is treated and HF can also be reversed if NSR can be established & maintained.

Joybel profile image
Joybel in reply to CDreamer

If we are honest about what might happen we can be more intelligent about our life choices and protect ourselves to the utmost degree.There is no point in ignoring the science by saying 'most' don't progress to something. If we bury our heads in the sand we end up being reactive rather than proactive and I know which one is the safest! It’s worth every inconvenience, in order to live longer, and be the healthiest version of ourselves so that we can enjoy a good and long life.

CDreamer profile image
CDreamer in reply to Joybel

And when you have someone who is very anxious it’s not a good idea to raise anxieties as worry = inflammation = illness.

Of course we should be proactive but not to the extreme that all we think about is our health and catastrophising about what this or that symptom might mean.

Joybel profile image
Joybel in reply to CDreamer

As someone living with PD,RA and AF being well informed has been a very important tool for my survival. A very distinguished surgeon and oncologist once told me to read read read, take it all in, be aware of the pitfalls and then put strategies in place to be the best I possibly can. I have and I do.

CDreamer profile image
CDreamer in reply to Joybel

I so agree. I think it is also part of a patient’s response ability to look to themselves and lifestyle and be an active agent in their own wellbeing.

I also have had a number of chronic conditions - colitis, AF and Myasthenia gravis for the last 5 years. It is hard to manage them all and without being diligent about my conditions I probably wouldn’t have survived at least one incident because so few people know anything about Myasthenia and what can happen very suddenly. Thankfully it is mostly controlled these days although it took a long time.

RA is such a difficult and painful condition to control. Best wishes.

BobD profile image
BobDVolunteer

If your rate is well controlled heart failufre is extremely unlikely. If you are well anticoagulated stroke risk is drastically reduced. Yes any and all treatment for AF is only about improving quailty if life (QOL) so if you are well controlled and the symptoms are not too troubling then why take the risk. Ablation is not risk free. For me, ablation was the only answer as my symptoms were so dibilitating so three procedures eventually stopped my AF although I still do have other arrhythmias

Love100cats profile image
Love100cats in reply to BobD

Hi BobD , interested in your last words. It seems the more I learn the more I realize I don't know. I had tachycardia and it took about 3 months to get heart rate beliw 100 b.p.m. using bisoprolol and furusemide. So what am I left with? Cardiologist describes it as 4 horses all galloping out of sync. Nurses say my plumbing is fine but electrics not. I'm definitely improving and feeling much better. I'm happy with my current treatment. Is it a Arrhythmia problems now? It's described as permanent Afib.

in reply to BobD

Doesn't stopping the arythmia stop thicken of the walls I thought they did it to prevent that occurring not just cos its more comfortable for the patients quality of life. That it has a structural effect over time so removing the afib prevents structural decline?

BobD profile image
BobDVolunteer in reply to

Two years ago I wrote this and it is still true. So long as rate is well controlled and the patient is anticoagulated there is no difference in morbidity. Many people in permanent AF live normal happy and long lives.

in reply to BobD

Ah that's cool. From what I read the longer you had it the larger the walls of some part of the heart grew creating a thickening of the walls that made the chamber smaller and preferentially enlarged one side instead of the other.... Can't remember which side now...which caused some problem that I can't remember the details of. When yohre new to this you read all manner of things which seem relevant but then turn out not to be.

secondtry profile image
secondtry

Hi, clearly the episodes are trouble some and need to be stopped. In the early days I had 9 episodes in a month (varying lengths), 2 cardiologists and an EP suggested ablation, I requested an increase in Flecainide to 200mgs/day and that stopped them. I then took an Mg compound incl Taurine and Co Q10 plus other lifestyle changes and felt better. No problem now for 5 years.

barbly1 profile image
barbly1

I thought I read somewhere that if you live with afib for a time rather than getting an ablation or controlling it with medication that the heart remodels and the electrical pathways and signals that are misfiring and causing the afib become permanent, and that they then become harder to fix with an ablation further down the road. That's what my cardiologist in the US told me anyway when recommending that I promptly get an ablation after having only two episodes of 220+ and medicine wasn't working. They are also of the attitude over here that the ablation will fix the problem. No discussion of just improving qol.

Buffafly profile image
Buffafly

If it helps, if I were you I would have the ablation and here's why.

Your quality of life is poor and will probably get worse.

Taking drugs for AF all your life doesn't do your body any good to say the least.

If you don't have it now you may go into persistent AF which makes a successful ablation less likely.

If you don't ever have it you may go into permanent AF. You may not feel the AF so much then but if not well controlled your heart may be damaged in the long term. I don't know your age but if you are already old you don't need to worry about that as you are fit now.

You seem to have understood all these points very well already so what I think is that you are worried about having the ablation and looking for an excuse not to have it, or a powerful reason (heart failure) to convince you to go ahead. As you are in the US cost may also be a factor?

I felt the same but as I couldn't tolerate the drugs any more I had a choice between a pacemaker or an ablation so I opted for the ablation with the pacemaker as a backup plan. Many people whose AF treatment hasn't worked or is no longer suitable have pacemakers and that seems very successful.

Really you have to decide for yourself whether you want to go for the ablation or continue as you are and put up with the consequences whatever they may be.

Most of us have been very nervous before our ablations so we are here to support you if you need it, best wishes 💜

inezelsie profile image
inezelsie

Hi Euve - I ended up with heart failure last year after ignoring my non-stop afib for several months. I felt fine and was able to do what I wanted during that time, until suddenly I found I couldn't really breathe when lying down. I finally went to the ED and after having an echo cardiogram learned my ejection fraction was 25% instead of the normal 65%. I had a cardioversion which lasted only 12 hours, so then I was put on amiodarone. It worked within a few days, and I stayed on it for about 4 months. My ejection fraction returned to normal within 3 weeks, and is still normal. My cardio heart failure specialist said he doesn't need to see me anymore, so the heart failure wasn't a permanent thing. I think they need to come up with another term for the conditions that are lumped together as heart "failure". I'm still dealing with occasional episodes of afib, but they usually only last a few days, and rarely go above 130.

When you have afib your heart is spasming...imagine your arm was spasming...after a while the walls of the heart start to get thicker from all the overwork that's happening. Just as yoir arm muscle would get bigger and bigger if it keeps spasming. OK your arm isn't a problem but your heart is...if the walls get thick the volume inside becomes less ..and I can't remember exactly what happens. Also the medications put you more at risk from things like high blood oressure and arterial or artherial sclerosis..hardening arteries. so if they can stop it that's preferable. Of course it would be nice if they checked you didn't have a causation. Since many causes are known. Yet ignored. Not spoken of. Not part if the conversation for some strange reason. If you find a cause you could fix that and not even have a problem any more. Its worth investigating in case you're lucky like me and just needed an essential item. Of which there are many and a lack of which may cause all sorts of arythmias. if they've already done all that for you and none of it worked then ablation stops the cause of further heart damage... Its all cause and effect..every action has a reaction... You stop it wherever you can along the line. But at source is the best place to stop anything...if you can find a source... Maybe the source is actually so obvious for doctors that they just ignore it I don't jnow if baffles me.

You may also like...

Confused- ablate or not

(always a different one) since being diagnosed with lone afib a few years ago, I’m confused! My...

Confused after Ablation today

what he meant by complete heart block . He didn't seem too worried or am I getting confused as I...

A question about ablation procedure

for an ablation next month during the ablation do they speed up your heart to see where the afib is...

Positive thoughts about having an AV node ablation.

years. The AFib became progressively more troublesome and eventually I was in permanent AFib. Over...

Ablation or not. I'm so confused..

years old and am on flecainide after several trips to emergency with a heart rate of 170 to 200....