I was schedules for an ablation on March 22. It was cancelled because my EP felt I was managing pretty well on medications. I take Flecainide was PIP but now 50 twice a day and Eliquis and I take Bystolic as needed when I am in AFIB that wont quit. I get it pretty badly when it does come on. My HR goes to 140-150+ , Im super dizzy and my gait is off. The Flecainide does help brings me out in 2 minutes to 3 hours.I am rescheduled for an Ablation for the 12th of this month but today my EP said I could stay on medications or have an ablation. He wanted me to know I have a choice. I hate taking blood thinners and he said after my ablation I only need to stay on for 3-4 months. He said there are possible issues with long term use of Flec and truthfully it makes my legs ache a bit and sometimes can put me in AFIB (mostly not) though. I feel that I am 62 and have a Chad of 2. I think that I should move forward with the ablation as it is just possible it will work and I will be able to get off most meds. I am wondering what your thoughts are. I really have the Best EP and he cares for professional athletes etc. I figure if he cant get it done no one can. I understand I may still need a second ablation to correct the issue. I appreciate all of your thoughts.
Ablation or Medication??: I was... - Atrial Fibrillati...
Ablation or Medication??
Go for the ablation but I would not agree that anticoagulation may stop afterwards There is no assurance that even successful ablation removes stroke risk and with a Chadsvasc of 2 I for sure would not risk it. I am eleven years post ablation and will never stop my warfarin.
I had an unsuccessful ablation last year which was to correct an arrhythmia that was believed to be causing my heart failure. I then took amiodarone for 3 months which suppressed my arrhythmia and my cardiac performance improved considerably. I didn’t want to remain on amiodarone for life and was offered flecainide to see if that would work, but I realised that I didn’t really want to rely on ANY medication long term.
I was offered a second ablation with an almost certain probability of success but with a significant risk of damage to my AV node. I decided that - if necessary - I wouldn’t mind relying on technology for life. I took the offer and came round from the procedure with a CRT pacemaker. The ablation was successful but - as anticipated- my AV node was damaged. I feel great and I am comfortable with my decision and outcome. I’m now looking forward to being allowed to stop my ‘heart protection’ meds.
Decisions such as these are very personal decisions and, I imagine, are similar to that taken by people who have to choose between a mechanical and a tissue replacement heart valve.
Go for it!
Thank you so much! I so appreciate the honesty and the knowledge you and others provide. Wow! Good for you!!
Go for ablation absolutely, listen to BobD, especially about the anticoagulation, the risk of stroke is 5 times higher when you have Afib. I have been on Riveroxiban for 3 years with the normal scrapes and finger cuts and no problems with stopping bleeding, it takes a few seconds longer.
I agree. I am on Rivaroxaban and was told I need to keep taking it after an ablation. I am still on Bisoprolol and wish I could come off that. I did not tolerate Flecainide!
Ablation was the way for me last year, I too felt really bad when in AF and Atrial Flutter, since the op I have been great apart from a few ectopic beats, off all meds except anticoagulant rivaroxaban which I have no problem with.
All the best, I hope what ever you decide it's the right choice for you.
Thank you😊
Hey Horse - my AF episodes have always been pretty much asymptomatic but they have been quite frequent, maybe 6 hours each 6 days, 8 days each 8 days etc. I put up with that for 3 years then found a confidence inspiring EP (as you have done) at around the same time that my frequency/duration had climbed by about 50%. Six months ago I had a cryo ablation of the pulmonary veins, I am still on all my meds but about to drop the rate and rhythm control, keeping the anticoagulant and Antihypertensives. I have been lucky and I’ve had no measurable AF since ablation. In my opinion, if you have a good EP, take the ablation option - the downside risk is always present but the upside is quite substantial. Best of health to you.
Thank you for your comments. I’m so glad that it helped you. I had breakthrough afib last night even taking the flecainide which is a first I know that it’s progressing. It’s interesting that now that I’m on flecainide regularly I don’t have BP problems. Prior I had to take BP meds in a higher dosage. Now a very low dose. I’m thinking that even when I’ve been in NSR it’s not as efficient as when I take Flecainide .
Oh Horse57, what a question! I think there is no answer to it really and it's down to personal choice, but here's my pennyworth:
People who have had successful ablations, say go for it and as it helped them then that's right as they see it.
People who haven't had successful ones, perhaps because of the severity of their AF and find themselves even worse (that was me after having two) may say look to your diet first and ablations are damaging to the heart, I was once told by a cardiologist while in hospital that ablation scarring had probably made my heart stiff! I had a third ablation and lo and behold was so much better afterwards (or was it my new healthier, plant based diet).
Have you tried changing your diet to a more plant based one and avoiding all food with artificial additives?
New ideas for curing/helping AF are popping up in the news all the time, the latest being a simple device that clips onto the ear sending a pulse to the vagal nerve. Should you wait and see how different methods for cures progress?
As I said, there is no firm answer really and I cant recommend any course of action. Unfortunately, it's you that has to weigh up all the pros and cons and decide.
Good luck.
Jean
I did see that clip on the ear study. I am on a 90 percent plant based diet. I ear or try mostly organic no caffeine. I do need weight loss about 25 pounds. I am. Dry active but what bothers me is that I can’t take my supplements like Tumerick or other vitamins that I like to take because they put me in a fib. I didn’t think about the part of the scar damaging your heart but I wonder what type of damage it does if people have a Blasian’s and they live many many years without issues from the ablation. Now in your case you’re saying that it made it worse but now you’re better possibly because of your plant-based diet. What I hate is that it just pops up out of nowhere and it’s so frustrating because I feel like I can’t even plan on doing things because it gets in the way of my quality-of-life. Thanks so much for your comments
I was a vegetarian for 12 years in my youth, and have eaten mainly organic food since and never processed foods not fizzy drinks or colas. Now, I eat a lot of fish and a tiny portion of meat on the rare occasion. Also, I just love vegetables, especially greens and salads. I am not overweight (more heading towards underweight to some people!) BUT here I am with both AFib and Atrial Flutter.
How often is your Afib and Flutter? Have you had an ablation?
I had an ablation for atrial flutter a couple of years ago (Hammersmith Hospital in London) and the last year at end of June, an ablation for AFib (at the Royal Brompton Hospital London) - they said this was done to improve my quality of life. It is not improved yet! My AFib can last up to 2 hours and flutters come and go - seconds, minutes or more. Weekly now, used to be monthly or 2/3 monthly after last ablation. Always randomly.
l would go for the medication route....as l am doing now
I too had this choice 6 years ago and after much soul searching and reading opted for ablation. I am free of af since then and off meds - except anticoagulants.
I had an ablation for PAF end of March this year. I had had no AF since starting flecainide 50mg twice daily previous Sept. I understand your uncertainty, I worried I would make things worse if I had an ablation because it has done for some people posting on this site. What helped me decide was that the cardiologist who put me on the waiting list said, in his opinion, it was a no brainer to have one! He also said, looking at my tape results, that my heart kept trying to get back into sinus when I was having fast AF. (Like you very symptomatic, longest episode I had was around 5-6 hours) so I thought I'd give it a hand by having the procedure :-). I don't believe the cash strapped NHS would be doing ablations if they didn't have a good success rate. Success for lone AF is better than when there are other contributing factors (high BP/BMI etc) and I believe better if you have it early, as AF progresses and becomes more frequent as I discovered. Jean is right diet and lifestyle changes do help but I have a low to normal BP and BMI and have been a cook from scratch vegetarian for years but still found AF episodes increasing from twice a year to 1-3 a month last year. If you trust in your EP (where are you based?) I'd go for it, especially as the meds aren't keeping you AF free.
Thank you for your response. I am actually in the Los Angeles California area. I am working on my BMI but it is difficult. 25 pounds does not seem like a lot but for some reason it is for me.!I am leaning towards the of ablasion and I appreciate so much all of the comments here it is so supportive and helpful I can’t even say how much.
Ah, so I guess cost is going to be a factor for you too. God bless our NHS.
Re trying to shed some pounds, I've been reading The Four Pillar plan by Dr Rangan Chatterjee and he recommends not calorie counting so much as choosing fresh products avoided processed foods and eating in a 12 hour window and fasting for 12hrs (ie mostly overnight)and then look at extending the fasting period to 14 or even 16hours. So delay breakfast to around 10a.m and no food after 6 or 7p.m
Good luck
Although I had a slightly different arrhythmia (SVT), I wholeheartedly agree ablation is the route to go. I had mine 15 mo ago but wish I had done it way sooner.
Thank you that’s what I’m hoping for if I do move forward!
I was very scared and cried for days leading up to it but my quality of life compared to what it was from my diagnosis is insanely different. Some days, I forget there was anything wrong with my heart or that I had to go to the ER and get my heart rebooted multiple times to get it back in sinus rhythm. I feel so normal now and I am happy.
That’s nice to hear well done you’ve been very brave☺️
Since you are in LA, you might look into the Ornish program, which is a lifestyle medication program that is covered by medicare and many insurance plans. They have an LA location here: UCLA Health
, 100 Medical Plaza, Los Angeles, CA, 90095
uclahealth.org/rehab/ornish... I just finished reading his latest book: "Undo It", about switching to a plant based diet and the heart healing assistance that his program provides. It has four parts -- plant based diet, more exercise, less stress and more love. You can check out the book from your local library and look into the program if you think it might be helpful to you. They say the average person loses 24 pounds in the first year and keeps it off. I wish there was one in Santa Fe, where I live, but we are planning to schedule one in Honolulu or San Diego when we can get the time away next year. Meanwhile, I am implementing the program from the book, and haven't eaten any meat in a month, and I am working on the other items as well. Good luck!
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