Private catheter ablation

[Melbuckton]

Anybody know ballpark cost?

[BobD Volunteer]

Said to be between £15 and £20k depending on Cryo or RF but of course that doesn't cover any side issues. Room costs of most hospitals can inflate that quiet seriously if extra days are required.

[Melbuckton in reply to BobD]

So that's either the new kitchen, or the new car or new central heating.

Don't really need them so eeny meeny whoops 3 ablations.

[JohnEagel]

Hi mate,

Mine was about 30K USD all together incl. 3 nights in 5* Hospital. Single Room.

But I had mine in Bangkok. Bumrungrad Hospital.

Cheers

J

[Fazerboy]

Where are you Melbuckton? In the UK most get it done on the NHS.

[Melbuckton in reply to Fazerboy]

Watford

[Melbuckton in reply to Fazerboy]

The assumption is that its much quicker getting it privately...

[cuore in reply to Melbuckton]

For each of the three times I went to Bordeaux, it was a one month wait.

[Melbuckton in reply to cuore]

So you flew out,stayed in a hotel, taxi to hospital, another night in hotel,fly back. Plus private operation etc.

4 week wait. Must have been long nhs wait.

[cuore in reply to Melbuckton]

I live in Vancouver, Canada. So, yes, it was a long flight.

The way it works is that you have to be at the hospital by seven Monday morning. The procedure is done the same day. You stay at the hospital for 4 nights -- Monday, Tuesday, Wednesday, and Thursday -- discharged Friday. You have your own room with accommodations also for the person who goes with you . Yes, you book your own hotel pre and post procedure.

Depending where you stay, you can taxi, transit, or walk.

In Vancouver, I would have had to stay in persistent for about a year, at least. So, at five months persistent (from June 5 ), I booked Bordeaux, and the procedure was done July 3, ( for the first ablation).

I was one of the most complicated patients at the 6 month persistent stage. My EP said that had I not had the ablation at 6 months, I never would have been able to return to sinus . This evaluation comes from one of the top, if not, the top EP in the world. Had I waited, I would have been destroyed. Like you, I am a PhD, so I did extensive reading on this matter, especially the literature from Bordeaux where the ablation procedure was invented.

I paid for the the procedures ( all three ) myself even though, in Vancouver , our health system would have covered it had I got to the stage of even being offered an ablation. Had I had the procedure at the paroxysmal, stage I might have had to have only one, but my GP and cardiologist (who I saw only once) let me deteriorate to persistent.

I do not know what "nhs" is unless it stands for your health system.

[Melbuckton in reply to cuore]

Well that's very interesting. And I didn't know ablation was invented in Bordeaux. I had a week's holiday there one summer really nice place.

I have just come back from seeing for the first time my private cardiologist. Reckons my atria are badly damaged because they are going so fast. Says unlikely to survive any technique to get me out of af..

Solution is a pacemaker. So Friday I'm having an echocardiogram and a 24-hour monitor taped to me.

NHS is the UK national health service set up in 1946. Every town has a large NHS hospital and some have area hospitals there is a huge one near me. Their cardiac unit sees 120 patients a day.

The wait to even see a cardiologist is long there are 1.5 million people with af.

The cardiologists in the evening tend to people who want to pay for themselves in private hospitals.

Very expensive I've just paid £200 for 10 minutes consultation.

Cardioversion over £2,000.

However I can afford it and of course I am not taking up an NHS queue space.

[cuore in reply to Melbuckton]

If you can afford it go to Bordeaux for a second opinion. Dr. Jais and Dr. Hocini do consultations (they speak English). Dr. Jais did my third ablation which was one of the most complicated at the six month persistent stage. But, now I am at exactly six months in sinus rhythm.

A friend of mine was offered a pacemaker rather than a second ablation. He went to Bordeaux for his second ablation. They not only fixed the first ablation but addressed the second. He is now over two years AF free.

I don't know how many months you are in persistent. I suggest you read Dr. Haissaguerre's paper that discusses persistent AF. He is the actual inventor of the procedure. The Bordeaux group treat patients from all over the world, and they publish more academic papers than the Mayo Clinic. I also suggest you visit Steve Ryan's site. He has been publishing a monthly piece for over 15 years.

I am suspicious of your cardiologist because of the manner he describes your heart. Dr. Jais described my heart as diseased which meant that my atria had remodelled. AF begets AF, so the longer you remain in AF, the more your heart gets remodelled.

Another point. Generally, if you have a cardioversion and you get back into sinus rhythm, you have a good chance that an ablation will be successful regardless of the length of time you remain in sinus. However, it appears that you will need more than one ablation.

[Melbuckton in reply to cuore]

Wow so much information.

Watford cardiology dept has 11 consultants and my Dr recommended the one I'm seeing privately.

Obviously not up to Bordeaux standards from what you say.

Today I've had an echocardiogram and I'm wearing a holter. I would hope this information is enough for him to decide on a way forward.

I should point out that he has the bearing of a senior consultant in his fifties.

At least 6 months in persistent.

I thought a pacemaker effectively takes one out of af as it takes over control?

I will certainly read the information from the gentlemen you suggest.

I am seeing my cardiologist on Monday as he will have had the test results. I can then consider your comments and the reading you have recommended.

Thanks

Mel

[cuore in reply to Melbuckton]

You might want to read

afsymposium.com/library/201...

which is Michael Haissaguerre's presentation on persistent AF. Time is of the essence and you say you have been persistent at least 6 months. From my experience, you cannot wait any longer to have an ablation if you want to return to sinus rhythm. You have never had a cardioversion?

You might want to read Steve S. Ryan's blog "a-fib. com" Here is a site:

a-fib.com/steve-s-ryan-phd/

The above doctor and doctorate are the two I mentioned earlier. Haissaguerre"s paper presents the urgency of not waiting if you are in persistent. Steve Ryan's blog has all sorts of information essential to an affiber.

Your echocardiogram will reveal if your atrium are enlarged, especially the left one. I strongly suspect that your left atrium will be somewhat enlarged since you have been in persistent for so long . Also look at your ejection factor to see how well your heart is pumping.

Your holter monitor will record your persistent AF, but that is a confirmation.

My understanding is that a pacemaker does not remove the AF. It will still be there. I recall reading on this forum that some have had an ablation even with a pacemaker. A pacemaker can be set at the rate in which you want your heart to be in. It's popularity is for those who have a very low heart rate. What is your heart rate?

Finally, I am sure you are surrounded by a very good team of doctors. But, that scenario will be of no use to you if you waste more time just waiting for the system to work. Again, my GP wasted one year of my life and got me to persistent. Then, the cardiac/clinic system was going to waste another year. So, at 5 months persistent I applied to Bordeaux which took me in a month, getting under the gun for four rotors to have formed beyond the pulmonary veins. But, I have had to have three ablations to target all the rogue signals in my remodelled heart. The longer you wait, the more your heart will remodel to the point that you will never be able to return to sinus.

If you would like to know more about my experience, I believe there is a way to chat separately. It saddens me when I read how the socialistic medical system, whether in Canada or the United Kingdom, complacently allows patients in persistent AF to deteriorate , in some cases, to the point of no return. I would have been one of those statistics had I not taken matters into my own hands.

[Goosebumps in reply to cuore]

What a brilliant post. I'm going to jump the gun and go private on the cardioversion so try and cut down the time in persistent AF. Mine really kicked off in July I think but the echo showed enlarged atria so it could have been there longer. I'll order Steve Ryan's book as well.

Thanks for opening my eyes.

Paul

[cuore in reply to Goosebumps]

If you have been persistent since July, you're reaching six months which is the cut-off time for 4 rotors. Steve Ryan does private consultations over the phone (obviously for a cost, but it is reasonable, and you will not have to wait ages.)

My friend did consult him. He followed Steve's suggestions, and now is two years in sinus rhythm. You might want to consider that route because I think he may place "time" in perspective for you.

Good luck. I do hope you get back to sinus.

[Goosebumps in reply to cuore]

Sad news for me. My cardioversion to sinus only lasted about an hour and a half. As soon as I had some soup in the hospital it went back to Afib. On the plus side the conversion only took one go and a small shock but the cardiologist decided not to use any drug to try and ' fix' the NSR. On reflection looks like a mistake but I found it hard to contradict him as he's the expert. I'm booked for another cardioversion in February. Not sure if it's worth it.

[Melbuckton in reply to Goosebumps]

Very sad news.

WebMD states:

Electrical cardioversion is more than 90% effective, though many have AFib again shortly after having it. Taking an antiarrhythmic drug before the procedure can prevent this.

So I guess it's worth trying again in February and have the drug before it.

I do think the definition of the effectiveness of cardioversion is suspect. It's like saying in winter my car starts more or less straight away but then the battery is drained so it stalls when I drive away. Perhaps not a very good analogy but I think you get my drift.

If I can get my heart rate down a bit more I will be having my first cardioversion early next year. After reading all the stories on this and similar forums I would put the success rate as nearer 25% not 90.

But then I am not a cardiologist.

[cuore in reply to Goosebumps]

If your intention is to return to sinus, yes it is worth it. Hang in there. The point is, you did get back to sinus, and that is what is important because it means that ablations can fix the AF. ( Statistics say you will need more than one) It appears that an electrical cardioversion may not give you much longevity. A chemical cardioversion (drugs) is the other type of cardioversion, but for me, even when I had a chemical cardioversion, I still went back into persistent quite rapidly.

In my case, I have had, in my journey, a total of three electrical cardioversions which lasted three days, four days and the last one five days. If I were in your shoes, I would be asking when I am to be booked for an ablation? You have been in persistent long enough; pressure to get a date. Or, go to Bordeaux where I went. I was six months persistent for my first ablation, and that was long enough because that was the time period when the damage was done. Don't give up; it will work out.

[Melbuckton in reply to cuore]

Good stuff. If the cardioversion fails I will have to research the way forward.

[Goosebumps in reply to cuore]

Many thanks for the encouragement. I had a long chat to one of the cardiologists I've spoken to so I have a plan. At the end of the conversation he mentioned a HR pulse indicator so I bought one. It now seems my Afib symptom of bad dizziness is caused when my heart rate drops below 60 bpm. Now I may need a rethink.

[Melbuckton in reply to cuore]

Only just discovered. High heart rate.

You got to persistent from what please?

When you say waste another year was that the wait time for a cardioversion or ablation? If the latter did cardioversion not work?

You sent so much information I'm chopping it into small parts I can understand!

Thanks

Mel

[cuore in reply to Melbuckton]

My arrhythmia was discovered by my GP during a routine visit for my high blood pressure. Upon discovery, clinicians will place you on drugs. GP's cannot prescribe anti-arrhythmic drugs to try and get you back to sinus rhythm. They can only prescribe rate control drugs to keep your heart rate down. So, my GP prescribed rate making me live with AF causing me to waste a year before even mentioning the word ablation. He never asked me do I want to live with AF or be in AF.

I got to persistent from "time." In one year, I went from paroxysmal to persistent with the duration of the episodes getting longer and more frequent to finally persistent with 11 appointments in one year with this GP. Then in persistent AF, my GP finally referred me to the cardiologist whose seminar he had attended.

This cardiologist was deficient and out of date in AF knowledge. With him, I had one appointment which was a total disaster. My saying "waste another year" is in the context that had I stayed with him , he would have let me deteriorate to long-standing persistent AF which refers to the one year mark. This cardiologist would have made me "waste another year." I would have been on the road to permanent AF. My GP was badly trained by this cardiologist.

That undesirable cardiologist did send me for a cardioversion which had a 9 week wait time. Most patients find cardioversions a temporary band-aid. Few will have it last for years.

Mine lasted only 3 days, but I deem it successful because it showed that I could return to sinus rhythm.

During the time in persistent , the heart remodels. So, I have had to have 3 ablations to get me at the stage of 6 months sinus rhythm 😀 which I am now in. Plus, my brilliant Bordeaux EP said I was one of the most complicated cases at the six month persistent stage and had I not had an ablation at that time, i would not have been able to return to sinus rhythm.

I would be pleased to answer any other of your questions.

[Goosebumps in reply to Melbuckton]

This seems high to me for a cardioversion cost. I've been quoted £1600 at a private hospital in Bristol , the Spire, and if I go the 'private' NHS route it looks like less than £1000. My local NHS hospital has a private ward, I assume that they all do.

[Melbuckton in reply to Goosebumps]

Thanks

[sandoval22]

I was quoted £15k in Liverpool . Probably more in London. If you don't mind going to India then £1500 + air fare.

[Melbuckton in reply to sandoval22]

Been to India on business. I may be able to justify a couple but would need to investigate success rate.

[sandoval22 in reply to Melbuckton]

The Indian EP that I contacted was Dr Vivek Chaturvedi. Excellent CV including Liverpool heart & chest clinic. Has done thousands of ablations and is only 25 mins from Delhi. Also has a few videos on Youtube if you type in his name.

[Melbuckton in reply to sandoval22]

Thanks I was going to get a new kitchen and new central heating but don't really need either...

[sandoval22 in reply to Melbuckton]

Good swap. I could afford ONE ablation in the UK but it seems many people need several , not because of the surgeons ability but because AF is not an exact science.

[charlwood35]

Had a Cryoablation early August at London Bridge Hospital, one night stay, just under £18,000....

[Melbuckton in reply to charlwood35]

Did you have any idea of the success rate. Presumably consultant thought it was quite good?

[charlwood35 in reply to Melbuckton]

I had one further AF episode post ablation but have now been 3 months clear. I travel hopefully! The EP claimed an 80% success rate after one ablation and 90% after two. I didn’t ask over what period but I’m shortly to go back for my, slightly late, 3 month check and will ask....

[Melbuckton in reply to charlwood35]

Heh those are excellent success rates. Surely he didn't mean success for the first half hour....

Seeing consultant privately re cardioversion tomorrow. Wait to see consultant:. next day.

[Jajarunner]

Ablation with an EP from Papworth but at a private hospital is around £15,000. I didn't get further details as I didn't fancy selling a kidney (or two) to pay for it

[Melbuckton in reply to Jajarunner]

Thanks for information. How long was nhs wait cf private please?

[Fazerboy in reply to Melbuckton]

I waited for just under 4 months for an ablation for svt on the nhs.

[Melbuckton in reply to Fazerboy]

Oh. I thought that was more dangerous than af so you would have got priority?

[Fazerboy in reply to Melbuckton]

I don't think svt is more dangerous. I wasn't in any rush in that I had opted not to have an ablation for about 6 months before changing my mind as my symptoms got progressively worse. I think svt is easier to fix than afib. I actually had AVNRT (google if needed).

[Melbuckton in reply to Fazerboy]

Oh didn't know...

I want out of af because my research shows that you lose about 5 percent a year of your cognitive abilities due to cognitive impairment and eventually dementia.

[Fazerboy]

I hadn’t heard that about the cognitive impairment (maybe I should look into it) but if I had af I’d want to get it sorted if possible.