I have been lurking here for a while, and gained lots of knowledge so now I would really like some advice please.
My history is as follows. I am a 71 year old male quite fit walking around 8 miles with a walking club on a regular basis and now not overweight. About 5 years ago I experienced a horrendous hammering from my heart which felt like it was going off the scale then going light headed and feeling faint, this went away almost as quick as it came but then I felt an irregular HR which after a couple of hours settled down. After this, and up to late last year/ early this year I would get a fast and very irregular HR around 3-6 month intervals lasting 24-36 hours which quite honestly never really bothered me just making feel a bit light headed, that was until early this year when it reappeared and wouldn't go away staying around 180-90bpm, for about 4 days before I saw my GP who sent me to A&E who in turn kept feeding me beta blockers until they sent me home with a HR of 80bpm but very irregular.
It all settled down to normal within 36 hours but would reappear fast and irregular about every month. Being then in the middle of lock down I was unable to see a cardiologist even though my GP had marked it urgent I raided the piggy bank and saw one privately at Royal Papworth with referral back to NHS for treatment, who is also a EP who diagnosed AF with atrial ectopics conducted with left bundle branch block!
He advised an ablation with a 75% success rate but leave it and you will a some time go into permanent AF which would reduce the success rate to 50%.
I am on 1.25mg Bisoprolol and Edoxaban.
So now the dilemma since Feb this year I've lost 21/2 stone in weight, cut caffeine right down, and only have around 2 glasses of wine over the week. since seeing the Cardiologist in April I have had one bout of AF in July which was mild over a couple of days and none since, and I feel really well.
A ablation is booked for week commencing 22nd November (never thought it would happen that quick) but I feel do I need it? could it make matters worst?
I spoke to a arrhythmia nurse who obviously couldn't advise either way, so any advice guys what would you do?
The statement keeps coming back to haunt me, Leave it and at some time you will go into permanent AF but will I?
Sorry its been a bit long any advice will be greatly received, thanks.
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westone1
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Thanks Paul, yes it was quite unpleasant, I’m sort of guessing that the beta blockers are keeping HR in check and giving me false impression that all is ok. Rob
You are on a very low dose of beta blocker so I think it’s more likely the weight loss that has worked its magic!
Can’t advise but as you have already had AF for 5 years (apparently) I shouldn’t think the ‘strike early’ applies. I have had AF for 20 years and had an ablation 5 years ago. Although AF returned its not as ‘fierce’ as it was.
It may be there was something else going on when you had the prolonged high heart rate eg a virus, but then you need to think that the same could happen again with say, flu.
Yes life style changes do often help AF burden but AF begets AF so yes normally it can progress. What you must understand is that any treatment is generally for quality of life as provided that rate is well controlled and you are anticoagulated where appropriate there is no difference in outcome as far as mobidity is concerned.
If you are highly symptomatic when in AF and the medicataion does not control it then ablation may well be of help but everything has risks even doing nothing. (I had three before my AF was terminmated in 2008. )
Always a difficult question to answer because no one is anxious to rush into having a procedure on their ticker! Most EP’s would, I think, advocate having an ablation sooner than later because there is evidence that the quicker the intervention, the more likely it is to be successful. On the other hand, there are many who are in persistent/permanent AF where their heart rate is maintained either naturally or with medication, at below 100 bpm who are happy with their situation and decide to leave well alone.
You are right, the problem is that no one knows how their condition will evolve. My motivation for going down the ablation route was that I wanted to avoid taking fairly potent medication for the rest of my life. Although I was diagnosed with lone persistent AF, a cardioversion was successful and I remained in sinus rhythm for more than a year and I felt good! I have had 2 ablations and at almost 75, would not hesitate to have a third if necessary but it’s with the knowledge that ablations do not cure AF but in my case, they have helped to control the symptoms.
From what we hear on this forum, although many experience the problems associated with the 3-6 month “blanking” period, hardly anyone has said that they regret having their ablation(s) as shown from the link below. Good luck.
I was told it is better to have ablation earlier rather than wait. Gets worse with age. Other than a long recovery where I had no energy at all I’m glad I had the ablation as prevention to worsening Afib. Good luck to you.
Thank you for sharing your post, I am sure all the Members are able to provide great advice to you, it is important to discuss any concerns with your medical provider as they are able to advice you on a personal basis on what is suitable for you. If you would like information or advice - you may find our HRC2021 A F Association Patients Day helpful? there are many presentations about the various treatment options, all the presentations are available 'on demand' for further details : heartrhythmalliance.org/afa...
Thank you all that have replied to my to my post, as they say the buck stops here, so I will update the final decision/outcome which should be in November.
Hi there. All I can say is that I had AF on and off as you describe for 10 years. Then oops!... one day in 2015 it just didn't stop. The next few months were full of anxiety as I waited12 weeks to see an EP and then 4 weeks for a cardioversion and then 3 months for an ablation. As Flapjack says it wasn't a cure ( my chances of that reduced by the fact it had become persistent). But it was a great relief to be back in rhythm most of the time. A year later I had a second ablation and the symptoms, when I have AF now, are much reduced and more manageable. In fact come to think of it I haven't had noticeable AF for a couple of months now and it's lovely. So in my case the ablation was the right choice. But I have to say that the three months after the procedure were rocky and I did wonder if it had worked then suddenly the episodes stopped. So it's a journey.
PS. I see you are on 1.25 Bisoprolol. This is a low dose but in my case 1.25 reduces my heart rate by a substantial amount. Some people are more affected than others.
Agree, in my case 1.25mg bisoptolol reduced my HR from 70 to 45 ish and I had terrible side effects. As we know drugs affect everyone in different ways. Clearly I was more sensitive to beta blockers than other people who happily take much larger doses.
I first started suffering from AF when I was 46. (I am now 71) I tried a lot of different drugs, beta blockers, digoxin, flecainade and amiodarone to name but a few. I tried not drinking alcohol or caffeine. My diet is healthy and I am not overweight. None of the drugs or the abstinence from alcohol or caffeine worked. I never knew when I would have a debilitating bout of AF. It would leave me breathless, exhausted and unable to function properly. The spells would go on for a long time, sometimes 10 or 12 hours.I had two spells in hospital because my heart refused to revert to a normal rhythm.I eventually took early retirement when I was 60.
I was constantly advised that I should have a catheter ablation which I did in 2013. It was an 8 hour procedure under general anaesthetic. I suffered a punctured lung and a urinary tract infection. The mending of the punctured lung was incredibly painful (worse than childbirth!) The ablation 'cured' the AF for about 6 months and then it came back. (I had been advised that a second procedure is often necessary.) I eventually summonsed up enough courage to have a second ablation in 2015. It was a 2 hour procedure and it worked! I now no longer get AF. I take Riveroxaban and statins. (I had 2 stents inserted because of coronary artery disease (i.e. blocked arteries) in 2014 and I have a mitral valve prolapse but neither of these conditions caused the AF,
I suspect (but this is guess work on my part) that the procedure for doing ablations is perhaps more sophisticated and more likely to succeed. I can genuinely say that the second ablation transformed my life. Not to have to worry about my heart going into 'orbit' is such a relief! Each person is so unique it is difficult to advise on what you should do. If the meds don't work and you have a skilful electrophysiologist conducting the ablation I would tentatively suggest it's worth going ahead with the ablation.
Most here are pro ablation and there have been some good balanced replies.
I would just like to add you need a robust healthy body for an ablation preferably without a Covid risk in hospital. Personally, if I thought my lifestyle changes & drugs were likely to stop AF, I would postpone the ablation for a year. I would discuss with my cardiologist whether taking a medium daily dose of Flecainide or similar would help keep AF away completely. Lastly, I would focus on each year the ablation procedures improve so a year or two delay is not necessarily a bad thing.
I also think it is important to realise that whatever your decision, it is not wrong, as the alternative (which we will never know) could have worked out worse, it is simply what you feel best with. Best wishes.
Hi there 61 yr old male lost around 2 stone and cut drinking when afib started. I would have the ablation without a backward glance . My two ( it took two) have made me much less worried about my heart and stopped afib since the second one. The likelihood of untreated afib getting worse is high and say when you are early eighties you may not be able to have the procedure . Go for it
Could it make it worse? Yes, I suppose it could, and no medical procedure is without some risk. Might it not work at all? Possible, but unlikely. It will be changed in some manner or form, but then, it will change of it's own accord over time anyway, so no difference there then.
Only you can decide whether the proposed gain is worth the risks. Everyone's evaluation of risk is different, and in my mind, most risks are blown out of all proportion anyway. If you want to stop this thing happening, at least for a while, then this is an opportunity to take some action that might help.
The decision is yours, though. It's your heart, your body, your life to live.
Have you worn a heart monitor to show your heart rate for an extended period ? At times the heart will beat fast without you noticing. Or perhaps it is being controlled by medication. Are you currently experiencing symptoms of the atrial ectopics ?
And did the physician discuss cardioversion vs ablation ? Both sometimes require a repeat procedure but the cardioversion is less invasive.
Do your research and good luck in making the decision you deem appropriate.
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