Had cryoballoon ablation, two RF ablations, three cardioversions and STILL on metoprolol (50mg 2x/day) and flecainide (100mg 2x/day). Nice NSR in 45-60 range now. Very active, healthy eating, BMI under 25, alcohol free, one cup tea/day.
IF (big if), ablations are “successful “ then when do I get to go off the metoprolol and flecainide?
I suppose it varies. I dropped the bisoprolol after a fortnight. Certainly wasn't going to wait until the six month check-up.
When your EP tells you that you may basically. If you have been AF free for say 6 months then there is an argument that you could try stopping but of course not the anticoagulant.
How long ago was your last ablation and as far as you know, how long have you been in NSR for. If you have had 3 ablations plus CV’s, the chances are your burden of AF was fairly high or complex so you may still be medicated to give your heart the support it needs to remain in rhythm. This is why you need guidance from your EP because anybody who takes it upon them self to just come off their medication is at risk of undoing all the good work which has been done on their behalf. However, if it is some time since you were last treated and do not have any further reviews scheduled, I suggest you contact your EP and ask the question......
Last month you were asking about the difference between AFib and A flutter and talking about having a 4th ablation so coming off medication seems unlikely so I guess it’s more of a question coming from frustration. I hope you manage to get things resolved......
I’m beginning to question the wisdom of thinking ablations are all that effective. I wonder if an implantable defibrillator would work better! Ha!
Fortunately they are very successful for many but sometimes less so for more complex cases. Not a lot of comfort for you I know..
My last ablation (my 4th) was nearly 2 years ago and I have remained on a very small dose of beta blockers (25mg Atenolol a day). I haven’t had AF episodes but I get tachycardic occasionally and feel the odd bumps.
I was on Flecainide for rhythm control and Cardizem for rate control. I was on C first. When the Flecainide began to work ... I did an experiment and dropped the C to see what would happen. Didn't have the high rate, so it appears low-dose Flecainide not only stopped AFIB but brought rate down, too. Told the cardiologist and EP I stopped the C. They didn't seem all that concerned about me stopping it.
I had an ablation in late OCT 2020. EP told me to stop Flecainide 60 days post procedure. I did so and have been in normal sinus since ablation and stopping F. So far ... so good.
Thx! That’s the kind of response I was hoping to hear. After three ablations and never getting off drugs yet, I’m beginning to wonder if ablations do much good! Maybe I expected too much too soon.
Ablations done at a top level are a life changer!
After my second one (actually 3rd. Not counting first one for Atrial Flutter) ... I went nearly 10 years AFIB free ...... normal. I would advise to get the best EP you can ... that correlates with how successful the ablation will be. I flew 2 or 3 hours to world-class practitioners my last 3 ..... There were plenty of EP's in the city where I live. But I want the best, so I sought them out and went there.
Hi, I was able to come off all medications three days after my ablation, apart from an anticoagulant.
All the best
Colin
Thx! I was hoping to hear that good news. I’m a bit of a skeptic re ablations after having three with little effect.
Hi
After the ablation (my first) the doctor initially started me on a Beta blocker, but after going home I rapidly became bradycardic with a resting pulse rate down to 42. A quick phone call to the arrhythmia nurse took me off the Beta blocker, and after a week or so my resting heart rate stabilised to around 65, occasionally 70. I have been in solid sinus rhythm ever since the ablation last November, so I am very pleased with the result.
I am now beginning to feel much better, and am recovering my fitness etc. after having had persistent AF for almost two years, and two cardioversions, neither of which sorted the arrhythmia for more than a couple of days.
All the best
Colin
I am replying two months later, but are you still in sinus rhythm? You say you had your ablation November 2020 after two years of persistent AF which is 24/7. At one year the term becomes long-standing persistent AF. Are you very young because the result sounds super fantastic? That would mean your EP would have ablated your pulmonary veins in addition to about seven rogue areas which means you would have had extensive ablation all at one go. Most remarkable. Or, did you mean paroxysmal AF?
Hi
I am still in sinus rhythm, just one very short blip when I had overdone it. Pulmonary veins were ablated.
I was in permanent AFib, I had paroxysmal AF for about 3 years prior.
I'm 77 in April, generally pretty fit.
I am obviously very pleased with the result. No drugs for AF now apart from an anticoagulant.
All best Colin
Remarkable. Three year paroxysmal, two years persistent and only pulmonary veins ablated and you're still in sinus.
From the time I was diagnosed, I went to persistent in one year. At six months persistent I had the first of three ablations to be in sinus. If I had not had an ablation at the six month stage, I never would have returned to sinus because I was one of the most complicated cases at the six month stage. I have an extensively ablated heart. I just turned 78. My story is the direct opposite of yours.
May you remain in sinus.
I was warned by the consultant that he anticipated only a 50% success rate for the procedure, also that the risk of serious complications/death was about 1:200 in my case. His view was simply that some hearts are never going to respond to treatment, and that some patients had to learn to live with the condition for life, generally with drug control for rate and rhythm.
Personally I found living with AFib had a few issues, notably problems when doing anything physical, for example having to take frequent rests when out walking. I suspect that these issues were a downside of the drugs I was then taking to keep me safe.
After discussing the risks with my wife, I decided to go ahead and have the ablation, which was much delayed because of the Covid lockdowns.
Immediately following the procedure, the doctor who had performed it said that a second ablation would not be possible, and the next step if necessary, would be a pacemaker. Luckily, to date at least, all looks to be going well.
Most ablations I believe are successful, but naturally folk only turn to this forum when they have a problem (as did I), so you don't hear many success stories.
All the best
Colin
My understanding is that even those in permanent AF and not taking drugs have physical limitations. Your results are remarkable and long may they last. As you state only your pulmonary veins were ablated, were you given a reason why a second ablation would not be possible if needed? A friend of mine was suggested a pacemaker. He went to Bordeaux, France for an ablation, and now four years later, he is still in sinus. I went there for my three ablations and am currently in sinus rhythm for one year and ten months. I am suggesting a second opinion before the pacemaker route. Best of luck to you.
Hi again
No reason was given for not being able to have a second ablation. The local policy in the cardiac department (Basildon) where I was treated appears to be that 70 is the maximum age for an ablation to be considered. Not sure why, but no doubt associated with increased risk as you get older. I think I was probably lucky to get one, though I did make a specific request, after two unsuccessful cardioversions as was treatment with Flecainide.
All the best
Colin
May I point you to this website by Steve S.Ryan who gives documented evidence that the elderly should hav an ablation and that their percentage of complications are even less than the young.
a-fib.com/faqs-a-fib-ablati...
It would be wise to get, should you need another ablation, from a department other than your local one.
I had my second ablation on Thursday. Been put back on flecanide until my check up in April until the area treated scars over. Think it’s called the blanking period but could be wrong. Had come off medication after my first ablation back in September 2019.
I have never come off any of my meds after my 4 ablations
I was very symptomatic and having episodes 4 or 5 times a week lasting 6 or 7 hours. I opted for ablation over meds route immediately on diagnosis. I was on bisoprolol whist awaiting ablation. My EP took me off bisoprolol (I was never on anti arrhythmithic drugs) on the day of my ablation. I had lots of bumps/ arrhythmias for about 5 months. Then nothing! That was 2013 and still free of AF. I take apixaban.
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