Should I have an ablation ?: I'm new to AF... - AF Association

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Should I have an ablation ?

sandoval22
sandoval22
35 Replies

I'm new to AF , having my first episode in August this year for which I had a Cardioverison on Sep 1st and have been fine ever since. Now I have a letter inviting me for an ablation in March and I can't help thinking maybe I don't need an ablation ? What should I do ?

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jeanjeannie50

What were your symptoms when in AF?

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sandoval22

Racing heart rate on the slightest exersion i.e playing golf. shopping. Struggled to get to the top of the stairs before cardioversion; went to A&E a few times before they got fed up seeing me and gave me a Cardioversion imo. Now I'm back on the treadmill 30 mins a day and apart from a little anxiety waiting for AF to come back (everyone says cardioversion is a sticking plaster) I feel ok.

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jeanjeannie50

If I were in your shoes I certainly wouldn't be going for an ablation so soon. I've had 3 and would say that the first two may well have made it worse. After my third I felt a lot better, but still get AF at times and need to be cardioverted. My EP has said I'm not suitable for any more.

Have you tried adjusting your diet to a more healthy, sugar and additive free one? Also it's important to stay well hydrated by drinking water and not just having tea and coffee. We have members on here who have found doing this very successful. Also taking magnesium supplements can be beneficial. One member has recently stated that after having lots of regular AF attacks she now takes magnesium glycinate tablets and has been AF free for 3 years.

It must be remembered that ablations involve freezing or burning inside the heart, which then creates scar tissue. I once was told that my ablation scarring had probably made my heart a little stiff in it's functioning.

It will be interesting to hear what other forum members have to say. I guess we can all only speak as we find.

Jean

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Ianp66
Ianp66
in reply to sandoval22

I had same choice 5 /6 years ago and held back after the first couple of yearly spaced episodes of racing heartbeat after gym exertion, then even a glass of wine would initiate it, or a bout of flu, dehydration, seemed anything stressful on the body . Suffered years of fear of it coming back, which it did higher in frequency and ferocity.

Personally for me I wish I had it done sooner as after having my ablation in April it's been life changing, for the better , and I believe the longer you leave it the more pathways form. The way it eventually stopped me going to the gym, exerting myself then even walking made me out of breath, basically stopped everyday life, it now wouldn't be a question of if, but when I did it again .

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Tomred
Tomred
in reply to Ianp66

hi could you explain what you mean by more pathways develop glad to hear you are feeling better

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Ianp66
Ianp66
in reply to Tomred

As I believe I my case the longer I left it the more work required, as the rogue signals become more active.

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BobD
BobDVolunteer

Lets be honest any treatment is only for quality of life so you decide. If you find it impossible to function in AF then you know the answer but even though I am a fan of ablation I think this is perhaps too hasty and you should wait and see how you are on whatever drugs you have been given. There is an old saying " when the pupil is ready the teacher will come. "

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sandoval22
sandoval22
in reply to BobD

I think what I need to do is wait until a month before date of ablation in case AF does come back. I already eat healthy (low carb) don't smoke or drink but AF may be due to a heart attack 19 yrs ago ? who knows ? I feel guilty complaing because I know what the NHS waiting lists are like but you would have thought they would check wether I actually need an ablation first but what do I know.

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Bob sums it up.

For me, at 31 years old, Cardioversions were only keeping a lid on some severely debilitating AF episodes for a matter of 6-8 weeks at some points. My QoL was poor, I couldn't do the things I used to for fear of kicking it off (12 our shifts at work three days a week, at least 7-10 miles walk once a week on a day off).

I had an ablation July 2014, it resolved things until the November of that year when it came back so he went in again on New Year's eve.

I was alright for a bit then atrial flutter developed. We aren't sure and probably never will be sure if this was a result of going over this area to ablate in 2014 or had caused the original AF.

I had 2 further ablations for flutter as the episodes were regular and just as debilitating as they had ever been. I also now had a baby to think about, and a partner working full time to enable me to drop my hours at work significantly leaving me with the bulk of the childcare.

The final blessed release came in January this year where I had a 5 hour ablation/flutter ablation/investigation mapping and cardioversion which (touch wood) has resulted in me being off all medications and only having 2 minor recurrances (Feb and August) of low level AF - during which I was able to climb stairs change a nappy get dressed and cook - all activities which would have been beyond me in previous years. No medications since March, not due to see EP again until next summer.

It was outlined to me that it may get worse before it gets better. Ablation should be referred to as ablation therapy - because it is not a cure but a treatment to lessen the intensity of the AF and/or the frequency it occurs. With this in mind - you could argue that an appropriate drug regime could give you equal control. It didn't for me. It does for some.

By contrast, Cardioversion is simply a "reset" to the heart muscle and does nothing to address/affect the cause of the AF.

Hope this helps.

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Padayn01

I seen on here that this happens a lot after abalations getting atrial flutter

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Aus19
Aus19
in reply to Padayn01

That's an excellent suggestion, jedimasterlincoln - adding the word "therapy" after "ablation".

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sandoval22

I sound lucky compared to most on here. I'm not on any medication apart from metformin for diabetes. The only reason I can see for an abaltion is "in case" AF comes back but if it did, no doubt I would blame it on the ablation. Thought I could wait until a month before procedure to decide but I have to confirm I am going to attend within 7 days. Surely I have a right to see an EP cardiologist beforehand. Feels an odd situation to be in. Feels like I've been put on a conveyor belt.

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Buffafly
Buffafly
in reply to sandoval22

You are not the only one, if you look at previous posts there is a long discussion on a post asking if it is normal to see an ep for a review before scheduling ablation - the answer was a resounding yes but you may find the discussion interesting.

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Pattering

Do you know your Chadsvasc score? With diabetes, it must be at least 1. Has anticoagulation been discussed with you?

Pat x

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sandoval22

I took apixaban a month before cardioversion and for one month after. Now on nattokinase , cayenne pepper, aged garlic etc by my choice. I don't do drugs for life.

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Poppy128

Where in the country are you? Had my first attack last May and have had three cardioversions. In Leicestershire there is a waiting list for a year for an ablation!!

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sandoval22
sandoval22
in reply to Poppy128

Hammersmith hospital is my area. I am surprised at the speed of the appointment. Was told when I was there for cardioversion that ablation wait time was 9 months.

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SteveCairns

I was diagnosed with AF in 2014, had gone undetected and due to excess anxiety when I was admitted , caused more damage

To me and was in Heart Failure with an ejection fraction of only 29-%, and had a 3cm blood clot in my left ventricul.

Since then , due to some good meds , clot gone , heart back into normal size and for two years after cardioversion no AF. Then one day it came back while I was sitting in a deck chair doing “ nothing” . Heart specialist did another cardioversion , but had a few episodes of my heart jinking into and out of AF, specialist suggested going on a magic pill called Flecinaide , to hopefully keep the AF away. The subject of Ablation came up as a possibly proceedure but Flecinide was the “recommended “ treatment which I started on but it came with side effects I noticed after 18 months , heart started getting multiple episodes of Eptopics which weren’t nice , so finally got my first ablation in May this year . Wasn’t in AF when thr cryo balloon ablation was done, so my understanding is a basic ablation conducted but without actually seeing where

In my heart the AF was coming from. ( from my understanding of you get an Ablation , it’s better to be IN AF at the time so they can see where the problem is . )

After a few months things had settled and was told to come off the Flecinaide , which I did , but 3 days later my heart has a bad reaction to trying to come off a drug it had relied on , since then , more Eptopic beats and just a blank look from my

Cardiologist . Let’s face it , despite some doctors and heart specialists thinking they’re GODS , they’re just people , and they make suggestions on YOUR health based ok their best GUESS. so

Do the research and be as Informed as you can regarding decisions on your health .

If I could do it all over again , I’d have had the Ablation earlier and

Instead of adding more drugs to the mix. And ask the specialist performing the proceeedure if they’ll put you in AF so they can identify the problem areas . If they say no , and do what they did

With me, who knows if you’d have been better off or not . Remember doctors are there to make us better , but also they’re j. It to make money - proceedures make them money .

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Shcldavies

No one can advise what is best for you other than your Doc, he has the best information available and the knowledge & experience. If your in the UK NHS there is a waiting list, a long waiting list in most areas and Docs do not just put you on it unless they have risk assessed your condition and decided its the best for you. There is one other reason to listen to your Doc, until they have performed an EP study (they do this at the same time as the ablation) they are not 100% sure of your condition so it does give piece of mind that there is nothing more sinister happening.

Its not an easy decision for you now while your not suffering, I would ask the Doc why he thinks an ablation is best for your condition and take it from there. I had my ablation after suffering for 23 years and really wish I was offered an ablation at the start.

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sandoval22

I would like to ask an EP why I am being fast tracked for ablation but my first appointment is the ablation !

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dmack4646

I would certainly ask how many he has done...

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Samazeuilh

Ablation is usually recommended when medication fails (this is, in fact, in the NICE guidelines). In your case, I would seek to establish exactly why they have recommended an ablation by speaking to the consultant. Given the cost of the procedure it is unlikely to have been proposed casually. You could discuss the timing of the proposed ablation, i.e. whether it needs to be done immediately or whether it would be reasonable to wait to see how things play out.

I am in a similar position- waiting for an ablation but not wanting to have it. My episodes of AF are fairly infrequent, but the consultants are adamant that things are likely to get worse over time and that it is better to intervene early.

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Fazerboy

I was a bit worried as to whether I really needed an ablation for svt but I decided that if they tried to trigger the svt, if they could then I obviously needed an ablation but if they couldn't trigger the svt then they wouldn't ablate and no harm would be done (apart from a hole in my groin!). I actually had 3 spells of svt in 4 days before the ablation so I went ahead with it. That was on 21 Oct. All ok since and not on any meds.

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Jonathan_C

I agree with comments that it may be a bit hasty to for it...BUT I have an excellent EP who has explained the science (or logic) behind an ablation to me very thoroughly and because of the advice he has given me, I would suggest taking the opportunity.

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Rodders7777

I’m in same predicament of experiencing low level AF very couple of months. (Only on 2.5 bisoprolol and no anticoagulant - yet!) I’ve held off having an ablation because in one sense, it is wilfully scarring the heart so if it’s not absolutely necessary, it seems about brutal!. But if the af is severe and affecting quality of life, then it does seem a great option.

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Ed1532

Hi. Unknown territory. Thinking aloud- some are on the waiting list for around 18 months for a date for an ablation,and in Afib. Get the date- then as the date approaches, re evaluate. Talk with the personnel who are offering ablation- advise them in good time for another person to use your if its not needed by you. Do whatever is good for you, and yours.

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sandoval22

I've decided to cancel ablation and wait until I can see an EP . I only had 7 days to confirm I was attending on date given so didn't have the luxury of waiting to see if AF came back. Seems odd to have an operation before seeing if I need one ? Guess the EP would blame the bookings dept.

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KMRobbo
KMRobbo
in reply to sandoval22

As well as asking why the ablation was being recommended I would also ask what type of ablation and where I the heart it will be done.

I am like others: I wish I had an ablation sooner even though I only had AF for 2.5 years before the ablation.

However in that time it developed from one event lasting just over a day through about 12 attacks that I found a way to stop it by exercise, which then ceased to work and led to 8 days in and out of hospital between 130 and 195 resting HR ( and over 220 when moving). I was only eventually being cardioverted by flecainide infusion in the CCU. All this in 20 months! AF begets AF. Then i was on an unpleasant drug regime for 10 months during which time I had the ablation, which turned into 2 ablations as 8 days after a successful afib pvi cryo ablation I developed atrial flutter possibly promoted by the Flecainide I was taking to supress the A fib! A second ablation a month after the first! RF that time.

Been ok since that time except for ectopics. !

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Bambi65

Each of us here have our own personal stories and experiences, and we are from different parts of the world. Im from the US, I don't like taking any meds and prefer the holistic approach to everything.

Having said that, I too was told my heart docs that ablation is the way to go, if medicines did not work. I don't take any meds for rate or control. Thats been 3 yrs now.

The only med I have recently consented to take, was a blood thinner because it reduces the risk of a stroke by 50%.

I have not and will not have an ablation, period. My afib is 2 or 3 x a week with HR between 130-190, 2- 30 hours at a time. My goal is to reduce frequency and duration. I keep a journal of what I eat, level of activity, supplements I take, and look for any consistent triggers or anything that appears to affect my afib.

Quality of Life (QOL),thats the major question here. Does it keep me from doing the things I want to do? No, I do them anyway, with or without the afib monster. There are no guarantees with any medical procedure, and from what I have learned, there is NO CURE for afib. Its all about QOL. I travel all over the globe, I bike, I dance, I swim, and I keep a positive outlook. I do all these things with and without afib. (sometimes just a bit slower) I live like I want to, and do not worry about the .."what if afib happens now" . At 65 yrs old, I only have maybe 40 years left so QOL is important and Im gonna live it....

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Palpman
Palpman
in reply to Bambi65

You are so lucky to have low intensity AF. Many of us are not as lucky. Our AF is so intense that it feels like a car running on 3 cylinders and leaves us breathless. I am mostly housebound as it makes me too dizzy to even go upstairs to my bed.

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Bambi65
Bambi65
in reply to Palpman

Mine was like that for the first year, the intesity was so new to me. I thought when it hit 140 it hurt, then 160 was painful, 200 I though I was gonna die. It knocked the wind out of me each time and I was exhausted, 4-30 continuous hours of this.. After a while of this crap, I decided not to just lay down and take it, but to get up and ignore it as best as possible. Now, when I feel it coming on, I tell myself, NO, not this time. and I keep going and doing the best I can. Over the last few months, I no longer get knocked down like before, I can breath, but the stairs, well they are a struggle with 160+. Walking for me seems to be the best way of getting on with it. It wasnt always like that, but it is now. Dont know if its what im taking or what im doing, but it works for me.

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JJHRT

Absolutely have an ablation. Afib only gets worse through time. Drugs do not work in the long term. I’ve been dealing with it did almost 30 years. I’m now 58, so they didn’t do ablations back when it all started. I also had a heart attack at age 31. I’ve had two ablations in the past three years. One RF and one Cryo. They failed by definition, but I’m now on tikosyn (which quit working before my ablations) and I have very little afib. My most recent problem is non sustained vtach which is potentially much more serious. I also had an ICD placed before my ablations. Ablations have very small risks vs possible great benefits. The sooner you act the greater chance of success. Sorry for rambling!

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sugarisit

This might be causing your problems. Try it and see.

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

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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Raytheboxman

Talk about topical! I am slated (is that the word?) for my second Ablation in January, although I could have had it at the beginning of December. At this moment in time I am in Sinus Rhythm and have been since my 5th Cardio version in July this year. My pulse rate is slow and strong (55+/- 5 bpm at the moment) and I feel good! I am painfully aware of the fact that my Afib/Flutter could return any time, for some whatever reason, and take nothing for granted.

I will, therefore, take the advice of my Arrhythmia Nurse, and the EP behind her, and take up their offer of a further ablation . I have been assured that, statistically at least, a further ablation can put off the return of my AFib. quite significantly because, having already mapped the walls of my atria the first time around, the EP has an even better idea, by a process of elimination, which areas should be 'zapped'. This is my understanding of the benefits of a further ablation.

My first ablation gave me a trouble free 18 months. Its return in the June of 2018 was probably due to 'doing too much' during the heatwave and not staying sufficiently hydrated. So, listen to your body, stay hydrated, keep cool and enjoy those periods of SR!

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Bob002

Of course to have an ablation will be yours and your Doctors decision, I am glad I had an ablation(BUT) it didn't cure my afib but it did help to control the amount and intensity of the episodes It was my choice, I thought that I would be free of the medication and blood thinners. But I still take meds and blood thinners. If a medication and blood thinners control the afib and prevent a stroke that is the main goal. I really have only heard of a few people that an ablation has let them quite there medication, most still take some form of medication to control heart rhythm or prevent blood clots. Talk to your Doctor if a ablation would help or is necessary. If your Doctor don't know have him refer you to someone would know.

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