Have been stuck in hospital since Christmas Eve with A fib and LV dysfunction. The EP I saw today has asked me to make a decision by end of the afternoon about moving forward. Am scared to death of ablation and I have a spinal cord injury that means it’s difficult for me to lay flat for any time plus bladder issues. He said in my case success is about 50% and we would have to accept that follow ups may need to be done especially as I have A Flutter at times too. However,he has also offered a pacemaker that he would do next week. I am really torn which way to go. I find uncertainty extremely anxiety inducing and would just like to be back to normal ASAP as I have had enough
Your thoughts would be most welcome - please be kind as I am feeling very sensitive at the moment
Written by
Diddyd
To view profiles and participate in discussions please or .
What a decision to make - no wonder you are feeling worried and sensitive.
I'm sorry but I can't offer advice - it needs to be your decision. 50 / 50 odds are a close call and only you can decide. It's almost like tossing a coin which is not a good idea when it comes to health issues.
Whatever you decide I wish you luck. Sorry I can't help further.
I wish you all the best with it whichever way you go.
If I could have a choice I would go for a pacemaker with pace and ablate. No more arrhythmias ever again. Now how great would that be.I know your concern is your back and bladder but the procedure itself to me is like having a tooth filled.
Sorry to hear that you've been in hospital over the Christmas period Diddyd.
What a decision you have to make and so quickly! If it were me having to choose I would go for the ablation. I've had experience of them and can honestly tell you that you will know little about it when having the procedure.
Explain to your EP about your spinal cord injury and bladder issues. It may be an idea to ask if you can have a general anaesthetic rather than just sedation if you choose the ablation option.
yall do ablations just under sedation ? Here in the states, it would be inconceivable to have that procedure done unless you are under general anesthesia.
I have had two ablations with mild sedation only. Neither were a problem. In fact it was very interesting watching the big screen seeing what was going on!Also I was home the same day.
Me either!! To be honest I think it was one of the worse procedures I’ve ever had done ( I’ve had a lot, including a liver transplant). I ended up with a pace maker a couple years after ablation and that procedure was a piece of cake!!
That says it all for me! I’ve also had two spinal surgeries and to be quite honest I’d rather have another one of those than an ablation at the moment. Think the PM procedure is sitting better with me
Absolutely agree Bambi! I have had 2 ablations both with GA. 2 friends have also had them with GA. (Different hospitals and EP from mine) it is routine . You can ask for GA here for even simple stuff as I did for an uncomplicated gynae procedure. You would unlikely be denied it unless there were a medical reason. Although GA is a mixed blessing when you are recovering from it. My BP went very low afterwards and I felt very groggy....
It's mostly done under a general anaesthetic here in England. I'm not sure if going by his Welsh sounding name Diddyd lives in Wales where things may be done a little differently. I've had ablations carried out both ways and to be honest there's not a great difference, with sedation you're not really aware of what's going on either.
Yes that's what they do at my hospital,partly why I've hesitated ! Just knock me out please!
Only just seen this so maybe the decision has already been made. Lying still is the best means of protecting the entry wounds in the groin and preventing unnecessary strain which could cause a bleed. I would have thought the odd wriggle to get comfy wouldn’t be a problem and I’m sure the nursing staff will be able to accommodate that. Similarly, although probably undignified and certainly not particularly easy, I think you will find having a pee can be accommodated to.
As for making the right decision, that’s more difficult and has to be something only you can do. I know many people with pacemakers and they are very happy with their decision. You could try asking the EP what he would recommend if you were his Dad! Might be worth a try.......good luck.....
I have a fused spine (rods and screws) but still have issues with lying flat for any length of time. I had a GA and was so woozy afterwards because they give you other drugs as well that lying flat(ish) was no problem. I did have to have a dose of antibiotics because of the fusion. Peeing lying down is weird but doable, some hospitals use a catheter as routine and if incontinence is a problem that would be the solution. However, you can have a pacemaker and still have an ablation for AF and flutter later according to my cardiologist, or decide to have an AV node ablation instead.My choice would be to have the pacemaker as it’s almost immediately available and hopefully is one of the more sophisticated ones. Best wishes whatever you decide, I hope things get better for you soon 💜
PS I suggest you read the earlier post from Age65 ‘Deciding on AV ablation’, particularly the reply from CDreamer, and possibly some of her other similar replies to posts.
I found this thread and it has been really useful. I have also connected by direct message and had quick reply back which has been helpful. Thanks for the suggestion
Peeing lying down is almost impossible for me! I was unlucky to be the last one operated on for my hip replacement nearly a fortnight ago. I was back in my room for 20-30 and then spent a totally miserable night with hardly any sleep because of my bladder. Several times I requested the bedpan to no avail and it was only the next morning that I was able to produce more than a teaspoon! An hour later the physio came to get me up - first stop the loo! If I had been operated on in the morning I would have been got up and moving in the afternoon.
How awful for you. That must have been literally great relief. I have Botox in bladder and when it gets frozen need to self catheterise so completely aware of that horrid feeling. Then it wears off and I have to go every 20 mins. Not great. They have said they would catheterise me so that takes one anxiety away as used to that!
That must be an awful lot to cope with. And with afib on top. You really have my sympathy. I had a colectomy nearly 3 years ago which has left me with bowel problems. I was warned about this by my surgeon before the op and in the last few months it has improved a little. Still it beats dying of peritonitis and they told me the 26 cm removed was in a right mess and sooner or later I would have perforated. I hope your pace and ablate goes well and turns out to be the right decision for you.
Thank you. A lot of these procedures feel only acceptable when you have no choice left. Never ideal as you would just prefer a magic wand to put you right. Sometimes you heal more than the professionals expect and get more of your life back so don’t give up hope and keep doing all you can to optimise your health. I look awful on paper and doctors are always surprised at my spinal recovery. I don’t match the paperwork expectations. I got more of my life back than predicted although never will be the same so now dealing with heart issues is a royal pain. Take care and wishing you lots of healing
Thank you and likewise. I have no regrets about having the colectomy and I resisted it for a while. I hope my hip replacement is equally successful. It will be 2 weeks tomorrow since the op and progress seems slow but I can do small tasks like washing up and yesterday cooked a large part of our dinner. The walking frame just slows things down a lot! Pity magic wands don't exist! At least I can be thankful that so far my heart has behaved after the hip op. I went into afib after the colectomy.
Thanks for all your messages. I spent a long time researching and scribbling pros and cons on paper. I have decided pace and possibly ablate due to certainty of success and although not without risks felt I could cope with the procedure better too. The EP had been very good and came and spent another 45-60mins with me. Poor chap has only just left at gone 10pm having started shift at8am. He has put me on another drug as well. Now on 2x40mg Furesmide; 2x10mg bisoprolol; 125 of digoxin and diltiazem per day. Being monitored24 hours and reviewed daily with pacemaker later in the week.
Those of you who went for the pace option have confirmed what I was thinking and I feel peaceful with the decision. So fingers crossed
Ablation miracle surgery for me! No issues for 5 years don't even see the heart doctor anymore. No medications. If you're under 60 years old I think this is usually the best option of course notwithstanding any other issues
I'm late to this thread, but must say that given the description in your original post, if it were me, I would go with the pacemaker. Good luck next week.
I would be very concerned if my EP said that I "HAVE TO MAKE A DECISION BY AFTERNOON" This is not life of death decision. I don't do ultimatums from anyone. Its an important decision, and getting educated on outcomes, risks, benefits , having all of your questions answered, then can you make an "informed" decision.
For me, the Pacemaker every time, ablation didn't work but for 3 years I have lived a good life with my trusty Pacemaker after 20 years of P/A/F, if your cardio recommends it then take his advice, you may still have to take meds afterwards but your condition should be so much better overall,, best decision I ever made.
Good luck with pace and ablate. I had mine two years ago and has never looked back. Best decision ever. I also have ME/CFS and was a wheelchair user. I am so much better and could start walking again. I had sedation, and the procedures were both done in a day six weeks apart ( no sleeping over) I had the pacemaker first and then the AV node ablation six weeks later when it was sure the pacemaker was successful. The AV node ablation was not painful or invasive at all. I had a bit of discomfort in my shoulder and arm for a few weeks after pacemaker op.
I agree with you Bettiehough. I also had Pace and Ablate 2 years ago and have never regretted that decision. In and out of hospital the same day for the Pacemaker then a month later the AV Node Ablation procedure, in and out the same day again. No more Mexican jumping beans in my chest 24/7 accompanied by utter exhaustion. Now I’m alive again, yeah.
My heart goes out to you. These decisions are hard. But in hospital and probably with too little sleep and the hospital food you are not in the best place to think straight. I have had two Ablations. The good news is that I feel they have worked well and I feel better. But I was warned I was a very bad case and told I might need follow ups. Sure enough I still get AF but it is muffled and less severe and tolerable unlike before.
The bad news is that I also still take meds - Flecainide and Bisoprolol - and the Bisoprolol lowers my heart rate. It was going too low. (But unlike you no LV issues) So now after a lot of anxiety, like yours, I have a backup pacemaker. Not yet pace and Ablate. It works ok though it sometimes kicks in a bit fast! There are sensors in it that tune into your needs but it requires tweaking. The clinic is able to adjust it though at very short notice within 48 hours, if necessary. Not like other outpatient appointments. I am glad I have it and will go for the Full Monty if advised to.
Another point for you is that both procedures require lying still. Inserting the pacemaker took 2 hrs and I was awake. It was fine but you did have to be still afterwards till allowed home . The Ablation was a GA. As for bladder issues, a catheter would help. My friend had it after her Ablation and had a peaceful night as a result.
I hope you reach a decision that makes you happy, but quality of life longer term is the important thing not the issues round comfort during the procedure. One thing I have learned is that we usually adapt and get used to things.❤❤
Thank you. EP said PM shorter procedure and would be more opportunity to change position/move. So that was good. No GA given here for ablation/PM but could do catheter which I am used to having so that is one anxiety addressed. I know everyone is unique but it’s nice to hear the range of experience from everyone for me to see what sits best with me both from age/condition and psychological point of vire
So sorry to hear your Christmas was messed up with your AFIB issues. I am the victim of two ablations and one cardioversion and I have never felt the same since. I have insufferable exhaustion issues . I now have persistent AF and my EP does not want to do any further procedures for fear of putting myself at high risk. He thinks my body will adjust to not being in sinus rhythm. He does not live in my body! I live in an Over 55's retirement village and it is quite amazing how many people in the village suffer from AF. So many of them have had pacemakers implanted, a very minor procedure. They recover very quickly and life goes on with very few problems. I was never offered a choice of ablation or pacemaker. My EP specializes in Ablation only. If I had my time over again I would go for the pacemaker but I do acknowledge that not everyone is the same and I could have well reacted with constant exhaustion with a pacemaker insertion. I do not know the answer to this. I have always been a joie de vivre sort of girl and I would so love to return to being so. My Quality of Life (QOL) has decreased beyond belief.
You have to make your own decision, hard as it is. I am just giving you my experience and we are all different.
AF is one of the most common heart problems these days and some people cope with it and others do not. The actual ablation procedure is nothing to worry about. I had a GA and was non the wiser on recovery.
I am an ex Health Professional and was somewhat concerned when my BP kept dropping to levels I was not happy about which meant I had to spend an extra day in hospital before I was discharged. Also that caused me great anxiety which is something you should avoid when having the condition.
I am sorry to hear how your QOL is not where you would like. It is hard to accept especially if you were very active.
Yes, it is good to hear each person’s story and recognising how unique we all are. It is good for me to see what fits from others with me in terms of age/condition and psychology of it all.
I hope you have some kind of resolution to your situation and once again find a better QOL.
I had a pacemaker installed March 5 2019. No problem with pacemaker. Problems with flecainide I take twice a day causing problem with constipation. Doctor mentioned ablation. That would be last resort for me.
Yes, Flecainide no good for me. They have now listed it on an allergy list for me as dropped me to 30bpm. Not allowed that any more! Good to hear PM was successful. Still think I will go with that option. Fingers crossed I can get something sorted this week
Hiya, I was only diagnosed with Atrial Flutter and Afib in July and been in A & E twice with a heart rate of 172bpm. I was put on flecainide and bisoprolol 1.25mg. With the flecainide I was having episodes every week lasting 24 hours, so I went to see a top professor who is an EP. He changed me to Sotolol and I have been ok so far but resting heart rate sometimes goes as low as 50bpm, apart from being tired when this happens, I feel OK...so far. I can feel an odd flutter sometimes but it has been going as quickly as it started. My EP is happy for me to have an ablation and quoted an 80% success rate with a 1% risk of stroke and 1 - 2% risk of tamponade. I know that complications from ablation are quite rare and that's food enough for me, so what I am saying is I would go for the ablation, chance to get off meds and get a more normal life. I also have a friend who has had AF for over 35 years, she has tried every drug going but had 3 ablations and now on sotalol, so far so good, seems to have worked this time. Good luck in what you decide and hope you feel better soon
Keep a stiff upper lip. You will make the right decision after listening to all these fantastic supporters here. I have had af for 17 years, 4 cardio versions, 3 ablations, ( one GA, 2 sedation,) PM 8 yrs ago, none of it a walk in the park for me, however I am so very glad I did all the above as it was hell for me before and now I have a QOL except for the odd mild ectopics, and odd mild HR increase which only last a few minutes.I am so so happy I live in these days were our health system in Canada have so many HEROES ( doctors and nurses etc. )
I am female , 78 next month and again love my life and contented.
I still read these supporters almost every day for the last 16. -17 years
I have had my pacemaker for seven years and it has been life changing for me. The only concern has been that I have needed an MRI for other health issues on several occasions but have had to settle for a CT scan since MRIs aren't done if one has a pacemaker - or so my experience has been. Good luck to you.
I too thought I could not have an MRI with a pacemaker. My make is Meditron and apparently I can have an MRI BUT only on a very specific machine. Did not know this for 6 years!!!
I had picked up on this and looked into it as I have had a few MRI and suspect I will need more in the future. It is possible as Eastwick said but tricky.
Do come back and tell us how you get on. I have recently discovered that the only effective medication suitable for me (without a pacemaker) is amiodarone which my EP warned me to avoid 🙄 So I am following pacemaker posts with interest as I am going to opt for one when the ‘excitement’ dies down. One ablation was enough for me as it only lasted two years and like you I have other issues.
I wish you all the best and hope your QOL is hugely improved 💜
Hi, what a tough choice and awful thing to have to contemplate over Xmas or anytime.I had a successful ablation in April 19 so would have to sit with the ablation camp, it gave me my life back, as a fellow back sufferer I broke my back in 2000 on serious RTA and have l5 S1 problems to this day, but easily managed to do near 7hrs under sedation on the table for the ablation . The meds in theatre see to any pain and its doable with a bad back trust me, I did it anyone can .
Best decision I ever made, and you don't get a guarantee that's true , but most seem to get a better quality of life after ablation, bar the odd one which is like anything in life . It's a throw of the dice, but afib is not something I could live with and worth the risks and short term pain in my case. Whatever you choose I hope you get some respite from the worry and pain.
Thank you. In my case they feel a success rate of 50% is realistic as considered to be in persistent AF and I am overweight( I have been in this episode since Oct 14th. I am pretty fed up now to say the least. The lower success rate and living with uncertainty of it coming back after a procedure I don’t want only to potentially go through it again is too much. So preferred the pace option. That might sound a bit weird but I felt more at peace with that choice.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
pacemaker & av mode ablation
AV Node Ablation with pacemaker
Dysnopea Pacemaker AND due an ablation! 
Svt, ablation or pacemaker
