New to the site and wanted a bit of information and advice.
Been diagnosed with paroxysmal atrial fibrillation in October last year. Went private and seen a electoral physiologist ( i think that's what they're called) had a chat and he put me on flecanide as a pill in pocket and talked-about ablation. ,since then had a few episodes but when taking the meds coma back to normal . In June this year had a really bad week for 6 days Kettering in and out of afib do they have put me flecanide twice aday and everything has been fine. Then I spoke 2 my cardioid last week and was discussing what was happening and he recommended I stay on the tablets but when I told him about ablation he tried to talk me out of it but when I told that I had been private to one of his superior he's basically put me on blood thinners and been told that I could have it done in about 6-8weeks.. When he sent the letter to my Dr he had said I was going against his recommendation of staying on the tablets. So I'm a bit confused as what to do now weather to go ahead ir stay on the medication?? I'm sorry thus is a bit long winded but would like to know how long would you normally wait for ablation ? Is it better to have the ablation etc.
Thanks in advance for reading and your replies.
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paul7807
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An electrophysiologist is a cardiologist who specialises in arrhythmias. An electrician if you like compared to a normal cardiologist who is a plumber. As the old saying goes, "if you go to see a carpet salesman he will sell you a carpet".
I'm a great fan of ablation myself but would caution you that since there is no guaranteed cure for atrial fibrillation, Any and All treatment is only ever for symptom control and quality of life (QOL).
If your symptoms are well controlled by drugs as are many people's and you have addressed the important life style issues such as weight loss (BMI less than 25) no alcohol, sensible (not over) exercise and improved diet (less meat and processed foods and a move to a more plant based diet) , then the risks from ablation may be avoided. Yes you will need to be anticoagulated for a while prior to ablation. Most people with AF benefit from this regardless as AF makes us five times more likely to have a stroke.
Another qood quote is "When the pupil is ready the teacher will come" and I think many people know instinctively when to proceed towards ablation. Go to AF Association main website and read till you drop as knowledge is power.
Thanks for the reply just unsure what to do.. i was under the impression by reading some of the posts here that people wait for ages for an ablation and that you would eventually end up having one anyway. But thought I would have it 1st as last seen that I have the option.
I so agree with Bob. I learned so much from the website. I spoke to my own cardiologist just yesterday about the very same thing. Why was I not given the opportunity for an ablation. He said that at the time I seemed to be doing okay on the drugs and my lifestyle was not being too effected. Because of my age 71 at the time he thought it best to not suggest an ablation because it was not without risks. I don’t entirely agree with him as I did have issues initially and I know of friends my age and younger both heavier and slimmer who had one! . Today I have persistent Afib and he is recommending another Holter monitor. Another reason for this I told him I would like a substitute pill rather than Digoxin. I read up on it and heard about others experiences especially memory loss and didn’t feel it was safe for me, so he took me off it. Will wait and see how I react to not being on it.
Ablations are not always the quick cure we expect them to be. I've had three, but still have AF and also flutter. After my first two I felt ill for about 3 months, but my third one made me feel a lot better almost instantly. The scarring that is created from the burning or freezing inside the heart can also cause it to become a little stiff in it's functioning.
I'd try the healthy diet that Bob has recommended first and avoid alcohol and all foods that contain artificial additives. Also a lot of people find that taking magnesium helps reduce their symptoms - either taurate, citrate or glycinate. It can be bought in tablet form, as a spray on oil or as a type of bath salt.
If your tablets are working I'd hang on, new ideas for curing AF may be near.
What I mean is new techniques are being tried and of course I don't know them all, they don't have to report to me what they're trialling (wish they did). For instance last year a pulsed clip that you put on your ear lobe was said to stimulate the vagus nerve and improve AF. A member on this forum was going to trial one and report back - but he hasn't as yet!
When I had my third ablation my EP and his registrar at Derriford Hospital in Plymouth had devised a piece of equipment to measure on the outside of the heart where rogue beats were coming from. I do wonder if that's why that ablation was so successful.
I get Google updates to my PC on all that's new regarding AF, but I'm female and really have little interest in the minor details, would rather be living life outside in my garden or on a walk. I'll see if I can find you the link later. My keyboard is playing up and missing out letters I type at the moment (never buy a cheap keyboard in the supermarket, even if it is made by Hewlett Packard).
I had an ablation booked but decided against it, more cons than pros for me to consider it worth going through with it, I chose meds instead and so glad I did.
I knew someone years ago (perhaps 10) who went into hospital to have an ablation carried out by the well known Prof Schilling. He talked to the people in the nearby beds, decided he wouldn't have it done and went home. Afraid I don't know how he is now.
I'm in the same situation as you. Ablation or no ablation ?? The longer you leave it the less likely it is to be successful - early days are best.
However there are a few points to add.
1. Flec has worked wonders for me - afib can 'do one' at the moment.
2. The technic's for ablation are improving all the time - we now have mapping etc and a far greater chance of success as medicial research improves.
For me I'm playing the waiting game. I'll stick with flec (it works for me) at the moment and wait and see what happens over the next few years. New treatments ? Who knows what will happen in a few years time ? I bet it will improve though.
I'm holding off these current days - saying that an ablation has a far better chance of success if I take a punt and go for it now. Personally I'm not. The decision though is completely yours - do your own research and decide from there.
It takes me back to my youth. The Clash 'should I stay or should I go'.
I'm staying on flec.
The current flec treatment at the moment works and unless things change I'm not going to change it. Please though (as said above) do your own research and decide what's best for you.
Best of luck either way. It's your decision but it sounds like a similar situation to mine. My personal choice is to hold fire for a year or so. I'm not medically qualified in anyway - just to clarify that.
HI, just a quick question on your reply. I had an ablation in December which has not worked possibly as I still have pretty regular AF episodes that are quite mild and self resolving after a few hours. The only medication I have been offered is Bisoprolol 1.5mg which I found affected me negatively due to a lowish HR so I only use it as a PIP when AF starts, which seems to stop my HR racing, although still irregular.
My EP and or GP have never mentioned Flec. but I see it mentioned on this site often so I'm curious as to who would benefit and why. My understanding is it is a rate control drug which from what I've read is benefiting many sufferers. Are there any drawbacks to taking it and tests to confirm is safety prior to prescribing.
Flec can either be used as a PIP or taken everyday (or both). For many people it really does help the heart return to normal rhythm.
If your afib only lasts a few hours then maybe your EP thinks it's not worthwhile taking it. I would certainly ask about it though the next time you see him - he can only say no.
Just one other thing. If it were me having regular afib episodes I would be eager to explore being put on an anticoagulant. I think you certainly should ask your EP about this if you are only on Bisoprolol. This is not medicial advice but simply offered as questions to discuss with your doc
Hi thanks for that, I am on anticoagulants due to my chadvas score of 2 but I was talking about afib related control drugs such as beta blockers and flec etc, sorry if I didn't make it clear.
I'm coming to terms with having the AF now and for the last 2 years it's stayed paroxysmal and only midly debilitating. With the ablation currently looking like it hasn't worked, as in still experiencing episodes I was just curious about how some are on drugs such as flec but it's never been mentioned to me prior to the procedure or in the 7 months since. To be honest I've always tried to stay off pills if possible believing my body will heal itself over time but this AF has changed my life to a degree, what with not being able to drink and having to consider what exercise I can manage etc. I naively thought having an ablation was a sort of cure and was certainly led to believe in my case it had a high chance of complete success by the EP.
"I naively thought having an ablation was a sort of cure and was certainly led to believe in my case it had a high chance of complete success by the EP"
You are certainly not naive HB. Far from it.
Your EP is far better to give you advice than I. If your EP thinks there is a high chance of success then certainly follow his guideance - he's the guy 'in the know'. His knowledge about the condition is far greater than mine. I'm just a fellow afibber a few years down the line. The thing with afib is we are all different. Sticking with med's at the moment is my personal decision - your situation and personal choice maybe totally different to mine.
For me (at the moment) flec is working wonders. However it might not for you - who knows ? I do think though it's worth following your EP's recommendation - the guy will have spent near on 8 years qualifying and knows his stuff.
You wrote
"To be honest I've always tried to stay off pills"
Yep - I fully understand that. Best to play it safe though even if you don't want to be on them.
You also wrote
"if possible believing my body will heal itself over time"
It's not going to 'heal itself' but lifestyle changes can really help - sounds like you're already on the ball with that one.
Good luck with which ever way you decide to go - for me I'm sticking on med's (for now) but would follow an EP's advice should he / she have a different take on the matter.
Can you suggest how long might be too long to wait. I've had AFib for 13 years now and the cardio is pushing for me to have an ablation, but I am not convinced it is the right choice for me. I have had my flecanide in creased and that seems to have solved much of the problem. I have complicated things by having a SCAD, spontaneous coronary artery dissection, which cause an MI, 20 months ago. I also have congenital pulmonary valve stenosis. Because of this, I just feel the less intervention the better and to stay on the tablets. I was never told that the ablation is better done sooner rather than later, thank goodness these sites are here so that we can be better informed. Thank you.
Please - I do need to perfectly clear here ! I am not a doctor or anyway medicially qualified. My understanding is that an ablation has a better success rate the less time you have been in permanment afib. If your cardio is pushing you to have one then follow his advice. He must think there is a good chance of success to suggest it.
The decision is completely yours of course. Personally I'm sticking with flec at the moment - however many others go the ablation route and have great success with it.
I think the important thing is to make an informed choice and decide what's best for you. This is a great forum but most people on here are not medic's. We are all in the same boat and fellow afibbers - to make important decisions it's your doc and cardio who will offer the best medicial advice for your needs.
Whichever route you take I wish you success. Have a great weekend.
The usual path for us AFers is see a cardiologist first and then referred to an EP if ablation is preferred to drugs. Like you I wanted the full picture earlier and so saw an EP privately but suggest you explain to your cardio you were not questioning his advice. My cardio had his own 'supply chain' to a particular EP and once the latter is involved and has given advice I believe the cardio is careful not to contradict them....professional etiquette.
Incidentally, I didn't like the EP I went to and suggested to my cardio I might go to someone else (not connected to him) and he almost had a coronary on the spot, no doubt at the thought of the EP thinking the cardio had recommended a different EP!
The above is all background from my experience. The important stuff is pills or ablation and I can do no better than suggest you re-read Bob's reply above and others. I was offered an ablation but went for 200mgs (medium dose) Flec per day and with a lot of lifestyle changes I have had over 6 yrs virtually AF free and increasingly good QOL.
hi, how old are you ? In my case I had Paroxysmal in early stage, after taking amiodarone n Xaralto for a month, everything was fine for a year. Then the relapse n then continue to take the Same medication For a month then ok again. Then a few month latter it happened n off again. As my age was 68 , n I opted for cryoablation as advised by EP. Till now about nearly 2 years after procedure. The procedure done considered good and fine. I don’t have HP n diabetes that could help in good recovery. Normally Paroxysmal at early stage, it will as time go on will become pertinent AFIb.
Hope that my case can help you to decide better. Tq
Hi Tankohyin I'm 43 and that's why I was thinking about the ablation I already take levothyroxine for an underactive thyroid so was thinking I didn't want to take more pills for the rest of my life.
Stay on the meds. My afib is so controlled. Am not even aware of it! Lucky me
I am on Flecainide 2 x 50mg daily and (touch wood) everything’s spot on. I have read much about ablation and for me it would definitely only ever be a last resort.
Hi thank you all for your replies a lot of information to consider.
I will find out in the latter part of next week as to when ill be going in but can still pull out if I change my mind. I will carry on reading and try and find out as much info as I can as a lot of you have suggested and then make up my mind and let you know what I decided
again thank you all for the advice and sorry for all the mistakes in the original post I can thank the phone for that and good old predictive text.
I have heard that ablation outcomes can be better if done sooner rather than later, as the rogue pathways have not truly established themselves like years and years of AF can cause (not to mention enlarged heart and heart failure from uncontrolled AF). The meds could not control my AF so I insisted on ablation and had the procedure 16 months after diagnosis. It has been 8 months and I have been AF free and on NO meds. I would do it again in a heartbeat. Pun intended.
I didn’t have AF but had svt. The episodes got more frequent. I put off having an ablation but eventually as Bob said the pupil knows when he is ready (or something like that). I had an ablation 9 months ago. Best thing I ever did. I took it easy for 3 months but I’m now back to normal. No meds or anything. I agree that if you leave svt too long the rogue pathways get more established so dealing with them sooner helps. I admit that dealing with svt seems easier than dealing with AF.
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