Tests before ablation

[Ivan_the_Terrible]

Various members asked me to keep them posted on my progress in Russia. They are nothing if not thorough here, a legacy of communist times I think. I sometimes think that if I had never come to Russia then for better or worse I might not know even now that I have AFib. Anyway as one of the pre-ablation tests they did a gastroscopy. Is that normal elsewhere? The reason for asking is if it isn't then I may have very good reason to be grateful that I am seeking treatment here, and feeling that way would help my mental state. Thanks in advance for answers.

[Hidden]

I don’t know very much about vagal AF but think there may be a connection here. Others who know more may comment…..

[Ivan_the_Terrible in reply to Hidden]

Mine is persistent and the doctors here know that.

[Desanthony in reply to Ivan_the_Terrible]

Vagal AF is mainly caused by the vagal nerve. My permanent AF is caused by this I can't remember what the EP said about this but I think they can ablate a particular area so that this stops causing AF or something - it's so long ago we spoke about this that I can't remember for sure. Maybe someone else can clarify? It seems likely that with all my digestive problems that this is what causes my AF as the vagal - vagus nerve brings signals from the digestive system.

[BobD Volunteer]

The only vaguely possible reason I can think of is if they want to check that they could do a TOE if required. (Trans oesphageal echocardiogram to check for any clots in the heart ). I have had several gastroscopies over the years but not to do with ablation.

[Ivan_the_Terrible in reply to BobD]

They've done all the heart tests and need to repeat the gastroscopy. They are incredibly thorough here and I may have reason to be grateful. I found out I had AFib because I went to get a swimming pool pass when I was staying in a, sanatorium with my partner and the doctor insisted on listening to my heart. It would have taken another couple of years to pick up in Britain. I used to subscribe to the 'ignorance is bliss/head in the sand' school of thought, rather less so these days.

[momist]

"Knowledge is power", and power over your own health has to be a good thing. I found that researching everything I could find about my paroxysmal AF was the best therapy for quelling the fear that first came with it.

As for the specific question, no, I have not heard of gastroscopy being a routine event before an ablation, but BobD's view makes a lot of sense. I had gastric investigations before my ablation, but only because I had reflux problems during the years I was waiting to move up the waiting list, and the usual approach with a protein pump inhibitor did not suit me. My EP wanted that investigated before he ventured into an invasive procedure.

[Ivan_the_Terrible in reply to momist]

Here the amount of testing is unbelievable, which is one reason for feeling confident in having an ablation. My other half says that if things go wrong doctors worry about criminal rather than civil law. In my case they found an ulcer which they say may be cancerous. If it is I'm extraordinarily lucky to have it spotted so early.

[Dodie117]

It’s interesting to get a report from Russia. It’s new to me and glad to hear the medical system is keeping up.

[Ivan_the_Terrible in reply to Dodie117]

In Moscow it's incredibly thorough.

[Ivan_the_Terrible in reply to Dodie117]

I'm happy to have an audience for my experiences. They seem almost surreal. I think also it's good to know how things are done in other countries. I was brought up to believe that Communism was evil and here I am forever encountering some good remnants from communist times. Paradox.

[momist]

I don't think communism is inherently evil, but most/all of the implementations of it became monolithic fiefdoms under a single ruling dictator, which was never the intention. Sadly, a committee would still design a camel when trying for a horse.

[seasicksurf]

You’re esophagus runs right behind your heart. Touching. There have been instances of patients having the esophagus damaged by ablation. Maybe these tests are to establish pre-condition.

[Ivan_the_Terrible in reply to seasicksurf]

In a posting some years back I asked how come they could do a cardioversion in Russia without you being on blood-thinners for a month and someone said there's a procedure where they put something down your throat. Maybe it's the sale with an ablation. My surgeon in Britain wrote a letter that there is a 1% chance of severe oesophagul injury from an ablation. I suspect he is covering himself and that's an overstatement of the risk in my case, I hope so.

[Snowgirl65]

A gastroscopy is normal procedure for some, but my particulars didn't warrant it. While I was waiting for my ablation in a separate room in the hospital with others, the patient in the next private bed was having one done before his ablation; I could hear what was going on as it was a quick procedure. It didn't last long at all.

[Ivan_the_Terrible in reply to Snowgirl65]

NICE wouldn't approve it but if it's an insurance job...

[Desanthony]

I had to have a gastroscopy and endoscopy at the start of my AF journey - not had an ablation so not sure that it would be done before one here. I wonder what the reason for it is? I too found a few polyps and that I had a small area of barretts oesophagus - a pre cancerous condition but not enough to worry about as most people of my elderly age have this too - especially if we have smoked. Yes it was good to have it because I had the polyps removed and biopsied and none were cancerous. So it was good to have it to put my mind at rest.

Hope all goes well with your ablation. I am not having one as no symptoms for me now and no need to take rate control medication- which caused me to be far more ill than anything else I have had including prostate cancer and side effects of radiotherapy and hormone therapy. resting heart rate in mid to high 50's and when exercising never get much above 125. So carrying on as normal in permanent AF gym 4 times a week and walking and cycling miles every day - weather allowing.

Hope once you have had your ablation you can get back to life as it was before AF for you.

[Ivan_the_Terrible in reply to Desanthony]

Thanks Des. To be quite honest if I hadn't had a doctor in Russia advise me to check my heart nearly four years ago I wouldn't have found out I had AFib for some time, maybe I wouldn't know even now. I don't do too badly on rate control but the atrium is a bit enlarged and if I don't go for ablation now it will be too late. I don't think my doctor likes me and doesn't mind alarming me. I rather doubt I have anything cancerous but if I do it must be very early stage and it's good that it's been caught. I was hesitant about taking the NHS treatment when first offered but the COVID compounded the delays. It will be nice if the ablation restores some energy.

[Desanthony in reply to Ivan_the_Terrible]

Lets hope it does. I am pleased to say it never robbed me of energy.