Hello Everyone my cardiologist has given me three choices : 1)
To put up with my AF (2) Ablation or a Pacemaker ,I’m not sure what to do .I was diagnose with AF and a leaky heart valve 3months ago and am on Apixiban and bisoprolol
Any comments would be much appreciated
Is it your decision? Pacemaker is not normally advised as a treatment for AF?
Ablation - dependant upon age, fitness, etc the chances of success will be variables, recovery can be lengthy, no guarantee of lasting success so research and consider well.
Pace and Ablate - is the final treatment for relieving symptomatic AF - but it doesn’t stop the AF! They implant a pacemaker, 6 weeks plus do an AV node ablation which will make you completely pacemaker dependant for life ( not something to consider lightly). Your pulse will be steady but you may still have and feel AF, sometimes with all the symptoms.
I had 2 ablations, 1st made things a whole lot worse and I didn’t help myself by doing too much, too soon as I felt great to begin with - but ended up in ICU for 3 days. I had a second ablation some 3 months later which did stop the AF for 3 years, but it wasn’t without complications.
Fast forward another 4 years and AF became so much more symptomatic again that I decided I couldn’t continue to live like that. Ablation was now very risky for me as I am at high risk if I have sedation or GA so I chose Pacemaker with the idea of AV node ablation but what I found in practice was that the Pacemaker stopped all the AF - or so I thought until recently. I cancelled the second part of the procedure, the AV node ablation but I am now experiencing AF again. It seems to be triggered by infection so the episodes are quite infrequent and I have to say that my QOL has been vastly improved since PM implant. The procedure is done under a local anaesthetic and doesn’t require sedation, although I believe it can be offered if you prefer.
It is a very personal choice the pros and cons of which need to be carefully researched and discussed with your EP who may advise what is most appropriate for your situation. I couldn’t have gone through another ablation, especially with the knowledge that the AF would probably return in a few years anyway. I don’t play contact sports, I was over 65 and with other conditions so I was hardly young or fit.
I hope that helps you consider your options. Let us know how you lean and what happens next as informed discussion can help other people in a similar situation.
Best wishes CD
Thank you Cdreamer it was very informative and gives me something to chew over
I was given 3 choices, ablation, pacemaker and meds to control the AF, pacemaker and av node ablation.
My EP advised an ablation because of my age (64) so I'm on the list but he did say it may not work and could need several attempts and he's not convinced it will solve the problem, I do have pauses and bradycardia as well.
Having read on here all the problems some people have post ablation, the length of recovery time and the possible need for it to be done again and again I'm going to ask for a pacemaker and meds instead as I feel this has more chance of success in one shot.
So much depends on how AF is affecting you, age, general health and fitness etc etc.
1. Lots of people do put up with it and manage to live relatively normal lives using medication to help control heart rate and minimise the risk of heart failure (not as dramatic as it sounds). This will mean taking fairly potent medication for the rest of your life. If your AF is paroxysmal, ie comes and goes then it is likely, over time, to become persistent but many find that transition easier to come to terms with, provided they can tolerate the medication and any symptoms they might experience. I’m now about to tread dangerously and please take this in the way it is meant, but if your nickname is a clue, then any lifestyle improvements to become a ThinnyLizzie will make a tremendous difference to your AF.
2. I’m not medically trained trained, but generally I think ablation is normally considered as the first option out of the two, but that depends on whether or not you are likely to respond well to the treatment. If you are in persistent AF ie, it is with you 24/7, then normally a cardioversion is considered first to see if you can be reverted to normal sinus rhythm and if so, how much better you might feel as a result. This might be worth discussing with your EP/cardiologist. I have no experience of pacemakers but know many who have had one fitted and they seem fine.
Obviously, this is not a decision anyone one can make for you, but hopefully with the right research, advice from your friends here and support from your Doctors, you will end up doing the right thing for you.....
Hi, I have AF and a leaky heart valve and couldn't tolerate an effective dose of medication so I was offered an ablation or a pacemaker. I tried the ablation first but it failed after two years and I am now in a 'putting up with it' phase. If the AF becomes intolerable I am going to hold out for pace and ablate as in my case there are other medical reasons why repeated ablations aren't suitable for me. Leaky valves are cited as one of the causes of AF so in any case I'd have doubts about another ablation being successful long-term but I may be quite wrong and that's a question to ask your cardiologist.
Best wishes whatever you decide 💜
Ok thank youb
One thing that’s not a nice way of telling you. Bet the person has never had any problems. I couldn’t make my mind up about a second ablation two years ago.i didn’t know whether to-stay on the flecanide or not. I stayed on the flecanide, but know I think I will have another ablation. Get your head round it, only you can make your mind up. A lot of people on here tell you to have these things done but at the end of the day only you can decide. Read all what people say on here and you will sort your head out. Best of luck have a fantastic Christmas. X
My EP has always said that a Pacemaker is the last resort as it is irreversible. I have had 4 ablations and would have another if needed and offered.
Thanks
Just to be specific - a pacemaker implant in itself is not irreversible as it can be turned off and the implant could be removed, unlikely that the wires could be though - but the AV node ablation certainly is as it takes out your natural pacemaker so that you are reliant upon the pacemaker.
You can have a pacemaker without having the AV node ablation as many people do.
I put up with P/A/F for many years and eventually had ablation, this for me did not work, although I was told it was a success it actually made me a lot worse than before and as a consequence I was fitted with a pacemaker 3 years ago. I have now lost 5 stone and reduced the drugs I was still taking by half. I have a yearly pacing appointment and am pleased to say A/F is, so far, a thing of the past. I hope this helps you to reach your decision.
Thank you
I check in here very infrequently these days as after my first and so far only ablation I’ve now been almost AF free for nearly three years. I say almost because I’ve had two episodes in that time that might or might not have been PAF, but so much milder than I used to have that I wasn’t sure! I’m now off all meds except anticoagulant but would have another ablation in a heartbeat(!) if the awful episodes returned. I suspect a lot of people with successful outcomes like me disappear off this forum as we’re busy getting on with our lives so newbies might not get to hear of the success stories.
In short, please don’t dismiss ablation as a possible solution, it does work for some. Ask your consultant how many ablations they carry out and what are the chances of success in your particular case, it often depends on whether you have other problems, I was told 70-80%. I’m so grateful to Professor Gill and his team at Guys and St Thomas’s, they’ve given me my life back.
Good luck whatever decision you make.
Thank you ,it’s good to hear success stories
of course I am not a doctor -- but I was given a pacemaker in the summer of 2018 after having 4 cardiac arrests, where my heart stopped beating completely and I passed out. Fortunately I was in the ER at the time, so was quickly & easily revived. But I LOVE my pacemaker. It is so comforting to know that it is there, just in case my heart slows down too much or stops beating again! I was dx with AFib and mild heart failure. But in all those months, I have only felt my AFib three times, and only for a few seconds or two minutes. I was told here on this forum that I don't feel my Afib because of the pacemaker. I don't know, but I just feel so safe having it.
Interesting, my cardiologist gave me the same three choices about a week ago (continue with drugs, ablation, pacemaker). Her comments on each were: that the amiodarone I was on was the last drug therapy they could try; that ablation had 70% success rate with 5% chance of complications and that I 'just made it' below the cut off point for being offered the procedure in terms of weight (say no more!); and finally that a pacemaker was, of course, a permanent fixture, no going back. I decided on the ablation and there is in our area (West of Scotland) a 6 month waiting list (Which will, hopefully, allow me to shed more than a few pounds to help my 'heart health' overall.)
I am sorry you have other problems like the leaky valve and do not know how that would factor into your situation or decisions. I have read varying reports on here about ablation, but, for me, the amiodarone isn't really working that well, so the ablation road it is.
All the best.
Polly
Thanks for your thoughts
I'm new to this site and am surprised to hear folks say what a terrible time they had with ablation. I have a sever flutter/afib and have been ablated 3 times. Two were done under a light sedation and one was general because the needed to also check the left atrium.
I can almost say there was no recovery, I was at work in 3 days 2 of the times and the last time I moved to Africa 3 days later, I just didn't do heavy lifting. All of these happened over a 4 year span.
I have a pacemaker for braydcardia and it is a God-send. I take cartizam for rate.
But it is back again and with a vengeance. I go back next week and see the electrophysiologist again to see what he has up his sleeve.
I'm saying all this to those who fear ablation. It has given me 5 years with far better QOL with only little bumps in the road. If he says we can try again I'll do it without hesitation. Now what he can do about the HF, I don't know.
I wish you well.
It's not always a case of "fear" of ablation, its more weighing up if the procedure is worth going through given the success rate can be low and the need for it to be done again and again can be quite high. Personally if I can get all my issues resolved with a pacemaker then it's a better option than possibly prolonging the problems trying ablation first.
Thanks for your response
Thank you , hope all goes well with you
I had a pacemaker installed March 4, 2019 because I had AF that occurred about once a month and when I reverted back to normal rhythm I passed out. My heart rate would slow to 38 bpm. The last time I passed out my heart paused for 8.6 seconds. So I had pacemaker installed. I do not have AF any more to my knowledge. So It was a right decision.
Thank you for replying
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