An update on EP refusing ablation because of obesity.

[Rhiannonimity1]

Hi. I have posted several times because my EP has told me I need to be under 13 stone to ablate. I am 18 stone.

In my last post I was back in hospital and about to be sent home on rate control because the hospital had said the drugs don’t work and they wouldn’t give me any more electro cardioversions. Interestingly the Dr in A and E give me flecainide intravenously ( 150 mg / over 10 mins) and it worked - 2 hours later but it worked.

I saw my EP privately tonight and have been prescribed 50mg flecainide twice a day - 2.5mg bisoprolol evening AND he is putting me on the nhs ablation waiting list ( about a year) - so even though I am still under pressure to lose weight for the procedure - it turns out that when I was told I had to be 13 stone for an ablation it was not entirely true. I think they must have meant - with your current symptoms you would have to be 13 stone. Obviously now I am more symptomatic, things have changed. I still must do my damnedest to lose as much weight and be as fit as possible for this procedure though.

Interestingly - my EP is really into sleep apnoea and it’s probable causal effects of AF. He says that even though my triggers are food related and my AF doesn’t happen at night - any sleep apnoea could be dramatically increasing my AF. I definitely have sleep apnoea - I snore and stop breathing sometimes. So EP has persuaded me into a private sleep test, which he says gives an awful lot more heart related information than an nhs test and Is much more comfy to do ( you only wear a watch) and can be done in the next couple of weeks. Does anyone have experience of this?

Anyway. Thank you all for your continued support and fingers crossed the meds keep me rhythmic until the ablation. I will be going to the gym this morning - feeling a lot more positive. X

[CDreamer]

I did the full NHS test some 8 years ago. The kit they use is very extensive including sensors to head and chest. It’s an incredibly expensive piece of kit. The physiologist who oversaw my diagnosis and initial treatment is now one of the leading expert and researcher in this country on sleep and at a recent seminar said that the error rate of data from the watch would be 20% from the NHS kit she used. Now I don’t know enough about it to be able to comment but in your shoes, I would be go back to your GP and ask for a referral for a SA assessment. GP will do a questionnaire to fulfill the NHS assessment criteria but as they recognise the link between AF and SA there should be no difficulty.

I would want to know a LOT more about the sleep test your EP suggests - including the kit that will be used, the technology it uses, who will oversee and assess the test. In the NHS it is the department of clinical measurements, all physiologists who do nothing else and are the experts. The ongoing service I have received was second to none. After the test results were in I was referred to Pulmonology for spirometer and VA testing and saw a pulmonologist before receiving CPAP therapy - 1:1 intro, 2 hour masterclass and 6 week follow up.

As far as I am aware there are 2 private specialist sleep centres in UK - Oxford and I think London.

You may find these links helpful

resmed.co.uk/

sleeptest.co.uk/what-is-a-h...

I didn’t have to wait for a SA test - I think within 6 weeks - but the conditions have drastically changed of course - but it is worth researching.

If your insurance is going to pay all well and good, but this stuff is not cheap.

The usual treatment for SA is CPAP and that takes some getting used to which is why I appreciated the class and follow up as left to my own devices I’m not sure I could have continued but so glad I did as improved my QOL generally. CPAP costs - about £600-700 for the basic machine + masks at £130 + filters etc etc. All available on the NHS but of course the service you receive depends upon where you live.

Hope that is of help.

[Rhiannonimity1 in reply to CDreamer]

Thank you for such an in-depth reply. Really really useful. I had been to my gp to ask for a referral about 6 months ago and it was refused. I will try again I think. My EP did say there was quite along waiting list and it would need to be resolved before the ablation. Your post has given me quite a lot of stuff to look into. Thanks again.

[Buffafly]

Great news! So pleased for you, please keep us updated.

[Padayn01]

When I had my abalation I was 21 stone not one doctor told me I must lose weight before abalation.

[Rhiannonimity1 in reply to Padayn01]

Hi. I really wish I had spoken to you over the last few years. I had been so worried and felt an ablation was out of reach. Do you mind me asking - how did the ablation go and was it successful?

[Padayn01 in reply to Rhiannonimity1]

The abalation was horrible never want to ever go through that expirence again I was awake through the whole thing almost 3 hours, but recovery had been a roller coaster a lot of ups and downs but now in the last 3 months I feel the best I ever have done lost weight excercise and eating clean I still get the odd little run and skip of the heart but I don’t regret one minute having an abalation but please remember everyone recovery is different

[Barb1]

So pleased that you have been offered an ablation. I am 18 stone as well and my 5th ablation is planned for Jan 19th. I was diagnosed with moderate sleep apnea but I just dont think I could wear the machine and my husband is not keen either.