Amiodarone and node ablation

[gokf]

Hi everyone

Your advice please. I had my 2and ablation 4 weeks ago, a 5 hour procedure with 4 cardioversion for A Fibulation, A flutter and tachycardia described as extensive. Last weekend I had a turn and went back into hospital for 3 days. The outcome after luckily seeing my cardiologist was that he has out me on Amiodarone for the next 2 months while my heart heals. As he could not get all the tachycardia (too near my diaphragm), he says he doesn't advice another ablation. His plan is a node ablation or permanent pacemaker. I am 65 so would appreciate any advice. Thank you for reading.

[BobD Volunteer]

This is generally a last chance saloon treatment as one becomes pacemaker dependent and of course it will not stop the AF anyway as the pm controls the ventricles not the atria which can continue to fibrillate at will, QOL (quality of life) is usualy greatly improved though as the heart rate (ventricular rate ) is stable and fatigue and shortness of breath should be a thing of the past.

[gokf in reply to BobD]

Thank you Bob, really helpful. QOL is important as I am struggling at the moment.

[CDreamer]

Pace & Ablate is not either or - it’s PM implant then 6 weeks later ablation of the AV (Atria/Ventricle) node - the heart’s natural pacemaker - which is why once it’s performed, you will be 90% reliant on the PM but there is a safety margin so in the very unlikely event of PM failure, you will have enough HR to be able to call for help.

I had the PM implanted in preparation but I cancelled the AV ablation as the PM seemed to work for me & I've had only 2 episodes of AF since 09/2018 which is amazing since I was almost daily & very symptomatic.

If the Amiodarone doesn’t work and it did for my husband - think about the Pace & Ablate - find out more about advantages & consequences because it is a big leap of faith but a permanent solution.

[gokf in reply to CDreamer]

I am nervous taking the Amiodarone for too long a period because of the side effects and am finding it difficult to walk very far. Interesting your experience regarding Pace and ablate. Thank you for your help.

[CDreamer in reply to gokf]

Unfortunately it is a bit of a lottery as to who gets the horrible side effects and who doesn’t. Thankfully, my husband doesn’t but he is monitored regularly.

[Desanthony in reply to gokf]

8 weeks of amiodorone is not too long and I was on it for 6 weeks 3 weeks before and 3 weeks after my 2nd CV and had no side effects other than a slightly raised Thyroid level which was back to normal within 3 months of stopping the amiodorone but still continued with 3 monthly thyroid tests for a year with the cardiology department just to make sure. Had the last test last October and it never changed once it went back to within normal levels. All the best with your treatment.

[gokf in reply to Desanthony]

Thank you, very reassuring.

[Desanthony in reply to gokf]

Of course we are all different though there have been people posting on here who have been on amiodorone long term with no problems. If when you are on them you get any problems contact your GP or pharmacist for advice.

[gokf in reply to Desanthony]

Thank you, I am due to see my arrhythmia nursing 4 to 8 weeks.

[Hidden]

Is pace and ablate inevitable at this stage? You may be relatively asymptomatic with amiodarone, and remain so if and when it is withdrawn. How have you been so far?

[gokf in reply to Hidden]

My cardiologist seems to think so. I am feeling better, no tachycardia. I am very tired, and struggling to walk very far feeling breathless. Thank you for replying.

[Hidden]

Would you regard permanent AFib as unacceptable to you? Many, including myself, remain active and comfortable with permanent AFib, and only notice it if overdoing things or getting stressed.Of course there are many paths to permanent AFib, and highly symptomatic paroxysmal AFib with intolerance of, or resistance to, rhythm control meds, is presumably a common indication for pace +/- AV nodal ablation in AFib.

[gokf]

Yes I would.. Before my ablation my pulse rate was 140 and I felt really bad. I thought that if you had permanent AF it is milder . Also my problem now is tachycardia.