I have had PAF for 7 years and am now 65. Otherwise healthy with normal blood pressure, heart structurally sound and a low heart beat. I am on apaxiban 5mgx2 a day. I was on Flecainide as a pill in the pocket which shortened the attacks but my EP says it has changed the T waves on my ecg. So I can’t take it any more. On average I get attacks every 4 weeks but this last attack lasted 21 hours. So I have elected to have an ablation. My EP says it has more success with without underlying conditions & at a relatively younger age. Just wondered what to expect and how many of you have had successful ablations.
Jane
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Janey1955
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Ablation must be considered as part of ongoing treatment for AF and is mainly for quality of life. I had three between 2005 and 8 following which my AF was terminated but more recently another arrythmia intruded for which I have had a fourth ablation. I am now ten years ahead of you. I was highly symptomatic so for me having ablation was a must but it can be an ongoing journey. Life style changes are important to help control AF burden so use the seacrh facility to look at those. There are two fact sheets on preparing for and recovering from ablation which you must read.
Thank you for this very helpful. Lifestyle changes well I drink very little, I am not overweight and walk half an hour to an hour a day. I have gone onto de caff drinks and always get 8 hours sleep a night so not sure what else I could do
Probably not much in your case Janey but it helps if we make people aware of how important good lifestyle changes are if they are appropriate. I have had 2 ablations since 2016 and would not hesitate to have a 3rd if necessary. It is a decision which requires a lot of thought but it is very rare to hear from anyone who has regretted having their ablation(s)....
Avoid sugar and eat more plants? I have read recently (sorry can’t remember where) that ablations are also considered to be for health reasons as well as QOL.
Forgot to say my ablation ‘succeeded’ for two years but now I am having episodes every few weeks and like you can’t take flecainide and also can’t take a large dose of rate control meds so back where I started after five years.
They started off much shorter and less often even though I wasn’t taking any meds. Then the intervals started getting shorter and the episodes longer, so I suppose you could say the ablation seems to have progressively worn off. But as we always say, we are all different, I had had AF (diagnosed) for 14 years before the ablation, I was 71 when I had it and I have a leaky mitral valve and other problems. So you are starting from a vastly better position. That’s why other people’s experiences really don’t count for much and your EPs opinion trumps many negative reports 🦋
"Worn off" is not a phrase I would use. There can be tissue reconnection of an ablated area, or the rogue signals have found a new pathway. My right superior vein reconnected twice, so that area was ablated three times. Also, signals in new areas fired up which were the reasons for my three ablations.
It’s not something you would normally think about but we had a big discussion about this some time ago and one of the members said they ate the equivalent of a large fruit bowl every day. They were very surprised to find that that did not count as a plant based diet, sadly 😢
I'm aware that fruit turns into sugar in your system. It raises the blood sugar which can harm the arteries. I've just in the last few weeks made a big change and am slowly weaning myself all animal products and going totally plant based. I was eating a lot of fruit but now thanks to your advice I'm down to 2-3 pieces. I'm off all meat so far and cheese. Off all oil except what I get from Avocados and seeds and nuts. It's called a Wholefood Plant-Based Diet. As prescribed by Dr Caldwell Esselstyn in the US. He's written a book called Preventing and Reversing Heart Disease. I feel a lot cleaner since starting on it, though I'm missing my olive oil. Washing up is so easy now with no greasy dishes! I have some furring in my arteries...no enough to need stents but it's there. Dr Esselstyn is a cardiologist!
I have noticed that if I eat a lot of sugary foods like biscuits, it can be upsetting to the heart with increased ectopics and palpitations the result (these are often a prelude to AF). Fruit seems to be ok however.
Interesting. Not an easy thing to give up though for nearly 50 years i’ve Had a mid morning and mid afternoon sugary snack at work. It’s a sort of treat to look forward to. Amazingly it’s never put any weight on but it may not be helping this
I haven’t had an ablation but have an AF episode every few months, treated with PIP flecanide. For me, refined sugar is a definite trigger for racing heart and AF so I don’t touch biscuits, chocs etc. (Very occasionally a small piece of eg. birthday cake) Fruit and dried fruit does not affect my AF at all. I have dates or raisins and loads of raw nuts for snacks. Good luck.
Cryoablation over 5 years ago and free of AF and drugs since. I walk every day, am not overweight and eat sensibly. I was older than you and having more frequent attacks so you should be coming from a better place. Try to make sure that you go to a centre that carries out a lot of ablations and has a good track record.
Hello Jane, a bit like you I have a structurally normal heart and couldn’t improve lifestyle apart from reducing stress which was difficult at the time. I had a cryo ablation 5 years ago which helped and then had an AF ablation nearly 3 years ago which was a life changer. No AF since, touch wood. It is always in the back of my mind it may come back and I am very aware of my heart. I have bisoprolol handy in case I have a stressful situation. I would definitely have a third ablation if needed as my quality of live improved 100%. If you would like any more info please don’t hesitate to message me. All the best. Bella
I didn’t know that Flecainide could modify T waves. How does this occur?
I don’t know. On my telephone appointment my EP said the T waves had changed since my last Ecg. Between the two ecg’s I had started Flecainide. He said he thought it had changed the waves slightly and under no circumstances to take any more. I now have to go for another ecg to see if the waves have resolved or whether they have worsened. I don’t really know what changed T waves even mean. My GP also questioned the EP’s reasoning. A bit
I think that given that flecainide has this property, patients should be told before they take it. As far as I know this isn’t always the case. I don’t know if Sotalol can do this as well- it is linked with prolongation of the QT interval (although this only seems to be above a certain dose) but presumably this risk is only whilst you are actually taking it, and disappears if you stop.
Well I have stopped it now I am hoping it will have reverted to normal on this next ecg. The EP in his letter to my dr says “to establish if these T wave changes have progressed or resolved “. So may be slight chance they don’t disappear when you stop.
Personally and we can only say personally, I would jump at the chance of an ablation. I have been suffering with various arrhythmia since 1996, not bad at first then over this years (and increase in medication) became really QOL limiting. Cardiologist and EP did not think an ablation was right for me until Flecainide I started taking 4 months earlier gave me Afl really bad. Jumped to the top of the Ablation waiting list. Had the ablation followed by a slow recovery (many have a quick recovery), did not think the ablation worked for the first 3 months. Thankfully the good people on this site re-assured me that my recovery was normal and that was really comforting .
EP who did the ablation said it was only partially successful (still had MAT that could not be fully ablated and would be controlled by Digoxin) and I would be back to normal in a week to fortnight. That was 20 months ago, now good as new on precautionary low (1.25) dose of Bisoprolol, QOL back to normal and feeling better than I did 25 years ago . EP did a really good job (better than he thought) though not so good at predicting the recovery. Over a year ago the Cardiologist and EP said there was no need for me to see them again - Like winning the lottery jackpot only much better!
If you would like to know more about my ablation and recovery details please see my posts from February 2018, I go into some detail, its not all rosy but well worth it to feel like I do today.
What is "MAT that could not be fully ablated "? And, you are saying Digoxin controlled it but you are not on this drug now, if I have read your post correctly.
MAT is Multifocal Atrial Tachycardia, its tachycardia that originates from more than one place in the atria. Digoxin did appear to control it but I was not on it long enough to say it did (less than 2 months before I had the ablation).
Had PVI cryoablation Jan 29th 2018. No AFib since but developed re entrant Aflutter 9 days after the ablation. nothing to do with the abalation, the flutter was in the right atria. It would not go away. EP advised it was likely caused by the flecainide. A flutter ablation Feb 26th 2018. Flutter stopped and has not returned. I stopped all drugs May 15 2018.
I do get ectopics fairly regularly but randomly. Not had any for few weeks now., but can last for days. I now just ignore them, I have them they then go away, they are just an irritation .
Neither of the ablations was a big issue.
if afib returns tomorrow morning I will happily have another ablation tomorrow afternoon to get another few years without drugs.
PS i liked flecaininde it kept my Afib in check and caused no side effects i was aware of but my afib was always high rate so I had to take a rate control drug as well and most of the ones I tried had awful side effects
I liked the Flecainide too. No side effects I was aware of it and it shortened the length of attack by two thirds. Now I can’t take it any more due to these T waves this is why I am electing to have the ablation. Your reply has made me feel I am making the right decision
Wow! you have a marvellous medical system. Not only was your ablation performed during the paroxysmal stage, but also your second one was within one month. Unfortunately, I did not have such luck. The best for continued sinus ,which I am optimistic you will have , because you were not allowed to get persistent.
Not sure about the paroxysmal phase.: I recognised my afib in September 2015 owing to my Garmin watch. I always had high rate afib in attacks so the trace told me the rate. My only other symptom was a fluttery feeling in my upper chest/ neck for a few seconds as I went into afib. Once I was in AFIB i did not have this feeling. My resting hr in afib was between 130 to 195 but I was totally asymptomatic. At that rate you cannot feel your pulse, probably owing to its random nature. And it's too fast for the flutter feeling. Despite the high hr I was totally asymptomatic. I have been running at 243 bpm and could not tell other than the hr monitor on the Garmin. I wasn't even noticibly slower! My first recognised attacks lasted 30 hours ish.
I was initially put on Bisoprolol as rate control but had bad side effects, so stopped it, then tried atenolol which was better but still bad, so ended up on 120mg verapamil daily a CCB , which was side effect free, but it did not keep my hr under 130 when in afib. I tried ( with medical approval) having extra tablets of 40 mg when in afib, but verapamil takes 4 to 6 hours to get into the system, so after 6 hours still went to A&E after this time for my second attack and despite other drugs given in hospital still spent 30 hours there and eventually self converted. I was always hoping they would electrically cardiovert me but they never did. (AFIB BEGETS AFIB that worried me)
On the third (i think) afib attack I discovered that going for a run stopped the afib and put me into NSR. So for the next 8 occasions I did this.
However in July 2017 I got afib and No amount of running would stop it. I was in hospital for the best part of 8 days week with a resting hr of 130 to 195 before being cardioverted with a flecainide infusion in the local coronary care unit. I think at this time I was past paroxysmal . If the IV flecainide had not worked I may not have gone back to NSR at all . Despite being asymptomatic I was also VERY tired - 8 days at average 165 bpm is a lot of marathons! At this time I decided I was having an ablation. I was put on flecainide for rhythm control and diltiazem for rate control of the flecainide. I could not have FLEC as a PIP owing to the difficulty in getting me back to NSR once I was in afib. The flec was fine, the only other afib attack I had was when I missed taking an evening dose. The diltiazem was terrible, lots of side effects. I only stopped on it as I knew I was having an ablation. It took 6 months to get the PVI cryo ablation. As I said previously I then developed reentrant atrial flutter at rate controlled 140 bpm. I was very asymptomatic with this. Walking a few yards had me breathless. I was just sitting or lying down all day as I could do nothing else. I think that is the reason I got a quick second ablation, as 3 weeks at 140 bpm is an even larger number of consecutive marathons! I was shattered. It took weeks to recover not least as my muscles has atrophied owing to doing nothing for the 3 weeks! I was 57.5 years old at the time.
Yes, if one is in the very early stages of persistent, one can get as good a results as in paroxysmal. Another member on this forum was slightly less than two months persistent, and his/her results were as good as yours. It's the remaining in persistent that will really cause the heart remodelling. You're post two years sinus. My best to you.
I had mine , aged 63 in 2013. I had no other issues and decided to go for ablation as a first choice rather than going down the meds route. So far I am free of AF, take no meds except anticoagulants and would do it again no problem. Good luck 🍀
Hi Janey. I had a PVI cryoablation a little over two years ago at age 61 and have been 100% AFib-free since then. My heart now operates like a well-oiled Swiss watch - NSR 24/7.
Prior to the ablation my long-time (10+ years) PAF condition deteriorated to the point where I was having an AFib episode about every 10 days, with episodes lasting anywhere from 10 to 22 hours. My episodes were always highly symptomatic. Due to PAF my quality of life (QoL) was severely impacted. Now, after having had an acutely successful PVI ablation, my QoL is as great as ever.
I wouldn't hesitate for a second to have another ablation, should I ever need to have a "touch-up" in future. They're making advances in this technology all the time, with trials taking place at this time for the very promising/revolutionary Pulsed Field Ablation (PFA) system that eliminates the thermal risks associated with the 'conventional' RF- and cryo-ablation systems. Following all the necessary trials I'm guessing PFA will be widely available sometime in 2022.
I’ll look at that but Might be a bit late for me, I was trying to hang on for that. However like you it’s deteriorating more frequent and more prolonged. I can still cope with the symptoms though. In my last attack of 21 hours I did go to work but I do have a sit down job, but you never know how long I can cope with the symptoms if they worsen. The actual procedure is a bit off putting but if you would go through it again it must be tolerable at least.
^ Those were my initial thoughts as well, that the procedure is a little off putting, but on the day of my procedure it was all so easy and problem-free that I felt quite silly afterwards for all those earlier worries I had. Note that my cardiologist/EP recommended I have a cryoablation rather than an RF ablation, given all my long-time gastro issues (i.e. hiatal hernia, GERD [aka GORD] and mild nutcracker esophagus). I was under GA (general anesthetic) for the procedure and woke up in recovery with the job all complete - and of course in blissful NSR. In retrospect, my having a root canal was a far less tolerable experience than what my ablation was. As mentioned, I'd go through it all again without a second thought (now).
I know it's not an easy thing to do (first time and all), but try not to stress about it.
Some diet changes to identify your individual AF triggers: decaff can be an issue so I now drink a great coffee substitute Orzo, avoid tonic water, minimise processed foods & preservatives like nitrites, cut sugar, gluten & red meat by 50%+, light early (before 6pm) evening meal, half any fruit juices incl your own e.g. our apple juice triggered my last episode.
If you check on this Forum there are a huge amount of lifestyle changes apart from diet e.g. is your sleep good, are you taking the most recommended supplements, are your teeth/gums in tip top condition?
Thank you for the tip re T waves & Flecainide, strangely my cardio doesn't request an ECG for my annual check-up but with your experience I will be sending him one from my Kardia this week.
Ok I will see what lifestyle changes I may be able to adopt. After all I have six months wait for the ablation at least and might as well see what else I can do in the meantime
I should have added that an emergency for me was 9 episodes in a month that needed to be stopped urgently - hence I had to start with a drug to buy me time for lifestyle changes. The fact that I had Lone PAF was a morale booster as it was more likely I could achieve some success focussing on lifestyle.
Really. Yes mine is lone AF. I would find having this condition easier to accept if there was something else wrong but to have this with no reason is annoying. However I will look into making some changes
I tried for many years to manage my PAF but in the end nothing worked and then I met a wonderfully emphatic EP Offered me a cryoblation under GA. i was 56 and aware that the option in an ablation would not always be available if my condition deteriorated. I still have the odd ectopic and fast regular heart rate at times but oh it is bliss compared to having AF. I Can drink strong coffee , lay on my left side and have wine without going into AF. Please take time to recover even though you will feel really well. Good luck and Let us know how you are x
Hello Janet! I fully understand your concern about having an ablation. As a healthy 24 years old, I was diagnosed with afib on Mars 2018 (first attack) and converted myself. On October 22 I had my second afib attack, from 22 to 25 October I was in fibrillation. Then I decided to have an ablation on November 28. I was a little bit anxious before the procedure. Today I'm fine, no AFIB since October 25 2018. I still experience extrasystole sometimes but no AFIB. If my heart needs a second ablation I guess I will have it, no doubt.
Also, take your time. I thought the recover process would be much shorter. My advice would be: don't push you.
Well, I think I did some mistakes and this is why the recover process took longer. I was an athlete 2 years ago, I used to practice 4 to 6 hours of training every day. Mostly swimming, acrobatic gymnastics, rugby. So 2 weeks after my cryoablation I started to run again, it was too soon. In fact you need to rest properly after your ablation and to stay active. Yes, done under general anaesthetic, you sleep like a baby.
In my opinion, moderate exercise and breathing exercise. I started by watching Yoga with Adrienne everyday and then I made my own routine including: walk, yoga, breathing exercise.
Diet changes can help too.
For me the major cause was stress, I mean a HUGE amount of stress. Seems I changed my life and my anxiety/stress level is near 0.
For me alcohol. That’s how it started but I was only ever a moderate social drinker. So I didn’t stop totally but if I ever have a drink now it’s just a half of weak lager. Sometimes I can have one and it doesn’t bring it on other times it comes on after one sip. There again it can come on with no alcohol at all. Anxiety too can start it but then I can’t always know when an anxious moment is going to happen
Afib can be tricky most of the time, I know how you feel. As you I am a moderate social drinker, maybe I have been drunk 3-4 times in my life for now and I never had afib following a good party. Lately I also started to take magnesium and spiruline supplement, maybe you should give a try to magnesium. I read some people here had some benefit by using it. Also, I try to be hydrated every day, I can clearly see the difference when I don't drink enough water, I start to have palpitations.
Good point I will try and up the water intake. I too have thought of magnesium and I mentioned it to the EP but he said it was unlikely to make a difference although anything is worth a try
You may need to push for a GA so mention this asap. With regard to moderate exercise in recovery I would say do nothing for a few weeks then very gradually build yourself up. You will find plenty of info on this forum. No need to rush it your heart will have been scared and the scars need to heal, it takes time even though you feel well in yourself. Actually I developed A migraine but was reassured by my doctor and it settled after a few days. Do not rush recovery it’s not worth the risk.
Great to read all these positive experiences. Maybe the difference between my experience of ablation and all these others is that when I had my first ablation a few years ago I had already been in persistent AF for a few years. I’d had about six cardioversions in that time. The first lasted for 10 months but each one after that lasted a shorter time until the last cardioversions which lasted all of one day. So they tried ablation. The first worked for four months. Then I went on the waiting list for a year to get a second ablation. That worked for about 6 weeks. They tried that sixth cardioversion after that, having put me on Sotalol, but as I say it only lasted a day. I’ve now been on a waiting list for about 18 months so far, waiting for a third ablation but have decided not to bother. I just have no faith it will work given the last one only lasted 6 weeks and each ablation has a lower chance of success than the previous one. They told me my chance of success with a third ablation will only be about 45%. so not worth it in my opinion. So I’m just going to put up with it and stay on a low dose of bisoprolol and edoxaban, accept I have permanent AF and just try and keep as fit as I can. What does annoy me though is the number of years I spent on waiting lists - which then took me over the ‘5 years with persistent AF’ , after which your chance of success with ablation is a lot lower. But good luck with yours. You have a much better chance of success given your AF isn’t persistent and it’s definitely worth going for. The procedure itself is fine. I was sedated for the first one (it’s cheaper for them apparently!) and had a GA for the second. But have to say the sedative is great stuff and you just float on a dreamy cloud only vaguely aware of what’s going on and not caring in the least ha ha. Good luck.
I feel for your story. My first ablation was at the 6 months persistent stage, and I had another two ablations for a total of three. My EP ( world class one ) told me that it is the time spent persistent for the first ablation that counts. For my third ablation, I was one of the most complicated cases at the 6 month stage (defined by first ablation), but I have been in sinus for 15 months and counting.
I am in B.C. Canada where ,if I remember correctly, I was quoted 60% for the third whereas Bordeaux, where I had my previous two, 85%. I went back to Bordeaux.
What I am trying to say is that rather than giving up trying to get back to sinus, get a second opinion from a world class place if you can afford it.
Also, it would be a good idea to find out exactly what was ablated in the first ablation, and also the second. They should have reports -- ask to see them. Because you were persistent probably for a long time, you would have had to have an ablation beyond the pulmonary veins to a number of rogue areas in the atria--in my case 4 areas. Also, my superior pulmonary vein could not be fully ablated in the first ablation due to swelling , reconnected, so ablated in second ablation, reconnected, and ablated again in third. Other areas fired up that were not there for the first ablation and second one. I had other stuff done so I have had extensive ablation. But, I'm in sinus.
Eighteen months is too long a wait. Talk to the manager of the cardiology department. I did.
One last thing. Find out what sort of mapping system they are using. If they can't properly see the signals, they can't ablate them. In my case, domestically, only the Carto system was used. Bordeaux used cutting edge technology with the added cardio-insight vest, rhythmic mapping ( if I remember the terminology correctly), and ethanol injection of the vein of Marshal.
I do take issues with medical centres that just prod along keeping the patient in the PERSISTENT drug path without detouring them to the ablation stage early in the game. AF begets AF; the more you have, the more you will get. That is what happened to me, and I will comfortably say, that is what may have happened to you. Cardioversion is a band-aid approach. Your caregivers appear to be saying it's you rather than them who did not give you the best treatment early. I do wish you the best.
I had two ablations, first one didn't work, second one only 18 months. I've since been on a regimen of Flecainide and Metropolol and haven't had an incident in 30 months. So for me, meds have done the trick and no side effects. Also, I am very active physically- cycling 100 miles per week, weights, skiing etc, so AFIB hasn't held me back too much although I exercise much more carefully and slowly than before. Still consider myself lucky.
Hope your ablation work better for you than me as it would be preferable to avoid meds.
Not silly at all. A cardioversion is where they give you a GA and shock your heart back into rhythm. As far as I’m aware that’s often the first thing they’ll try when someone goes into AF. But it only works when you’re not in normal sinus rhythm so trickier when your AF is intermittent!
I've not contributed on this forum for over a year but wanted to let you know I had an ablation for lone AF March 2019. I started Flecanide the year before whilst I was on the waiting list. Had no episodes or side effects with the Flecanide but I wanted the AF 'fixed'. (The consensus on this site is that AF can't be cured so I use the term remission). The cardiologist said it was 'no brainer' to have it done. My episodes lasted 4-6 hours and went from once or twice a year to monthly which is why I had the ablation. I was 59 when I had the ablation. I had an uneventful recovery -took two weeks off sick and gradually upped my activities. Some people take longer to recover - the fact sheets on this site are helpful. Good luck with it, I hope it goes smoothly.
Janey, it is all up to you. I was 52 when I had my first and only ablation. Almost 10 years later I am still in sinus. I too went the drug route first. Flecanide and Metoprolol for a year and a half. Unfortunately, I did suffer from side effects of the drugs. The thought of increasing the dosage of the drugs did not sit well with me given the side effects I was already suffering. My older brother had an ablation done 2 years before I had mine. He came through with flying colors and no meds. I went to the University of Maryland Medical Center Electrophysiological department. My surgeon was the head of the unit. The actual surgery is a non event for you. You sleep through the whole thing. The surgical suite is a marvel to behold. 9 large video screens on the left side of the bed with 4 more on the right side for the anesthesiologist. After they explained what all the screens were for and finished slapping sticky pads all over my torso, I went out like a light. The surgery lasted 4 hours. All of my electrical leakage was around the pulmonary nerves. In my experience no doctor will ever take you off of a drug. They will up the dosage or switch to something else or maybe even reduce dosage. Never zero though. I was dismayed upon waking up that they wanted to keep me on Flecanide and Metoprolol. In addition they wanted me on an anticoagulant. I had to give myself injections of the anticoagulant for one month. I am already a slow clotter and adding an anticoagulant made that problem worse. After reading some European studies between aspirin and anticoagulants, I got off the blood thinning drugs ASAP. I still take 81mg of Enteric Aspirin a day. The Flecanide and Metoprolol is all gone too. I keep them on hand as a PIP. I cannot remember when I used them that way. It took me time to wean myself of of the drugs, but I did it. I weaned myself off of caffeine too. I cannot remember the last time I had alcohol. I no longer feel skipped heart beats. Even when I exercise I have a nice clean rhythm. Maybe I was just lucky. My brother had to have a second ablation last year.
Read up on the procedure. Then get it scheduled if that is what you want to do.
I think it is the best course of action as this AFib will only get worse. Thanks for sharing your ablation experience, sounds pretty ok. I think I am a good candidate to have it with no other known health issues, and the afib comes on about once a month. So I am hoping that it will work for me as it has worked for you.
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