PAF Early stages

[Sherbett]

As I previously posted spent Boxing Day in A & E and got diagnosed with AF. New Year’s Day and night in A & E with heart rate in Tachy then Brachy missing beats and all over the place but not AF. It settled overnight and a consultant diagnosed over medicating ( had h/a 18 years ago ) she stopped a 10mg dose of Amlodipine and halved my Atenolol from 50 to 25mg, the following couple of days I had 2 short AF events ( 1 hour each ) but up until today nothing. I assumed the drugs were out of my system and the trigger for AF had gone.

Last night had a very bad stomach and only got about 3 hours sleep, this morning for about an hour I got a high heart for me ( I’m on a beta blocker, resting normally 50 beats ). See Kardia results, in the middle there was 5 minutes of AF which I never got analysed. First result : 1 Ventricular Ectopic, Multiple Atrial Ectopics.

2nd result which was in normal sinus, 1st Degree AV Block

From what I have read I don’t think there is a huge concern ?

I have already seen a cardiologist, had an ECG and Echocardiogram done, both came up with normal results. I have had CT angiogram ( waiting for results ) and I am having a 48 Holter fitted on Monday, with a follow up with cardiologist on Friday.

From my first meeting with him he seemed to want do a Cardio Ablation asap if an AF event occurred, if the Holter doesn’t show up anything, do you think he would want to do an Ablation on the back of a 5minute event on my Kardia.

I would respect any advice given, thanks.

Albert

[BobD Volunteer]

Since you are in UK the financial incentive to press patients to early ablations does not occur. You can rest assured that if offered then the EP thinks it will benefit you. There is no doubt that early intervention does stand the best chances of a good outcome but all said and done it does seem a rapid response. MY feeling would be to wait a few months and see what occurs although unless you are paying privately there is likely to be a long wait anyway during which time you can change your mind.

[Sherbett in reply to BobD]

Thanks Bob, I’m in BUPA at the moment, I think that’s why things have moved quite quickly. As it is PAF and I do realise everyone is different, at what stage and with what evidence would a EP / Cardiologist require to do an ablation.

[BobD Volunteer in reply to Sherbett]

If drugs and other intervention such as life style changes have not improved quality of life(QOL). Remember that any and all treatment for AF is only for QOL since provided that rate is well controlled and the patient anticoagulated for stroke prevention where appropriate there is no "best " treatment. I do worry that outside NHS there may be a financial incentive though. What many people do is see an electrophysiologist (EP) privately for a first consultation and then go on NHS lists .

Personally I think there is undue haste here and considering I am a great fan of ablation that does ring alarm bells.

[Sherbett in reply to BobD]

Thanks, I agree with everything you have just quoted and I will tread warily. The first consultation did seem a bit like a conveyor belt, I will make sure I get my questions off and answered on the next appointment.

[msc667 in reply to Sherbett]

Same thing happened to me in the States. Had first Afib incident in October of 2020. Met EP in December and scared me to death stating I shouldn't want to be on meds my whole life and I should schedule the procedure ASAP. Talked to Cleveland Clinic doc, and he stated wait to see my progression. I had an episode 9+ months later that was short lived, and resolved using PiP. Closing in on 7 months since that episode. Lifestyle changes have helped, and I plan on continuing to tinker with vitamins and lifestyle. If I get to the point where episodes are more frequent I will reconsider options. Good luck!

[Sherbett]

That’s great news MSC667, I am planning to do the same, good luck to you to.

[Janith]

I would think long and hard about having an ablation … my cardiologist suggested that l have one and l totally refused … l have had a cardio version which l highly recommend if you go into stubborn afib … but that’s just me … cutting around my heart terrifies me. Best.

[Sherbett in reply to Janith]

I can imagine the way you feel, if it is the correct procedure for the given time then I will have it but I want some time on lifestyle and exercise etc. Thanks for your reply