Cryo or elec ablation

[7164]

Hi all

I am seeing the EP on Thursday to discuss ablation.

What is your thoughts on the best procedure please

Rod

[BobD Volunteer]

There is no best Rod. Each have their uses. Cryo is often used as a first attempt as IF you have four conveniently shaped pulmonary veins it is quicker and often sorts the problem. Unfortunately not many people do. Some have conjoined veins or maybe one larger than the others meaning that the cro balloon is unable to form a seal and produce a good freeze burn.

RF (heat ) ablation takes longer but is more flexible in that it can access areas the balloon can't.

Why not go to AF Association website and read the booklet/fact sheet which explains all this.

[7164 in reply to BobD]

As always Bob thank you

Rod

[chris45558]

I had an ablation 3 weeks ago for SVT They started with burning but had to change it during the procedure to freezing as it was so close to my AV node.

[7164 in reply to chris45558]

Chris

How are you doing now?

Rod

[chris45558 in reply to 7164]

Hi Rod

I feel ok now but first week or so was up and down.

I'm back doing steady exercise with no problems

[7164 in reply to chris45558]

Good news

Rod

[jennydog]

I had an RF ablation which was fortunate as I am one of the 25% of the population with conjoined pulmonary veins. See Bob's reply .

[lindat15]

From your prev posts assume you are seeing EP in Aberdeen. I've had both Cryo and RF ablation carried out by Dr Broadhurst. My understanding from discussion with him was that he usually does Cryo for first attempt as this works well for many (Paroxysmal esp). Pulmonary vein isolation remained intact but as I was in persistent AF, with extensive scarring, I needed further RF ablation which took more than twice as long( although I was a complex case)- involved fairly extensive EP study to identify hot spots. Personally I found recovery time much longer from the RF ablation but we are all different. Best of luck Rod

[7164 in reply to lindat15]

Linda

Thank you

How’s the Af?

I’m hoping gone!!

Any observations/advice

Rod

[lindat15 in reply to 7164]

Hi Rod unfortunately have had several episodes of Atrial Tachycardia since Nov which have then morphed into AF. EP said AT happens infrequently after ablation- just my luck!!! Not outcome I'd have wanted but getting some respite/ control with Flecainide at the moment which is something. Ablation asap is way to go as increases chance of success early on. Best advice as others on forum have said- aim for healthy weight/lifestyle ( this was reinforced by both EP and his reg).

Being as informed as possible IMO also makes for more useful discussion with EP. Post 2nd ablation Kardia monitor has proved invaluable as captured events to send onto EP. Hope this helps. Let's know how today's appt goes. Linda

[7164 in reply to lindat15]

Hi Linda

Saw Dr Affolter on Friday

He wants to try Flecanine with Verapamil first then if that doesn’t work cryoablation.

How do you find those drugs?

Seems like a good man👍

Thanks

Rod

[lindat15 in reply to 7164]

Hi Rod good to hear you've now got a treatment plan. Think very fortunate to have 2 fantastic EPs in Aberdeen. Once you're in the system the care is excellent. I know someone who has him as EP - treated with same drugs as you've been put on , had cryo and more than 2 years on still in NSR as far as I'm aware. I have no experience of Verapamil ( on minimal dose of Bisoprolol as my BP goes too low!) but my experience of Flec so far is positive. Was put on max dose though couple of weeks ago due to Tachycardia I've been experiencing since 2nd ablation so not quite sure what happens next!! Let me know how things progress for you. Linda

[7164 in reply to lindat15]

Linda

Thank you for the help

My GP didn’t really know whether I had to be in hospital when I took the first dose of Flec and was waiting for the EP letter. Rang Dr Affolters secretary as he is on holiday she read his letter and told me just to take it.

Thank you for the advice. Did you just take the Flec at home?

If you ever need a podiatrist in Nairn I owe you a freebie😊

Rod

[lindat15 in reply to 7164]

Hi Rod I was changed from Dronedarone to Flec following emergency cardioversion for Tachycardia beg Dec. Memory hazy( due to light anaesthetic!!)? sent home with instructions to start the following day,50mg twice daily . Saw EP again Jan , increased to 100mg * 2 then increased couple of weeks ago to max dose. Due to see EP again soon. Important thing is that you get a follow up ECG after starting flec to ensure no effect on QT prolongation.

You might have to educate your GP by the sound of things. I'll bear the podiatrist appt in mind🙂

[7164 in reply to lindat15]

Linda

Thank you

My gp is on the same learning curve as me 😊

[7164 in reply to lindat15]

Hi Linda

How are you? I have had a few episodes lately as I have had a virus for about 5 weeks.

I am still on the verapamil as I am too scared to try the Dronedarome just now. As you know the Flec put me in hospital.

Ablation delayed of course so scary times

😊

Rod

[lindat15 in reply to 7164]

Hi Rod ok at the moment. Keeping myself as busy a possible, trying to divert my thoughts from a further tachycardic episode occurring. AF is just such a horrible condition, and affects mental as well as physical wellbeing. Sorry to hear you've had such a long running virus which can sometimes be a trigger. I can imagine the effect the indefinite postponement is having- it took me a long time to get to the first ablation in Dec 2018 after 2 cardioversions which failed after 6 days- at times it felt like it completely took over my life. You just want the normality back which everybody around you seems to have. It's good that you're on Verapamil as rate control more important of the two. I think most of us get uneasy when meds change and prob more so after a bad reaction as lots of these meds are pretty heavy duty. Sounds like your consultant is approachable so might be worth contacting him for a further chat. Hang on in there and happy to help if I can. Best wishes Linda.

[7164 in reply to lindat15]

Linda

Good to hear that you are okay 😊

You are the first person to mention the mental health side of this illness. I thought that I was strong before this. I now find that 24/7 I think about it an feel scared. My mental health is not in a good place. Scared to eat and go to bed as that is when it hits me. I would do anything to get this to stop.

As a matter of interest I got this 20 months ago when I was 59. Some poor people seem to get it much younger how on earth do they cope with work and life??

Please stay safe. We are in the best part if the UK IF we are all sensible 😊

Rod

[Cookie24 in reply to lindat15]

Same as me.

[cuore in reply to lindat15]

Join the club. I was one of the most complicated cases at the six month's persistent stage.

[UScore]

Are you being given any say in which procedure it is? I'd have thought the EP would be the one making that decision, using their knowledge of what's best for the patient and their own skill set.

[7164 in reply to UScore]

Uscore

No just checking things out on this great forum

Rod

[7164 in reply to UScore]

EP says cryo after we have try Flecanine

Rod

[Madscientist16]

My EP (in the US) only does cryo-ablations first for AF. He says it has a higher first time success rate than RF. Cryo also is a faster procedure and that it usually has a quicker and easier recovery for the patient.