New criteria for an ablation recently published in medscape

[Ianc2]

New Patient Criteria

Among the proposals:

No patient would be able to undergo more than one 'redo' procedure without review carried out by experts external to the organisation

Ablation for persistent AF would only be offered if the patient had a successful DC cardioversion (DCCV) beforehand, and had been tried on rate control with at least two rate control drugs for at least 3 months

Ablation for long standing persistent AF of more than 2 years standing would no longer be possible

Ablation for paroxysmal or persistent AF will not be allowed for patients with a body mass index (BMI) of more than 40

Patients with a BMI of 35 to 40 would need to demonstrate a documented weight loss of at least 10% of their body weight before they are offered AF ablation

[Jalia]

I think we have had this on here before...

[Ianc2 in reply to Jalia]

Yes , I agree with you, but it doesn't seem to be going away?

[BobD Volunteer]

Most of that seems quite sensible especially the BMI bit as it is just a waste of time and money. I first heard of such rumblings probably four years ago maybe five.

[Steve101 in reply to BobD]

Why is it a waste of time and money?

If you are obese is there less chance of ablation being successful?

[BobD Volunteer in reply to Steve101]

Yes. If the underlying cause is not removed, chance of lasting sucess is very low. It has been shown that weight loss leading to a BMI of 25 or lower often removes the need for ablation. Same with lots of things. We all need to help oursleves.

[Steve101 in reply to BobD]

Thanks Bob

Since my diagnosis in December of persistent AF, I have abstained from alcohol (was about 20 units a week) and lost 10 pounds. Aiming to lose another two stone. I recognise I need to help myself. Go to the gym two times a week (have done for two years), and two three 45 min walks a week, generally active in between playing bowls. Although shattered today as have two grandclidren for last two day!

Thank you for giving up your time as a volunteer on this website, it is invaluable.!

Cordioversion on 13th December and sleep test on 17th March.

Still learning about AF mostly through this site,

Thanks again

Steve

[BobD Volunteer in reply to Steve101]

Well done Steve that is fantastic progress .

It has been said before but worth repeating that AF is not generally fatal and in fact many people who use it as a prompt to change their life styles often live longer than they would otherwise have done.

[Steve101 in reply to BobD]

Thanks Bob for the reassurance, initially I was very anxious, being better informed helps you manage concerns and have a more proportionate response to AF.

I’m lucky my heart rate is normal usually 65/70 and don’t feel any papatations. Occasionally light headed, no sure whether meds (on Exodaban) or the AF, could be sleep apnoea.

Keep up the good work and thanks to all the volunteers.

Steve

[cuore]

Whew! Who makes up these proposals? Someone in persistent AF has to fool around with rate control drugs, not even anti-arrhythmic drugs, for three months allowing the rotors to spread (four in the first six months persistent), and another three in the next six months guaranteeing a poor ablation outcome. Then at three months an ablation can be offered which has its own waiting time period. For persistent AF, such a proposal would be regressive not progressive.

[Desanthony]

Wow! This would mean hardly any one in the area I used to live would get an ablation. I would have waited 14 months to see a cardiologist as there wasn't one in our area as they could not recruit. I went to a private cardio. Was given various drugs, bisoprolol, verapamil and two others I can't remember the name of which didn't make me any better - sometimes worse. Was on apixaban all this time. When I moved house my appointment came up with a local cardiologist at my old hospital. Would take me in for a CV when available and then the hospital was closed to outpatients because of norovirus for a couple of months. Thankfully got onto cardio rehab classes near new house and got to see a fantastic cardiologist at the new local hospital and had a successful CV just over a year after first diagnosed and a month before that found that low dose digoxin seemed best for me a higher dose did nothing and found out a ower dose was available by accident! This CV lasted nearly a year. The second lasted less and third done 3 weeks ago still OK. I am on the waiting list for an ablation with EP I paid to see privately in the first instance as long waiting list and he said he would do ablation on NHS but I was about to have knee replacement on Aug 30th so wanted to wait until after I had recovered. I am hoping now that I will be having my ablation either next month or month after which is the earliest I could get it after having first having been referred to him by cardiologist in October on NHS and got appointment with the EP in January. So I would never have been able to meet this criteria. I know of at least 3 other friends who would never have been able to meet this criteria just through the length of waiting lists and various cancellations of appointments and treatments.

[Steve101]

Does this proposed criteria apply to the NHS.