I have learned much more from this site than I have from any of my doctors and really appreciate all of you. I wake up every morning in the US to read your posts and have only written once to ask about anxiety. My question now is I have had A-Fib for 8 years and 4 years ago I was put on Multag (Dronedarone) which I thought was my miracle drug.....well it has stopped working! I have been getting more frequent attacks and have been on a 7 day monitor which showed that I am in A-Fib 27% of the time. I think it's BobD that says when it starts effecting the quality of your life its time to do something and I'm afraid I may be at that point. I am terribly scared of having an ablation and my EP says that I have a 60% chance of it working. I have always told him when he tells me I have a 90% chance I'll do it!
I am scheduled to see the doctor who does the ablations on Thursday to see what he says. Someone told me that I have waited too long with the A-Fib and it's too late. So, I am asking you guys, my friends across the pond for your advice.......
thanks!
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PamJN
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I’m no expert but a few thoughts, firstly it does seem that most “ fixes” for afib are temporary they are a miracle for a while, then quite good then seem to fizzle and a new miracle is needed.
Regarding ablation the statistics are a bit misleading I think ( FYI I had ablation 1 in July and it has not fixed the problem ) the 60% chance is a bit too muddy , thing is it either works ( for 6 out of ten that is the case) or it doesn’t and for those that’s it doesn’t ( 4 out of 10) it is entirely possible to have a further procedure .
In my case the first ablation appears to have made my afib “ less complicated” so hopefully a second procedure will be a success. To that end I’m thinking of this as a two step process ( hopefully only 2!) with a likely chance of success over 90%
Obviously everyone is different but I’m sure that if you have had some normal heart rate time recentlythey will have real confidence ablation can work
So good luck and as a big nervous coward when it comes to all things hospital it is scary but really not that bad
Whilst the success rate of ablation does fall over time I would say that until yourAF is continuous it is never too late. That said it may require more than one procedure but once you pluck up courage to make that step, the next is easy.
Can you pinpoint what your fear is about? The procedure? The recovery? Of it not working? Until you pinpoint your fear, address it by asking your doctor the questions you need answering you may well be stuck in ambivalence.
I think there are no certaintities in life but there are opportunities. The flip side of opportunity is threat. So ..... do you see ablation as an opportunity to improve your quality of life OR a threat to ???????
Once you have dug deep and have a clearer idea the next mind experiment to try is - What would it be like to have ablation which worked? What would it be like to live with AF as it is, assuming that it will progress? Which is better and which worse?
You might also ask about alternatives and do your research on this - start with the AFA information sheets on available treatments.
Only you can decide what is right for you but you may need some help deciding so write down all the questions you have for the ablation doctor, don’t hold back and ask them how they think they can help? Be rigorous because until you have faith in the person who will be performing the procedure, you will not be content with your decision to have the ablation and do not be talked into or out of anything.
My biggest fear is it NOT working at all or the A-Fib getting worse than it is now. Also concerned about having it done during a pandemic.....not worried so much about the hospital but would if I had it I when in (I know I would have to have a test before) but would if I got it after I had the ablation done? My timing here is not real good......plus I love Christmas and the month before....I don't want to be laid up but then I don't want my heart going crazy either. I'll see what the doctor says and go from there. I sound like a little kid here and I'm 74! I want my health without the sacrifice I guess......
Thanks to all of you for your responses.
Pam
The only thing I would add to what has already been said is that we rarely hear from anyone saying that they wished they had NOT had their ablation. Yes there are risks but they are minimal, crossing the road is far more dangerous!!
My neighbour had had paroxysmal AF for about 10 years before having an ablation 6 or 7 years ago (he was a firefighter at the time). He hasn’t missed a beat since and has never had a recurrence. My AF took a couple of ablations but is now under control and it’s nice to have a relatively normal life again. Everyone is different.
I wrote down something a football coach said recently after his team played in a losing final. “You’ve got to risk the hurt.” We can’t not do things because we’re afraid of failure.
Of course it’s your decision, based on medical advice. I’m glad I had mine.
Hi Pam, I can’t add to the great replies you had already except to say that your chances of a ‘successful’ ablation go down with time so your 90% requirement is never going to be met. It reminds me of my daughter who was waiting at home for her birth contraction to go from 3 minutes apart to 5 minutes before heading to hospital. Luckily the hospital was just around the corner so she made it in time but the birth plan was left in the car 🤣
I was determined not to have an ablation but eventually my EP told me it was ‘make your mind up time’ otherwise I might be in permanent AF and maybe need a pacemaker as well! I’m not sorry I had mine, although my AF is back my situation has improved and the pacemaker isn’t necessary either.
Have you got all your ducks on a row? Is your weight where it should be? Is your waist half your height? Do you take regular exercise? Have you had your bloods tested with particular regard to your blood sugar levels to Identify any possibility of diabetes? Do you eat a reasonably low carb diet with plenty of fresh veg?
I am 74 ,I had an ablation at 70 which worked very well for a year and then the gremlins crept back in again. I have had the usual tests done and my irregularity is in a part of my heart that is difficult to get at in a place where the heart wall is very thin and up against a major artery and a critical nerve. The chances of a problem developing are rated at 30%.
If I was younger I would probably go for it without a backward glance but my ability to recover from a mistake has to be questionable. For me, in this case, the odds are not acceptable.
However my ducks are in a row. I control my weight , watch what I eat and try very hard get 10,000 steps in every day. My pulse is irregular but not noticeably so and I can live with it.
I hope this helps. Please accept my best wishes, it is not an easy decision.
The figure of 60% you have been given is for a *first* ablation. It’s common to need a second one - the chance of success then increases. Some EP’s actually tell patients that they should think of ablation as a potentially two-step procedure.
The chance of success depends on the type of AF- the success rate is higher for PAF on first ablation than for permanent or persistent AF. The skill of the operator also matters a great deal. What is crucial- a friend who lives in Costa Rica was told this by a retired US cardiologist and this is also confined by what I have read-is that it is very important that the operator has carried out the procedure dozens of times in a given year, preferably with the same team. So choice of hospital/operator matters.
The following exerpt from the University of Michigan website gives some typical figures:
“*Paroxysmal* atrial fibrillation can be eliminated in 70-75 percent of patients with a single procedure. When the procedure is repeated in patients who still have atrial fibrillation after the first procedure, the overall success rate is approximately 85-90 percent.
*Persistent* atrial fibrillation can be eliminated in approximately 50 percent of patients with a single procedure. In about 30 percent of patients who undergo ablation of chronic atrial fibrillation, the atrial fibrillation is replaced by a different kind of short circuit referred to as “left atrial flutter.” These patients are treated temporarily with medications and the left atrial flutter sometimes goes away on its own within a few months. If it does not, you may need a second catheter ablation procedure to eliminate the flutter. In these cases, the overall success rate is approximately 75-85 percent. If the atrial fibrillation has been persistent for more than 1-2 years, almost all patients will require more than one ablation procedure before a normal heart rhythm is restored.”
I can’t say if it’s ‘too late’ or not. My hubby had x5 ablations for AF which all worked for a while. He couldn’t tolerate Multag. He now has a pacemaker for his AF and says he wishes he had had that done sooner - despite being ‘dragged in’ for the procedure. I wish you all the very best - May I suggest what might be behind the theory of ‘too late’, I’m not an expert - or even a patient- but my though would be ‘ what do you have to lose’
Is it possible that a different medication might help? That would be something to discuss with your specialist, as there are a number of medications that are considered the first line of defense with AF--you've already used Multag (Dronedarone) with success for 4 years until it didn't work so well... it might be worth a conversation.
I would check with your cardiologist if a different drug e.g. Flecainide would be a possibility in your case. Otherwise an ablation may be best provided you are fit and healthy and well dosed up with Vitamin C before the procedure.
2 years 8 months later i am afib free , and have not taken any drugs for 2 years 6 months.
If AFib returned tommorrow I would happily have another for another 2 years 8 months.
No drug side effects, no forgetting to take tablets c, no travel Insurance hassle, no worry afib will kick in just when you are doing something important.
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