Pace maker and ablation

[4chickens]

Hi All, I’ve had 4 ablations, 1 terminated due to excessive bleeding. I have never remained out of AF for longer than 8months afterwards. My AF has been with me for the last 10 years and during that time we haven’t been able to find a trigger. it doesn’t resolve itself without cardio version. Since my last Ablation I’ve felt generally unwell with excessive belching and two admissions to hospital with fast AF. The next step I’m told is a pacemaker and destroy the AV node, the bottoms chambers of the heart will then beat normally and the top two may well remain in AF. I’m very unsure that this is a positive move, it feels very final. I have done a small amount of research into the cox maze procedure and whilst it’s a much bigger operation the outcomes appear good. I would appreciate any thoughts on this before discussing with my cardio team next week.

[Buffafly]

Many people who comment on that procedure here wish they’d had it sooner and most seem pleased or delighted. A search for ‘pacemaker/AV node ablation’ should come up with a few posts I hope.

[4chickens in reply to Buffafly]

Thank you I’ll have a look

[jeanjeannie50]

This man cured his AF by diet. Read how he did it right here. I've just re-read it and feel I need to share, although it's been placed on this forum many times:

carrafibdietinfo.com/

[Diddyd]

Hi I have not long had the pace and Ablate procedure and am in early days of recovery.

I had fast heart rate at 130-140bpm and ended up being stuck there for 10 months. I tried all the lifestyle changes in the two years leading up to this point; was put on high doses of digitoxin, diltiazem, bisoprolol; had cardioversion and still it would not stop. I had many hospital admissions and developed heart failure with a LVEF.

The hospital offered me an ablation or a pacemaker as they were at the end of the road for what they could offer me. I was so scared and extremely distressed at making this decision as i had a few hours in hospital to decide. (See my previous posts) The ablation was likely to be 50% successful in my case and may need repeating. I have a spinal cord injury which would mean lying flat for a number of hours would be extremely difficult.

The pacemaker and ablate procedure would be shorter to carry out, a quicker recovery time (so less time off work- I am self employed) and also a very high success rate.

I don’t like uncertainty and on balance decided on pace and ablate. But i found it an agonising choice especially due to the irreversible nature and I felt I was choosing to harm my body. Yes, it is irreversible and causing ‘harm’ but for me there was little choice and I became so ill. If I did not do this then my life would certainly be shortened due to the HF and I had absolutely no quality of life.

Unfortunately for me, the procedure was not as straight forward as it should have been. But I am in the minority. The EP said my heart was physiologically different and in a slightly different position to what they would expect and it made the procedure more challenging. The success rate is normally about 95%.

Some of the things done in a normal ablation had to be carried out so I did not escape the slower recovery.

Skip to 12 weeks later….. I have lost 2.5 stone in fluid; cannot feel the AF; have normal LVEF; no longer have severe shortness of breath; can actually look after myself and go for short walks. I have not felt this well in 2 years and have realised how bad the underlying constant fatigue was when I just powered through and kept going. Even better, with a pace and ablate you generally don’t have to take medication so I have stopped ALL my heart medications so no side effects from these.

I am 51 - considered young 😊 so getting off the medication was also important to me.

I often ask myself if I have done the right thing. Sometimes(not often)- I hate that I chose to do this to myself. But I remind myself of how well I am now and what life was like before. I think it just takes time for the mental adjustment.

Would I choose to do this again?

On balance, I think the answer would be definitely yes.

Neither procedures are a walk in the park and everyone’s decision is a personal one. Others may make a different decision to me but I thought I would share a little bit of my journey and how I feel about my decision now.

Hope this helps and good luck on your journey

[Barb1 in reply to Diddyd]

I am intrigued that you say you have lost 2 1/2 stone of fluid. Were you on a diuretic before? I am retaining fluid and have shortness of breath. I am 6 weeks after the ablate part of the pace and ablate.

[Diddyd in reply to Barb1]

Yes, I was on Furosemide twice daily before my procedures and it kept some fluid down but obviously not enough! AF had lowered my LVEF so after node ablation and the CRT pacemaker working the blood could flow out of my ventricles better and this gave me the weight loss. However, I do have some days still where I put on 7pounds and am breathless again as my atria have enlarged and that can give you congestion. I have one furosemide every day to keep on top of things but then double up on more fluid days. This hot weather and humidity seems to make it worse ☹️ But hopefully it will stabilise again soon 🤞🏻

[Barb1 in reply to Diddyd]

You give me some hope.

[TracyAdmin Partner]

Hi there, please contact our Patient Services Team for advice if you are concerned. We also offer patient resources and videos available on the website regarding the 'pace and ablate' procedure. heartrhythmalliance.org/afa...

[Golfer60UK]

Hello am intrigued by '4chickens', name

Anyway I have been a little like yourself except I passed out on a golf course. So my EP suggested Pace and ablate which should resolve the passing out episode. Had it done August and can say brilliant result, my advice go for it.

Best of luck

Dave J

[4chickens in reply to Golfer60UK]

I have 4 chickens, nutmeg, ivy, bramble and nettle.

[Skertchly]

My pacemaker of 2 years going well. Very little AF. Just tiredness but I’m 75 years.

[Eastwick]

Was the best thing I did to have the pace and ablate. Life is now so much better than it was. Three months without playing golf and then really worrying when I hit that first ball off the tee if it would all come apart!! Was a bit uncomfortable but a lot better than the ablations I had.

[Jspjkc6]

Hi 4 chickens,I have a very similar history with Afib to yours, and am having the same conversation with my EP and Cardiologist about the AV node ablation. It seems final to me too. My team has advised me that before going that route, which might indeed be the best route, to try Tikosyn (dofetilide), an antiarrhythnmic drug. It requires three days in the hospital while they administer five doses, and also do a cardioversion. I guess if you tolerate it well with no adverse side effects, you will be out of Afib. That is the goal. If it doesn't work I will have to go to the AV node ablation since they have tried the other antiarrhythmics with no success. What are you thinking?

[4chickens in reply to Jspjkc6]

To be honest I’ve never heard of it, so just done a quick search are you in the USA as doesn’t appear to be licensed in UK. I’m not in constant AF normal reoccurs about every 4-6 months but nothing works except cardio version to regain NSR. I’m now researching the mini maze procedure.

[MJZaw]

I recently attended a two day virtual (zoom) AFIB conference which included presentations by top EP's in the US & Europe. During the seminar I learned of several procedures including the "Cox Maze" procedure and the Mini Maze procedure both of which are purportedly less invasive than a full maze procedure. In addition, the Cox Maze procedure is the only surgical procedure with an FDA indication to treat AFIB. I'm not sure of the applicability to the UK or Europe, but the results were impressive - it's probably worth researching.