I am offered an ablation in Russia far cheaper than in the UK. The doctor says the chance of success is 50 to 70/80 per cent but when I ask for how long the ablation has to be effective to be considered 'successful' is puzzled by the question and won't reply. As ablation said are often categorised as either 'successful' or 'unsuccessful' there must be some time period which is applicable.
I may have other questions, arising from my present situation but I think they are best asked one-by-one. Thanks in advance for any help.
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Ivan_the_Terrible
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If your AFib is paroxysmal (occasional) the chance for long term relief is much better than if the AFib is persistent (constant). If your AFib is persistent it is much harder to treat and requires a highly skilled EP to achieve a successful result.
The odds Doctors give us are typically based on a "blanking period" which is the healing period where short bouts of AFib are not counted as failures and not included in the odds quoted. 3 months is the standard blanking period.
A few hospitals are starting to use a 30 day, and even a few 23 day "blanking period", because failures beyond these times suggest a higher probability of a return of AFib.
Thank you. My AFib is persistent. I'm not feeling that optimistic about the chances of success and am questioning whether an ablation is worth the risk.
Persistent does not mean poor odds of success. The amount of enlargement of the upper chamber can be important. My echocardiogram showed only slight enlargement of my heart causing my EP to be optimistic. Also a 12 lead EKG can provide a basis for assessing the odds of success.
I think it's one of those questions like how long is a piece of string. I was told there was 'only' a 70% chance of success. Mine was successful. No Afib for fifteen months. No breakthroughs during any blanking period which I didn't notice anyway.
Reading what people say on this forum, there seems to be an awful lot of variety in degrees of success or failure. Most of the people who have no more AFib probably leave us.
That was in the good old days of short waiting lists. My atrium is somewhat enlarged and I am already borderline for an ablation. No hope of getting one in time in the UK and for private Russia is far cheaper. Whether it's as good is, another matter.
There are numerous NIH (US) papers on the number of procedures of both the hospital and EP versus the outcome. The higher the better, you want a EP that has done 200 or more with at least 25 in the last year.
Thanks. I'm in Russia. I doubt such data is available here and it may not be the done thing to ask, but I do have respect for their medical expertise. Off to bed as 2 hours ahead.
I believe that success is no AF at five years. It is ridiculous to think in terms of weeks as many people are still healing and improving at six months.
I thought it was like cardioversion, either you are better immediately or it hasn't worked. Shows how much I know. (off to bed as 2 hours, ahead of UK)
I think it is wrong to only count success as no AFib for five years. Fifteen months with no AFib makes me feel that I am one of the 70%. As for the other 30% there are varying degrees of success from not making any difference to making a lot of improvement.
Sometimes, it seems to me, not all the rogue signals are caught, some just don't fire up and are missed so the EP has to have another go at catching them.
As I said in a different post, mine would fire up every two or three days and it may have been lucky that my last episode finished on the Sunday and the ablation was on the Wednesday when they were all ready to get going again. I wonder if I had had the ablation on the Monday whether they would have been prepared to get out of bed so soon.
Argue that with Prof Schilling. I do agee that there are various levels of success and a drastic reduction in symptoms and or frequency are what it is all about after all as there is no actual cure.
Well, we've argued about this before. As far as I am concerned, after fifteen months with no AFib whatsoever, I think I've been cured. If a different set of rogue signals start getting their act together over the next few years, I will have another ablation to knock them out too.
I've really got so much to do I haven't got time to go through Professor Schilling's results. However, I noticed that his average time for a paroxysmal ablation was 57 minutes whereas the UK average was 173 minutes. Mine took less than an hour.
A not well known EP in a district general hospital in the UK! I'm very grateful to him and to have had had the op so quickly. And I've never even met him.
I'm not sitting here wondering when it will come back.
There are other definitions of success. Sometimes no AF but remaining on medication is still counted a success. Personally I wouldn't even consider an ablation in Russia, there are other countries which are more open. For instance, Thailand has a thriving medical system for foreigners. My son was ill there with rhabdo. He was on an island and I had visions of the local hospital being a 3rd world affair. In fact it was luxurious with top facilities and consultants. And the total cost for 7 days in hospital, numerous tests and visits from the consultant every day? £3,000.
I note that there is a specialist place doing ablation in Baghdad: pacificrimep.com/
I would do your research online and there may be other places such as India as well.
I have a girlfriend here and a foothold in the language. Ablation is about 2.6 k GBP. I had a quote of 20k GBP in Britain. Standard of medical care in Moscow is very good.
None of here is qualified to answer however, the longer you have been in afin the harder it is to stop- rather like an unruly child not being corrected, so takes a long if effort to correct behaviour. Not sure why you are having to pay. If you are in the Uk and nhs then it is free? But maybe nit an nhs patient yet?
I expect that you have seen a cardiologist here who has advised treatment here. Afin is nit just a one off issue and you may need further input from a cardiologist do I would suggest perhaps saving pennies to have treatment here- then at least you have consistent care?
You would have to wait forever post COVID, it would be too late. It would cost at least 10k GBP more in Britain, a fair bit for me. NHS cardiologist encouraged me to follow this route, he has a brief to reduce waiting lists.
I don't think that is completely true. I had AFib for longer than ten years. I saw a cardiologist in 1996 who said I had ectopics and it was nothing to worry about. I was diagnosed with AF when in hospital in 2013 and again in 2018.
It was only in 2019 when I got my apple watch that I finally realised the scale of it and that I needed to take it seriously.
With regard to having the ablation in Russia, the fact that they are advertising for patients from overseas suggests that they are confident that their success rates/prices are competitive. If you speak Russian then it would be a good idea to research the hospital that you plan to use, as -like anywhere else - there will be a lot of variation in terms of quality between hospitals. The figures that you have been given seem to be in line with those elsewhere - the lower figure reflects the uncertainly re the enlargement left atrium I would say.
The figure is the same regardless of my condition. They are not advertising at this hospital, it's not geared up for non-Russian speakers at all but being a hospitable people they will not turn me away. I'm not sure one should name hospitals here but it's prestigious. They found me a doctor who speaks reasonable English but she doesn't understand my mentality wanting to take a few days out to ponder the results of the initial tests. As for comparing results of different hospitals they might take offence (which is not to say this place is no good) So I've an opportunity to save 10k GBP (half my annual income) but having just read what an ablation entails I feel like having a stiff vodka even though it's only morning.
Thank you. The doctor yesterday using a translation machine wrote that she needed to 'write me in for crucifixion', I wonder what medical term she was trying to translate. There is an Anglican church here in Moscow, if I go ahead I shall be requesting prayers.
Hi Ivan, I think success depends on what you class as success and how your QOL is.? . Iv had 3 pvi ablations but still get the odd episode of afib every few months and still get times of nuisance ectopics.!! But life is a lot better than it was so I’d class this as success. Hopefully I’ll stay like this for some years to come as I’m happy with the situation I’m in with my afib. I suppose some people would expect a better outcome after 3 ablations but thankfully for what Iv got.👍👍 best wishes Ivan and I wish you well. Ron.
Thanks Ron, Things aren't that bad at present, it's just being stuck on meds and lack of energy. If I pay my 2.6k GBP and get some improvement it's money well spent. Peter
When I discussed ablation with my EP he gave a 80% success rate. I asked how long will it last, the duration? He said maybe 5 years. It did not and I had to have another ablation for atypical flutter. I have had two flutter episodes in two years both caused by stress and dehydration. The is a vast improvement for me.
Hi Ivan, I live in Australia. Here we are assessed before an ablation ; age, weight, diabetic, other heart disease , kidney function and lifestyle. An assessment is made and you are categorised according to statistics how successful your ablation could be . After the ablation it is a 6 month blanking period to say whether it is successful. The first three months your heart is healing from the scar tissue and then the next 3 months is crucial to see if they got everything. If they are only giving you 50% that means they think you will be coming back for more procedures. If the number is more like 85% and your lifestyle pertains to super healthy all could be good. But I have heard of people at 70 and quite sedentary having a very successful ablation and maybe it lasts 10 years . I had an ablation in March and still going okay. The hard thing is they just really don’t know . You do need to have confidence in the electrophysists you are getting …it really is how good they are that makes a difference. Good luck and so sorry your medical system doesn’t afford for you to have it done in the UK.
Russian medicine can be very good, I'm impressed by the operations my girlfriend has had here. I've as much confidence as I would have in an NHS doctor. Prices are low. It's not a problem coming here.
Yes, I know. I hesitated about treatment at first and then when I decided I wanted it ran into COVID delays. There is already some enlargement and preliminary tests indicate I am on the borderline. They will do further tests before deciding whether to go ahead. My policy of questioning medical advice worked very well for the first 65 years of my life but not thereafter.
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