Requirements for Cardioversion or Catheter Ablation

[paulbasel]

I am a male, 82 years old and have persistent permanent Afib for at least the last 5 years. I never had symptoms and still don't. My Afib was picked up in a routine check before a minor surgery. After seeing a cardiologist he confirmed the Afib as well as left ventricular heart failure with an ejection fraction LVEF of 40%. I am on a cocktail of drugs which lower my heart rate but have never returned my heart to normal sinus rhythm.

He has never mentioned either cardioversion or ablation as an option for me. I also never asked him about these possible treatments simply because I was unaware of them. I have an appointment in a few months and will ask him about why he has never consider them for my case. However, I would appreciate any input about whether anyone has a similar case and the reasons why I may not be a candidate for these procedures.

Many thanks

[BobD Volunteer]

Any and all treatment for AF is only ever about quality of life so if you are not aware of it (asymptomatic) then treatment is merely rate control and anticoagulation for stroke prevention.

[paulbasel in reply to BobD]

I did not know that. Thanks for the information.

[3138REDROSE]

Having the same age and similar symptoms and NO improvement or further suggestions to improve quality of life ,I would say it is age discrimination by the NHS Budgets— unfortunately for the over 80 ‘’Old Codgers ‘’

[paulbasel in reply to 3138REDROSE]

In my case it is not a question of NHS budgets because I am from Switzerland. However, with no symptoms I can't complain too much unless I stroke out. But, we all have to go one day.

[BobD Volunteer in reply to paulbasel]

I presume that you are on anticoagulants?

[BobD Volunteer in reply to 3138REDROSE]

Nothing to do with age or budgets. See my post above. Any treatement is only about symptom controland rate control along with stroke prevention as there is no cure for AF. If you are asymptomatic then you are one of the lucky ones.

[Desanthony in reply to BobD]

BobD have I read somewhere that ejection fraction should be between 40% and 60% for ablation or am I getting mixed up here? This question has given me something to ask at my last pre ablation talk this evening - If I remember.

[BobD Volunteer in reply to Desanthony]

I am not aware of any such requirements but I am not an EP!

[Desanthony in reply to BobD]

I think I may be getting things mixed up then as am sure someone here would have heard of that as I have only had AFib for 3 years now there is a wealth of experience here. It could be that a GP has said this without knowing exactly.

[Dawsonmackay in reply to Desanthony]

My ejection fraction was about 34% and I still had an ablation. Now that I have reverted to NSR, my ejection fraction, within a month, went from 34% to 69%!

[Desanthony in reply to Dawsonmackay]

I asked the nurses last night at my pre-ablation talk and she said that no EF is 100% but usually around 60 - 75% is average. Don't know where I got the 40 to 60% from obviously along the way I have read all sorts of info and talked to all sorts of people and inevitably a lot of the info read or given will be out of date or misunderstood - either by the giver or the receiver. For some reason I had EF and 40 to 60% paired together in my mind.

[Dawsonmackay in reply to Desanthony]

My cardiologist said that 69% is the highest number.

[Desanthony in reply to Dawsonmackay]

Yes. a good number

[Dawsonmackay in reply to 3138REDROSE]

Here in the United States, a friend of a friend's father who was 88 had a successful ablation last year. So have no idea of your circumstances

[Desanthony in reply to Dawsonmackay]

Yes I checked last night with the nurse at my pre ablation talk. They take into account all sorts of things when offering ablation and there is no saying whether it will work or not - though they can give a highly educated guess. If you are living life happily without the symptoms affecting how you live your life and are on anticoagulants and possibly heart rate medication and it is working for you with none or minimum side effects then why go and have any other procedure that may not make any difference when the medication is working perfectly well? However you have to beware of symptom creep and modifying your life to live within those symptoms and getting used to the symptoms when in effect an ablation could make you feel better.