Doctors concerns about ablation

[seasider18]

Atrial Fibrillation Ablation: Two Concerning Trends

medscape.com/viewarticle/91...

[wilsond]

A very interesting article indeed, it confirms for me that ,at this time,ablation as an elective proceedure is not the way to go.

[seasider18 in reply to wilsond]

So many here have had several and the recovery times can be quite long.

I sometimes wonder if they know the right one to do. I was first offered an RF ablation but turned it down as I was not on Warfarin. He told me that didn't matter. Next he had convinced me to have an AV node ablation but an MRI scan I had been waiting for was offered for the same week so I took that and then decided against the AV node ablation. I then saw another EP at the same hospital and he wanted to do a cryoabltion.

I'll stick with my permanent AF.

[CDreamer in reply to seasider18]

AV node ablation requires implantation of Pacemaker. I opted for AV node ablation, had the pacemaker inserted which has removed all symptoms so I am not going further for the AV node ablation.

I think any intervention such as ablation is only ever offered as symptom relief and if you are in permanent AF and can live with it, I would probably agree with you.

I had 2 ablations, they did improve things to an extent but I had complications due to an undiagnosed, underlying condition which have been far more disabling than the AF. 2nd ablation did stop the AF for 3 years but I think I would rather have the AF than the consequences!

[seasider18 in reply to CDreamer]

I have a pacemaker that I was talked into after having a seven day monitor. I turned down the later offer of AV node ablation.

I had always had a slow heart rate in the 40's apart from when in AF. They phoned after the monitor on a Sunday morning and said that I needed a pacemaker as a matter of some urgency as my heart rate was dropping to 37 during the night and I was having 3.5 second pauses.

An A&E nurse once asked me if because of my low heart rate I used to be very fit. I said that was something I could never be accused of although I had a lot of stamina and not being a driver walked a lot

Now my heart rate is in the low to mid 60's and they say that the pacemaker kicks in 14% of the time.

[Seawalk in reply to wilsond]

After much reading and pondering I agree with you. I’m just about to turn down an ablation scheduled for end of this month for reasons expressed and my other concern was recovery as I have FMS and recently diagnosed with Chronic migraine. All will impact on recovery. Brain MRI scan this coming Saturday. I don’t take pain killers I meditate /mindfulness and avoid certain foods etc. Though it’s difficult some days. I stopped taking amiodarone of my own accord in May so just taking anticoagulant. Only had one episode of AF since then, minor flutters. Relating to your other post on patient day - No join up service where I am between GP , EP and do not have an arrhythmia nurse so I feel quite alone. This site has help me enormously so thank to all the contributor.

[CDreamer in reply to Seawalk]

One huge benefit for me after ablation - all migraines which had plagued my life - stopped. Have you been investigated for PFO - hole in the atria septum? Big link between PFO and migraines.

[Seawalk in reply to CDreamer]

Thank you for your reply. I will read up on it No one has mentioned i havePFO. I’ve had a scan where they inject radio active dye. Would that show it.

[CDreamer in reply to Seawalk]

Nothing showed up on my scans because it was in an odd place but the EP found it when doing the first ablation. Many people don’t know they have one as it is estimated that 20-25% may have one. It’s not dangerous, unless blood leaks through and that was not happening in my case. I used to do scuba diving and there is some controversy of whether or not you should dive but that is about the only restriction I have come across.

ahajournals.org/doi/pdf/10....

sciencedirect.com/science/a...

[Seawalk in reply to CDreamer]

Thanks for that info. I’ll follow the links. It’s interesting.

[Hidden]

Dr John Mandrola has a good reputation and it is always worth listening to his views. We hear from many experts about the importance of making lifestyle changes but what about folk who do not abuse their bodies, have a BMI well within limits but still suffer from the debilitating symptoms AF often present. A lifetime of potent drugs, where doses may need to be increased due to the progressive nature of the condition, is not an attractive prospect for many.

I guess at the end of the day, we all must take heed of the professional advice we are given regarding our personal circumstances and then make our decision as to what we think is right for us and then pray that we have got it right........

Regarding the LAAO (Watchman) procedure, it is my understanding that this is not normally available in the UK.

[seasider18 in reply to Hidden]

The NHS put a two year block on it and Amplatzer after trials because of the cost. The two years is over now but I've not heard any more.

I paid to have the Amplatzer amulet fitted 2 1/2 years ago as I could not stand Warfarin and NOACs were contra indicated with a tissue valve according to the makers. God like cardiologists said that they could ignore that as they just had not been trialled on patients with tissue valves as they are a minority group.

[CDreamer in reply to seasider18]

LAO is now available on NHS for very few patients with good reason to not be able to take anticoagulants so it’s not a patient choice.

[seasider18 in reply to CDreamer]

Unless you pay for it as I did. I had thought about it from when it first came to our shores when London Bridge hospital and the Harley Street Clinic were doing it as I was never happy with Warfarin.

After I had my pacemaker fitted I thought lets add another piece of metal

[Kaz747 in reply to Hidden]

And when you’ve addressed all the lifestyle issues and none of the medications (even the “last resort” ones) aren’t controlling things, a successful ablation is a great relief.

I’m convinced my arrhythmias are linked to my pregnancies. The more I read about preeclampsia and the links to cardiovascular disease and AF later in life the more I wish I could go back in time and ask more questions (like how high did my BP go after the early delivery of my first child when I was in a hypertensive crisis and it was too dangerous to move me from the delivery table until the next day). Preeclampsia increases your stroke risk x 2 (and more if you had it in multiple pregnancies as I did) and of course AF increases your stroke risk x 5. I’m no mathematician butI do know that I have to take really good care of myself. 😉

[CDreamer in reply to Kaz747]

You may be onto something there and this is the sort of gender difference which I believe needs to be investigated further. Advice is always to prevent BP from rising .....mmmm......DA!

[Kaz747 in reply to CDreamer]

My BP was always great except in the later stages of pregnancy and then again when I injured my ankle 4 years ago and started having arrhythmia issues. It’s perfect now 110/70 but it’s not guaranteed to stay that way.

[djmnet]

Well, that was an eye opening read that I plan to save and read again and again. Very interesting point of view. Thank you for posting this link, Seasider18.

[seasider18]

I'm surprised that we have not had posts disagreeing with the author.