1 month out from RF ablation for asymptomatic afib

[nmack]

Hi. I was diagnosed with afib in late 2019 at age 66 and put on an anti-coag and sotalol. I was in and out of afib quite regularly but rarely symptomatic. Three cardioversions failed to restore normal sinus rhythm (NSR) for any real length of time, so ablations were suggested (I live in the US.) Since I was asymptomatic with good quality of life (QOL), I put the ablations off. I progressed to persistent afib in May or June of 2021 and because of my moderately dilated left atrium (47 ml/m2), I decided to have the ablation. My goals were to hopefully reduce the risk of stroke, postpone heart failure and preserve my QOL.

Since being released 4 weeks ago. I've been in NSR with a heartrate (HR) of 62 bpm and BP of 110/70. There were a couple days where I had a HR of 100, but nothing else. Unfortunately, at the time of the ablation they found moderate left atrial scarring/fibrosis (LAS). From what I've read, the pre-existing LAS increases the chance of procedure failure and precludes any further ablations. Should I have had the ablation done sooner? Probably. It's not an easy decision when you feel fine and hear about the risks involved and the need possibly for 2 or 3 ablations. And it's difficult to say how long the LAS has been present. Am I glad I had the ablation? If I've prevented further LAS, lowered the risk of stroke and prolonged my QOL, of course I am. I guess time will be the final arbitrator.

From reading other's experiences on this great forum, I still consider myself one of the fortunate ones. Thanks, and I wish you all the best.

[BobD Volunteer]

It is difficult to blame the time you were in AF for causing the scarring I feel. Here in UK and Europe it is considered that any and all treatment for AF including ablation is only ever for QOL as provided that rate is well controlled and the patient anticoagulated there is no difference in outcome between treatments. In other words AF is not a fatal condition.

I recently heard of a study questioning if LAS was actually a cause of AF and how relevant it was to the progression of the condition.

That said I think most EPs would agree that if one is going the ablation route then sooner is better than later. Against this it must also be accepted that life style changes (diet weight loss, no alcohol etc.) all have been shown to greatly reduce AF burden and often remove the need for ablation so my own opinion is first life style, second ablation.

Regarding the last point of your penultimate paragraph it is agreed by many that even successful ablation does not remove stroke risk so don't be too hasty in stopping anticoagulation.

[KMRobbo]

This was posted only a week or so ago. Appears to conclude that fibrosis IS NOT the cause of AFIB. If this is correct no need to worry about your ablation.

IMO worry doest help heart's anyway! Best wishes.

mdpi.com/2073-4409/11/3/427

[nmack in reply to KMRobbo]

Thanks

[blulla1]

This guy is exactly your age. carrafibdietinfo.com/ See if what he has worked out for himself can also help you. So far, it has been quite effective for me.

[Windlepoons in reply to blulla1]

Thank you. That is very a informative and helpful link that I would never have found on my own. Much appreciated. 😊

[blulla1 in reply to Windlepoons]

My pleasure. Hope it helps.

Give it some time to work but if done correctly, encouraging results can happen quickly.

Beware of hidden sources of calcium which may prevent success. I found out that my local water company was adding lime to our water to make it less acidic. Lime is calcium compounds. So I bought a water filter and have noticed the difference rather quickly.

[Windlepoons in reply to blulla1]

Yes we have filtered our water for a long time as ours comes from a chalk aquifer. I have also just bought a better filter jug for if and when fluoride is added. I've been taking vitamin D3 for a few years at the levels mentioned but had no idea about the calcium aspect. Very interesting. 😊

[nmack in reply to blulla1]

Thank you. I will check it out.

[captainKFF]

Hi, what was your heart beat rate during your in and out Afib episodes, and what is now that you are in persistent Afib?

[nmack in reply to captainKFF]

Hi.My portable EKG would read 70s when in NSR and in 80-90s whilst in afib. When I became persistent, my HR was always 80.Here is a summary from my last telemetry when I wore a monitor for 28 days in Feb, '21.

" Rhythm was sinus rhythm. Average heart rate 70 bpm. Minimum 30

bpm. Max 145 bpm. Patient had 44% atrial fibrillation with 171 episodes.

Longest episode 15 hours 18 minutes with average heart 77 bpm. Range

42-125 bpm. "

Since I was asymptomatic, I could never feel when I was in afib.

Post ablation my HR now is 62 but I'm still on sotalol 120mg twice a day. I will be slowly tapering down starting next week.