Catheter ablation, or not?: I was diagnosed... - AF Association

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Catheter ablation, or not?

HowMyHeartSings
HowMyHeartSings
26 Replies

I was diagnosed with Atrial Tachycardia three months ago. I am currently on 5 mg of Nebivolol each day. I am getting occasional small runs of rapid heart beats every few days largely only in the night and haven't had a full on 'episode' of 200 bpm for a month (I've had about 5 of them) - when the episodes come they last about 30 mins, burping and leaning forward tend to slow them down and end them for me. My EP recommends a catheter ablation. I am still undecided. I do want the chance of being drug free (I'm 53 yers old and I dislike the side effects of sluggishness from betablockers) but I am still - probably irrationally - concerned about the possibility of the procedure making things worse. I also don't relish coming off beta blockers several days before the procedure - what happens if I start having more frequent episodes where I can't take a beta blocker as I am going to have the ablation? I have also been told I can't have the ablation with a general anaesthetic as it decreases the chance of success - I'm worried about coping with just sedation as I am a nervous patient. Also what do they do if you need the loo if it becomes a longer procedure? Lastly (sorry this is so long) is there any better catheter ablation technology about to come into play that would make it worth waiting for? Thanks as ever for any feedback and more rational experience than my over worried imaginings!

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BobD
BobDVolunteer

Sorry I am a little confused by some of what you have said. For example I had an ablation for AT in August under GA. MY EP never uses sedation. He also triggers events during the procedure using stimulus from a catheter. In my case he found four sites which he was able to trigger. I have never had to stop any drugs before any of my ablataion either.

I would also say that the period of recovery may be less than calm for the first few months.

I am a fan of ablation but one must understand that it is only for quality of life so any other things you can do in the way of life style changes, (weight loss,alcohol avoidance, stress reduction. diet etc ) can all be as beneficial.

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HowMyHeartSings

Thanks Bob - that’s interestingly contradictory - not sure how to proceed now re sedation vs general anaesthetic. My atrial tachycardia is paroxysmal - don’t know if that makes any difference? I’ve not proceeded with anything yet but Just assumed you’d have to come off beta blockers. The EP said it was sometimes difficult to get an arrhythmia started in cases like mine do they’d have to abandon the procedure. Do you think I should get another opinion re general anaesthetic - I’d heard on the forum that using sedation was possibly a cost-saving measure although the EP I was seeing was going to do it privately. I already don’t drink alcohol or caffeine, exercise and try to minimise stress - as best I can.

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CDreamer

How is that contradictory? Don’t assume anything. Many people continue with drugs after ablation, at least in the early months.

GA take MUCH longer to recover from & more side effects - sedation for me every time, yes it is less expensive as you often don’t need an anaesthetist but that is not a clinical reason which should be and in my experience is the only one that counts. (Had 2 ablations).

You remember very little with sedation, only thing is that you may move more on the table - it’s usually the EP who prefers GA so you don’t move but as a patient, unless you are a fidgeter or very, very anxious - sedation.

I agree with Bob - Lifestyle changes first, then if no underlying reason can be established ablation is a good option, however, it may not be a permanent solution & may need to be repeated.

A month of HR if 200 sounds horrible!

Hope that helps.

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BobD
BobDVolunteer
in reply to HowMyHeartSings

Mine was paroxysmal, usually about once a year but always needing cardioversion. As I discovered that is not without risks so my EP decided ablation was a low risk procedure by comparison.

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Padayn01
Padayn01
in reply to BobD

Hi bobd I was told to stop my beta blockers a week before ablation

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Fazerboy

Hi, I know how you feel. I'm 63 and reasonably fit. I suffer from supra ventricular tachycardia (svt). Initially it wasn't very often so I put off having an ablation. It then got worse and I went back on the waiting list for an ablation. I then needed Bisoprolol betablocker to stop my svt. I came off this 4 days before my ablation date with no problem. The ablation was then postponed for 3 weeks and I stayed off the betablocker. I've had a couple of short periods of high hr in the last few days but my ablation is tomorrow.

So, I got told that I needed to come off the betablockers 3 days before the ablation but if I had a really bad episode then I could take one as long as I told the cardiologist etc.

I also thought I was going to have a general anaesthetic (I'm a wimp) but at my pre-meeting they said I was having a local anaesthetic, they said they almost always do them that way.

The ablation is tomorrow. I'll put a post about it when I've been.

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HowMyHeartSings

Very best of luck - not that you'll need it. Look forward to hearing about your experience and recovery.

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Padayn01
Padayn01
in reply to Fazerboy

Good luck please let us know how it went

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higgy52
higgy52
in reply to Fazerboy

Good luck mate

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SteveCairns

I had a Cryo ablation for AF 5 months ago , diagnosed with heart failure and AF in 2014, after two doctors in Cairns Australia , mis diagnosed my condition , lucky I asked for a chest X-ray which showed all wasn’t well - despite being told “I’ll be fine .

Recovered from Heart failure , Had a cardioversion but a year later went back to AF, another cardioversion , and my new heart specialist recommended going on Flecinaide , which ive been on for 3 years - then comes the Eptopic beats ( possible side effect ) and my heart starts doing unexplained stuff , Dr “thinks” it’s a reaction to the medication ( let’s face it , despite some doctors thinking they’re GODS , they’re actually just people educated as best they can be , and they guess treatments sometimes based on what they know ) and suggests an Ablation ., whixh I had in May this year . Things started settling , then at 3 months after ablation , come off thr Flecinaide and 3 days later heart has a reaction, Again doctors can’t explain it and I recommenced the Flecinaide . Looking at possibly having a second ablation now as sometimes Eptopic beats are pretty bad .

Long story short - I avoided the ablation cos it sounded scary - I was out under general anethetic , and the first day after the ablation was uncomfortable but they didn’t last long , if I had the chance to start my heArt problems all over again . I would have had the ablation sooner , and NOT gone on more AF drugs , which it seems my body now can’t do without .

So he brave , and if it was me , k owing

What I know now , I’d have it in a heartbeat and try nip it in the bud sooner than later.

Remember of course your not me and each case of AF/heart issues is not the same , although some doctors seeks to think it is . My opinion would be get a second opinion of an different specialist .

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KMRobbo

I did not stop any drugs before ablation by orders of my EP. I stopped them 3 months after the ablation. Same a Bob in that the AF I had was induced for the ablation.

Mild sedation is what I had except for the local in the groin.

I found it very interesting watching the events on the part of the screen I could see.

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avma

Hi,

I saw your post and wanted to respond. I’m 54 and had AT, since my EP thought I was too young to be under medication for the rest of my life and probably in the long term the AT would be getting worse, he wanted me to have an ablation. In my case the EP did a thorough 3D-mapping of my heart under GA during 3 hours and found my AT was situated at a difficult spot namely on the phrenic nerve, so he told me to have a hybrid ablation, which is an ablation where they go from the outside of the heart and burn the AT spots away and at the same time go through the groin and look at the inside of the heart. All this was also under GA.

They have medication to trigger your AT under GA so there is really no need not to have it without.

I really would consider a second opinion.

👍👍

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HowMyHeartSings

Thank you - so that was two separate procedures? My EP has always talked as if it were one procedure. Should I be asking for a separate mapping procedure first - or do they normally do these together - whilst they are in there?

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avma

Hi,

Perhaps I need to give you more background info. The first time I had an ablation they thought I had AVNRT, so they tried a normal ablation through the groin, but then they saw it was AT. So they stopped and didn’t ablatie. This was without GA. I found that a horrible experience because the sedation they gave me didn’t work, because I was too nervous. So then they tried again and this time under GA with the mapping like I told you, but then they saw that they couldn’t burn the spots because they were situated at my phrenic nerve so this was too dangerous and they stopped again. So then the next time I had a hybrid one, this was in 1 operation, but they were 2 specialists at the time that were operating on me: an EP and a thorax surgeon/EP. They did this so that they could put my phrenic nerve aside by opening my pericardium from the outside and then they burned the AT away. In my case it was the only possibility to get rid of my AT. This was a more heavy operation so it was of course under GA.

But if your AT is situated in a normal spot or spots, they can do it through the groin so in a normal ablation. This will take less time to recuperate from than a hybrid one.

But my point is, they can always do this under GA if they want to because the medication they give you under GA to trigger the arrhythmia works 99% of the time perfectly. I know because I asked my anaesthesiologist beforehand, it was she who told me how this all works. Why do they do that not all the time then? Mostly because they want to save money and time. So if you get the right EP and/or hospital they will do this with GA if you want to.

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HowMyHeartSings

Thank you that's useful. Did the ablation work for you?

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avma

I’m still in my recuperating phase, because of the way they have operated on me, I have to give it at least 6 months, now I’m in my 5th month after the operation. so I’m doing a cardiac revalidation and I have a really sensitive heart, but the doctors all say that I’m rid of the arrhythmia. I try to believe them and regain believe in myself psychically and psychologically but that’s not easy after this adventure which already is ongoing since January of this year.

So, yes I’m cured, but let’s say my mind doesn’t believe it yet so my body is still scared. Luckily in my cardiac revalidation there is a psychotherapist involved and I now have a few sessions with her to regain trust is my body.

I don’t take any medication not for the heart or mind, so that’s already a good thing.

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Mikee69

The mapping is done at the same time as the ablation.

My ablation was for AF and flutter, and was done under GA, my EP would not do it any other way.

Are you in the UK? It may be time for a second opinion

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Lamsie

Hi

Having my ablation on Monday 28 Oct. I asked my EP this question re GA and sedation he said that the body reacts differently when you are sedated than when you have GA. Also the reason to stop meds is that the rhythm is how the heart is performing without them. X

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HowMyHeartSings

Good luck and let us know how it goes.

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HowMyHeartSings

Thanks. So will it be sedation or GA for you?

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Lamsie

Hi I’m having sedation with heart mapping also - my consultant only uses sedation for ablations x

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allserene

So many similarities with my situation. My tachycardia consists of a single 150 pulse event in April, but it was a tenacious thing and they ended up stopping my heart by accident when getting me down to 63.... ... I came off anti-coagulants in August and I am presently coming of metoprolol beta blocker (very, very slowly). Should be done in another week.. now at 12.5 mg twice a day. I know that if I were to have say 2 more events by spring, my EP would suggest ablation. Latest info is that my chances of my episode not repeating are small, and the isolated events like mine, are usually due to external factors like pneumonia etc which can be identified... Mine isn't identified but heck it could be extreme dehydration coz I dont like water and I got 100% of my liquids via coffee/beer. When I had cyberknife for prostate cancer, they would interrupt the session for "bathroom breaks" but that was easier than in the midst of an ablation, so I dont know...somebody will and that will be interesting... I have had 'ectopic' palpitations since scaling down betas, but like you, an induced burp often stops them, so I think they are stomach/gut-sourced rather than heart sourced and ectopic means 'outside of' the heart......

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Trashsite

Hello I share some similarities also with you and. I'm set to have my ablation on the 29th and I have the same kind of concern that that you do but my biggest question is do I need to go forward with it I've had A-fib twice that required conversion the first time I needed three transfusions of potassium to get me to normal and after monitoring my episode was chalked up to that and now 5 years later I had an episode in July that required conversion but on that one I have been taking magnesium supplements and I stopped taking them the month before as of today I'm still set for the procedure though I'm questioning if I should move forward with it obviously the concern of something going into your heart is worrisome for all I believe

My doctor also wants me to stop the beta blockers a few days prior to the procedure starting on the 25th where by the way are you having yours done at are you in the US or someplace else

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HowMyHeartSings

I'm in Leeds in the UK.

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sugarisit

Not sure if this will work for you, but it does for my Afib problems. If this works, let me know:

------------------------------------------

After 9 years of trying different foods and logging EVERYTHING I ate, I found sugar (and to a lesser degree, salt – i.e. dehydration) was triggering my Afib. Doctors don't want to hear this - there is no money in telling patients to eat less sugar. Each person has a different sugar threshold - and it changes as you get older, so you need to count every gram of sugar you eat every day (including natural sugars in fruits, etc.). My tolerance level was 190 grams of sugar per day 8 years ago, 85 grams a year and a half ago, and 60 grams today, so AFIB episodes are more frequent and last longer. If you keep your intake of sugar below your threshold level your AFIB will not happen again (easier said than done of course). It's not the food - it's the sugar (or salt - see below) IN the food that's causing your problems. Try it and you will see - should only take you 1 or 2 months of trial-and-error to find your threshold level. And for the record - ALL sugars are treated the same (honey, refined, agave, natural sugars in fruits, etc.). I successfully triggered AFIB by eating a bunch of plums and peaches one day just to test it out. In addition, I have noticed that moderate exercise (7-mile bike ride or 5-mile hike in the park) often puts my Afib heart back in to normal rhythm a couple hours later. Don’t know why – perhaps you burn off the excess sugars in your blood/muscles or sweat out excess salt?? I also found that strenuous exercise does no good – perhaps you make yourself dehydrated??

Also, in addition to sugar, if you are dehydrated - this will trigger AFIB as well. It seems (but I have no proof of this) that a little uptick of salt in your blood is being treated the same as an uptick of sugar - both cause AFIB episodes. (I’m not a doctor – it may be the sugar in your muscles/organs and not in your blood, don’t know). In any case you have to keep hydrated, and not eat too much salt. The root problem is that our bodies are not processing sugar/salt properly and no doctor knows why, but the AFIB seems to be a symptom of this and not the primary problem, but medicine is not advanced enough to know the core reason that causes AFIB at this time. You can have a healthy heart and still have Afib – something inside us is triggering it when we eat too much sugar or get (even a little) dehydrated. Find out the core reason for this and you will be a millionaire and make the cover of Time Magazine! Good luck! - Rick Hyer

PS – there is a study backing up this data you can view at:

Cardiab.biomedcentral.com/articles/10.1186/1475-2840-7-28

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