The Ablate part of the Pace and ablate procedure

[Tototcx]

In the AF Association leaflet it says the following:

"The procedure does not restore the normal heart sinus rhythm and so the heart will not work as well as it would in the normal rhythm. Therefore symptom relief may not be as good as might be expected with restoration of the normal heart rhythm. "

I've had my pacemaker fitted and awaiting the AV node ablation. I read this today and nobody else has mentioned this at all. Are there any other people on here that have had the pace and ablate procedure that can give me their experience please.

[BobD Volunteer]

I always point out to people who ask about P and A that it does not stop AF. It merely breaks the link so that the ventricle is governed by the pacemaker allowing the atrium to continue fibrillating should it so wish whilst ensuring good circulation. It should improve quality of life but the person may well still notice the fibrillation.

[Tototcx in reply to BobD]

I totally understand that the fibrillation continues although I get paroxysmal AF so I'm mostly in normal sinus rhythm. But the drugs are failing and I have to stop the amiodarone soon. Hence the AV node ablation. I'm unsure what fibrillation feels like without the consequent arrhythmic tachycardia but it's surely not as bad as fast AF! My concern is that the pacemaker pacing doesn't actually mimic your own heart rate the same so you never actually feel normal again!

Have you had a pace and ablate BobD?

[BobD Volunteer in reply to Tototcx]

No but people I know who have tell me that the fatigue caused by the AF is largely gone though they occasionally feel things going on.

[Tototcx in reply to BobD]

Ok. Fair enough. Thanks BobD.I think it's slightly different for me in that I'm not in AF all the time so I don't get that tiredness or breathlessness. When it starts though it's horrendous and my heart rate shoots up to around 140-160-180 for 10-15hrs at a time and the sort of spontaneously reverts to NSR for no particular reason. They've tried everything to slow my ventricles down in these episodes but nothing really works. Absolutely nothing- drugs wise. I've never had to have an electric shock thankfully although last time they were preparing for it but A&E got busy and I reverted in the meantime. I really would like to hear from anyone who's been in a similar situation as me. TIA. 😊

[reinaway in reply to Tototcx]

Your AF is identical to mine and I know just how awful it is. I have gone through all the beta blockers and have been offered the various other alternatives and because I also hear that they might not work I just haven't the nerve to try any of them so I just soldier on 😕

[Tototcx in reply to reinaway]

Thankyou for your reply. I really don't know how you soldier on. But I know that the alternatives are daunting. The flecainide was brilliant at keeping me in normal rhythm for 6years. It was a bit tricky to get the dosage right at the start but it served me well. I didn't get any side effects from it so it was pretty good. Just got to keep talking to your specialist I think. X

[ETFCfan]

Hello, I was in permanent AF for many years and had my Pacemaker last June . After I felt no better and didn’t get my ablation because of Covid cancellations until just before Christmas. It took me a while to get back to normal but can honestly say that for me it’s the best thing I’ve ever had done. I don’t feel the AF at all even when I lie on my left or walk up stairs. The breathlessness had gone and it’s taking a while but I am gradually getting back some fitness after 8 years of struggling. I don’t get any dizzy spells even when bending down, I honestly can’t recommend it enough. Also I’ve been able to come off my large dose of Bisoprolol which of course helps. Good luck and I hope that you feel as well as I do despite being in AF.

[Tototcx in reply to ETFCfan]

Thanks so much for your reply. It's helpful to know that there is some sort of normal life after the ablation. I'm so fed up at the moment. I've had so many health issues since Xmas, covid included. I really don't know how you coped with permanent AF because paroxysmal AF is rubbish. Anyway they're not going to do anything until after my 6week check so I've just got to relax and heal 😊

[ETFCfan in reply to Tototcx]

I had Covid a month after my ablation I think in our situation that can bring you down more than you imagine. It took a while but so nice to feel normal again,

[playcards]

Had P and A over 2 years ago - quality of life immediately better! I wonder if the reference to normal heart rhythm not being restored is also about the fact that the rate response mechanism can be a bit crude and not necessarily give you a faster heart rate quickly enough when you are exercising.

[Tototcx in reply to playcards]

Thanks for your reply playcards. That would make sense I guess. Is it something that you have noticed?

[playcards]

Definitely. The lovely staff at the Pacemaker Clinic keep promising they will “tweak” it for me but then at the last minute they chicken out - they don’t want to go too far the other way.

[Tototcx in reply to playcards]

I can understand that. When they test my leads in clinic I jump because its such an unfamiliar feeling and I'm not yet used to it. The technician says I'm very sensitive and I think she looked at me dubiously and I was under the impression that she thought I'd struggle with the feelings of it post ablation. That put me off tbh because I really don't want to be aware of it at all! However I need this. I've no other options left and it'll be good to be drug free.

[Eastwick]

It was honestly the best thing I had done. My af was paroxysmal occasionally went up to 250. Many collapses and hospitalisations. I have apparently gone into af in my upper chamber but am not aware of it. I can now lead a fairly normal life. I am due a new pacemaker fairly soon, had this one since 2015 and I understand that the new batteries last much longer.

[Tototcx in reply to Eastwick]

Thanks for the very reassuring reply. It's quite a journey! I've had 6 bad episodes since December. 4 of these I was blue lighted to A&E and my highest rate was 205. I can't live with this hanging over me and the amiodarone is working now but it's not a nice drug. Just got to wait now.

[Eastwick]

Good luck and I hope you don’t have to wait too long

[Ashburton51]

I am also on the pace and ablate journey and have my AV Node ablation on Monday. I have had AF for about ten years and the past year it has been awful, suffering long episodes most days and as you say it is so debilitating and life really doesn't feel like living. After changing consultants and being on several medications that didn't help the AF but gave me some quite awful side effects, my new consultant said that the pace and ablate procedure was the last option but that it had a very high success rate and that life would return to some normality afterwards. I also understand that it doesn't stop AF but makes it 'livable'. Like some of the replies to your post everyone that has had this procedure has said that it really does restore life to us and that is what we need to hold on to.

I do hope all goes well for you.

[Tototcx in reply to Ashburton51]

Thankyou so much for your reply. There's a lot of positive responses which is good. I'm a "worrier" unfortunately. I really must start being more positive. It actually helps knowing that someone else is going through the same thing. You must let us know how you get on next Monday. I'd be interested to hear. 😊

[Hardjuice in reply to Ashburton51]

how has your pace and ablate been

[Ashburton51]

Thank you I will. I think when we suffer from AF we feel totally alone and that no one else is there to support us. When I am suffering I try concentrate on my breathing and keep saying to myself 'this will stop' and it does - eventually! However everyone in this site is really supportive and encouraging and as you say there are a lot of positive responses about the pace and ablate procedure.

[Eadaoin]

I had a pacemaker implanted in 2008 for a slowing heart rate. Later on, episodes of paroxysmal AF began. In 2018 I had an AV Node Ablation which was a straightforward procedure carried out in a Cath Lab. I now no longer feel the AF though I know it is still happening because I am told its frequency at my annual pacing check. I now also have a heart monitor beside my bed. Remote pm readings are downloaded wirelessly by the hospital during the night. This gives me a lot of confidence and means that future pacing reviews will be done over the phone, including finding out when the pm battery needs changing. All good.

[Tototcx in reply to Eadaoin]

Thanks for your reply. Are you aware of your pacemaker at all?

I've got a home monitor too. It's a good development in terms of monitoring because it's remote. Technology is a wonderful thing if you understand it 🤣

[Eadaoin in reply to Tototcx]

Hardly aware of the pm except occasionally when I curl up in bed on my left side. But I find that reassuring! I agree with you about this particular technology. The science of it completely baffles me 😂