Waiting list

[Statusqu]

Looking for views on AV node ablation and pacemaker which has been suggested as I have been on waiting list for an ordinary ablation for so long that they think it may not work.

[BobD Volunteer]

Are you permanently in AF then? Pace and ablate will not stop Af but is should enable the pacemaker to govern your venticular rate. You may still feel the AF of course.

[Buffafly]

It’s very difficult at the moment but in normal circumstances I would suggest a second opinion, particularly if you are very symptomatic and very keen to achieve NSR. However, if the opinion you have had is correct then you would probably be faced with two or three ablations and you have to ask yourself if you are prepared for that? I have had one ablation which didn’t last and because of other complications I have decided that if my AF affects my QOL too much to bear in the future I am going to have a pacemaker instead of trying another ablation. It is an individual decision.

Maybe if you gave a little more detail we could be more helpful. Best wishes💜

[Statusqu in reply to Buffafly]

Thank you for your reply.I’m afraid I didn’t make my situation more clear.I have already had two ablations-the first lasted four years, the second two and a half years until June 2019 since when I have been on the waiting list for a third.

Hence the discussion about AV node ablation and pacemaker as a third ablation may not work in view of the time which has elapsed.

[Buffafly in reply to Statusqu]

I’d go for the pacemaker etc but as I said that’s me, some people here have had four or more ablations.

[The_Lord_is_with_Us in reply to Statusqu]

I've had 1 Atrial Flutter ablation and 3 AFIB ablations ...... probably going in for a 5th procedure to see if I need further minor ablation or a Watchman Device installed.

Not getting a pacemaker, ever, unless I absolutely have to.

Ablations with world-class EP's are not that big of deal. If it goes well .... you can get 10 years or more or possibly a cure. I went 10 years normal and AFIB free after my 3rd ablation, then in AUG this past year AFIB returned. Fourth ablation performed in OCT. So far, AFIB and tachycardia gone.

Definitely get a second opinion from the best Electrophysiologist you can find. Not from some local that does 2 a month.

[Statusqu in reply to The_Lord_is_with_Us]

Thank you

[cuore in reply to Statusqu]

Since June 19, you do not say whether you have been persistent continuously or whether you have had electrical or chemical cardioversions. After my second ablation, I did ask what was going to be ablated, with the answer being she didn't know until she was in my heart. After my third ablation, I was told the the remodelling is done during the time persistent before the first ablation.

So, other than being told "waiting time," I suggest you review what has been ablated and how long you were persistent before your first ablation. Maybe there has been a reconnection which happened to me. My right superior vein was ablated three times, which means it reconnected twice.

I agree with The_Lord_is_with_us that I will never get a pacemaker unless I absolutely have to. I do respect all the lovely people that have pacemakers and do very well.

If you have the money, you might want to investigate getting an ablation privately either in or out of the country.

May I ask why you are on a waiting list so long other than Covid-19?

[Statusqu in reply to cuore]

Thank you for your reply-I have had two electrical cardioversions the second one being in November 2019 which didn’t work at all.This was following a consultation in August 2019 when I was put on the waiting list for my ablation and was meant to tide me over in the meantime. I might add that the waiting list at that time was estimated to mean a wait of approx. 14 months.Obviously Covid has thrown a spanner in the works since then and seemingly it is impossible give any further estimate.

I have, in fact, considered going privately but in view of the fact that an ablation may not now work anyway because of the time which has elapsed then I have not explored this further.

[cuore in reply to Statusqu]

If you wish to explore it further privately, may I suggest Haut Leveque Hospital in France. They do specialize in persistent AF.

[Statusqu in reply to cuore]

Thank you

[CDreamer]

After 2 ablations the first of which made things a lot worse and then second which left me AF free for 3 years, I opted for Pace and Ablate 2 years ago.

Best thing I ever did. Pacemaker inplanted in Nov 2018 and I felt SO much better immediately the PM was switched on. I had a few teething problems but the PM worked for me so well that I then cancelled the AV ablation - I couldn’t see the point of putting myself through another procedure when I was no longer symptomatic. My EP said that he has had a few patients with similar experiences.

Since then I have had 2 episodes of AF which lasted no longer than 30 minutes and both episodes were when I had a severe infections. The PM seemed to correct the AF pretty quickly. I just had a check and my PM is now working 98% of the time but as I still have AV conductivity my HR can rise but the PM has stopped the fast ventricular response so I’m a very happy bunny so I have no hesitation in recommending as an alternative but like everything else, we all react differently.

Having a really good EP with this as their speciality is a must, whichever procedure that you go for - research their credentials, training and experience and outcomes.

Hope that helps, best wishes

[Statusqu in reply to CDreamer]

Thank you

[Sally_Scott]

I’m a permanent afiber. Have been for 3 years apart from 3 cardioversions which have given me few respites going from 6=weeks first time then 6 months then 18 months. I had an ablation which unfortunately I had a stroke during procedure. Recently whilst in Afib I was taken into hospital with heart failure and fluid on the lung. They did a cardioversion and for the last month I’ve been Afib free. I’m having a pacemaker fitted in 2 days followed in 6 weeks approx by an ablation to cut off the AV nodes.

[Statusqu in reply to Sally_Scott]

Thank you

[Barlick43]

I got responsive pacemaker 2012 and had node ablation in 2018 as I was then in permanent AF. No issues......absolutely fine, don’t know it’s there

[Statusqu in reply to Barlick43]

Yy

[Statusqu in reply to Barlick43]

Thank you