I’m on the list for a 2nd ablation, 9 years after my first which was successful in that it’s only been in the last 12 months that I’ve started to get regular monthly bouts of AF.
Cardiologist informs me that they’ll probably do it under a general anaesthetic, unlike the first which was under sedation.
Anyone had any experience of this? I’d prefer to be sedated but he explained that it might be a bit more uncomfortable although not sure why.
Thanks.
You must be in the minority Frank as most of us prefer to be away playing with the fairies whilst our EP goes searching inside our hearts. My EP has never not used GA as he explained to me that he prefers to have an anaesthetist looking after his patients whilst he works. It also gives them more control over your body which they can monitor much more effectively.
OK some say that recovery is quicker with sedation but I know what I would want.
Many hospitals started sedation as a cost saving I fear to reduce the number of personel involved and possibly speed the through put.
I had my cryoablation under a general just over 11 weeks ago. I was given the option of sedation or a general and chose a general. Not knowing level of sedation I didn’t think I could lie still for a couple of hours and knowing there could be some discomfort was more than I wanted to try and cope with. EP said most opt for a G.A. As it was I chose right as they had to shock me 3 times as I went into Afib as they were finishing.
Didn’t have any effects from G.A apart from being a bit more tired than usual. If ever I need another one I wouldn’t hesitate having a G.A again. That’s just a personal opinion.
Take care
Frances X
I had GA and was shocked four times as they were finishing. Notes said heart was irritable.
Thanks Frances. Good to hear your experience. Take care.
I was 3 hours on that table fully awake something I never want to to do again
I was 6 hours on the table the last time I had ablation with sedation. I since had GA.
GA was much better for me but having said that we are all different and some do prefer sedation.
Pete
I had sedation during 2nd ablation and woke up and was kicking my feet. Ended up having a cardiac tamponade and almost died because I wasn't out completely and moved during the procedure.
I then had to have a repeat under GA and it was a breeze. I will never consider ablation under sedation again.
I would always prefer sedation - I think GA’s are sometimes preferred by the EP’s as you will be paralysed so will not move whereas sedation doesn’t always ensure the patient keeps still - but it is also more expensive. You will recover much more quickly from sedation as GA’s can have very long lasting affects.
I don’t mind being awake during procedures and for me GA is very risky, as is sedation but slightly less risky.
I do agree with Bob in one respect, even with sedation there should be an anaesthetist looking after you during the procedure and in both my ablations the anaesthetist looked after me and told me she would revert to GA at any time either the EP or I felt it was preferable.
I think that would be my ideal.
That’s just what I was thinking, first time I had a colonoscopy, the dr only agreed to do it without any sedation as long as I had a cannula fitted & could sedate me if needed, similar kind of situation
I've had two ablations with sedation and one with a GA, far preferred the GA.
Bordeaux uses sedation. I have had three ablations there with no problems.
3 wow, there’s me thinking they were the dogs bo**ocks & would sort it first time, that’s a big chunk of change!
If you are in paroxysmal AF, generally only the pulmonary veins need be ablated as the AF has not spread beyond them. If you get into persistent the rogue signals have spread to other parts as "AF begets AF." Next it depends how long you have been persistent for the rogue signal to spread. If it's within the first month or two, you might be lucky with just one ablation. I believe I read that one of the members had to have only one as he was not even two months persistent. If you are at six months, probably 4 rogue areas have formed ( read Dr. Haissaguerre of Bordeaux.) Then the procedure will be long, the heart swells somewhat making it difficult to ablate all the areas. So, a second ablation is needed to address the area(s) that could not be ablated in the first and any reconnection that may have occurred and any new signals that start firing. At this point you might be fine with just two ablations. On the other hand, areas that had not fired before might act up requiring a third. The substrate of the heart remodels, and the extent of the remodelling is determined by the time in persistent before the first ablation. ( At least I think that is correct because I did ask my EP)
Going persistent beyond six months will create more rogue areas. ( I remember three more according to Dr. Haissaguerre). Once you get to a year persistent , you are now in long-standing persistent with your heart having to have totally extensive ablations to get back hopefully into consistent sinus.
In my case, I had to have three. The first was extensive as I was six months persistent. The second was for the right pulmonary vein that reconnected plus pari-mitral atrial flutter ( the left side). The third to again address the right superior pulmonary vein which reconnected plus ablation for right side atrial flutter cavo-tricuspid isthmus. So I have had ablation for flutter both in my left and right atria. Plus, ablating three times the superior pulmonary vein. Now 7 months after my third ablation, I have been in sinus rhythm consistently. And, lastly, I was one of the most complicated cases at the six month stage. Had I not had the first ablation at six months persistent, I would not have been able to return to sinus which was the diagnosis of one of the top, if not, the top EP in the world.
This diatribe has been somewhat long-winded, Nugger, but I hope it sheds some light for you on the frequency of ablation.
Wow, very impressive explanation!
When I first heard about ablations, I thought it was a cure & thought that’s for me but after reading posts on here of people having 6 plus, I learnt there’s no such thing as a cure & it blows me away that the medical powers to be Cannot find a cure for an electrical fault of the heart, so what chance is there of curing cancer.
Deliberately burning the main muscle in our body seems so arcade in this day & age, change must come soon because having your heart burnt time after time is just crazy!
Frank
The clinicians are working hard to find a "cure" . Two important aspect must be considered. The first is the mapping. The EP's must be able to see the rogue signals. A great number of the AF clinics use the Carto system. (I believe that is what it is called.) Some are able to obtain adjunct or more advanced systems. The cardio-insight vest is one assistance ( you might want to look that up because I might get too long-winded again to explain). The other is the Rhythm system that is more advanced than the Carto giving more of a 20/20 vision.
The second is the technique -- how the EP does the ablation. In my case, to ablate around the mitral valve is tricky and hard to get to. My excellent Bordaeux EPs had been using ethanol injection in the vein of Marshall (near the Mitral valve) to create the scar. They had been using this technique for only 4 months when it was applied to me. ( For the third ablation, there were no rogue signals around the Mitral valve as in the second one. ) Also there are better catheters that are constantly being invented.
Currently , Pulsed Electric Field is the hot topic for technique. This system is not supposed to create scars, I believe, but somehow uses magnets to get to the actual source of origin rather than creating scars. This topic will be presented at the annual AF symposium at Washington, D.C. in January. You might want to Google Steve S. Ryan for he will give a report on this symposium in language that the layman can understand. I believe in Czechoslovakia , the EPs are experimenting with laser.
Finally, at Pessac, France (right near Bordeaux) , the LIRYC institute was established about 4 years ago. This centre , with directors Dr. Haissaguerre (practically invented the ablation technique known today), Dr. Jais and Dr. Hocini , brings together under one roof, clinicians from all over the world to find hopefully a permanent cure for not just AF but also ventricular arrhythmia which is more dangerous. You might want to look up LIRYC institute to see what great work they are doing. It's on its way to being world renown for heart disease.
Frank, I'm being long-winded again, but I have been at this for 4 years and have had three ablations, so I couldn't help but attempt to explain since you appear to be interested. Hopefully your AF is not advanced so you will be able to benefit from recent advances.
Long winded is good, your teaching lots of people on here all about the ins & outs of ablations.
As AI (Artificial Intelligence)gets more advanced, we will see the errors of our ways but for now, all we got is us humans,of which lots are fueled by greed & thats bad for the patient.
I will be following you as I’ve learn so much already, long winded lol
That’s ridiculous-to say that an EP is fueled by greed...
I said lots are fueled by greed, example I needed a cardioversion in the USA & was given a quote of $109,888,75
Now you tell me if that’s not greed
Eliquis/Apixaban is $500 a month as aposed to UK at $70 a month to the NHS
No, it's not greed. My second ablation was $112K, and the third was $130K. They implemented the Topera system while I was under to find the AF hot spots. The UK is cheaper because everyone chips in - in the US not so. Don't blame it on the hospital. I would rather be cured than not...
Frank - try this and you might not need another ablation:
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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 (this is why all doctors agree that afib gets worse as you get older). 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 (afternoon) 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??
I'm pretty sure that Afib is caused by a gland(s) - like the Pancreas, Thyroid (sends signals to the heart to increase speed or strength of beat), Adrenal Gland (sends signals to increase heart rate), Sympathetic Nerve (increases heart rate) or Vagus Nerve (decreases heart rate), Hypothalamus Gland or others - or an organ that, in our old age, is not working well anymore and excess sugar or dehydration is causing them to send mixed signals to the heart - for example telling the heart to beat fast and slow at the same time - which causes it to skip beats, etc. I can't prove that (and neither can my doctors), but I have a very strong suspicion that that is the root cause of our Afib problems. I am working on this with a Nutritionist and hope to get some definitive proof in a few months.
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:
https//cardiab.biomedcentral.com/a...
I definitely think there’s something in the dehydration point. As for the others, I can’t help feel that we all have different tolerance levels to things and the old maxim about everything in moderation is a sound one. Let’s hope the study finds something we can all rely on as applying to all of us. Thanks.
Yes I read your post a few weeks back & have been making an effort to watch my sugar intake
2nd Ablation
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2nd Ablation 
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