Follow up Ablation: Hi guys ,bolt out of the... - AF Association

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Follow up Ablation

Hammerboy profile image

Hi guys ,bolt out of the blue. In my post this morning was my appointment for an RF follow up ablation .

My first Cryo was in Dec 2019 which didn't completely deal with my paroxysmal AF .

Since then my episodes have been less frequent and still self resolve within 12 hours. Probably because I've become accustomed to AF and adapted my lifestyle it is more an irritation due to the randomness of the episodes and the time spent doing nothing till it passes that bothers me .I'm also aware that it may well progress as could the mild stenosis of my atrial valve , which seems to be , at the moment , not getting any worse after my annual echo last week .

I'm in good health , not overweight and exercise daily with my last episode of AF three weeks ago , which was the first in over four months , although I seem to suffer more ectopics these days.

Without asking for medical advice I'd like your thoughts on wether I should put off the follow up and hope it all stays the same or go ahead and hope I can be free of it for the foreseeable future if it's successful.

I'm not worried about the procedure but realise I'm in for another bout of rest and recuperation which will mean stopping the gym I've been enjoying and climbs in the Lake District I have planned for October .

I know its a decision for me alone but thanks in advance for any comments

35 Replies

How many episodes of AF do you think you're having a year?

Hi , I'd say about 6 or 7 but of course I have no idea if that will change

That's quite a lot of attacks. Will the procedure be carried out by the same cardiologist who did your first? Does your heart rate go up very high when in AF.

Have a look at the posts of MummyLuv about a different procedure for AF before you decide. Also Bambi65 .

Jean

My HR usually goes up to the mid 90's but erratic so hard to put a definite figure on it .I feel tired but not exhausted so usually sit quietly waiting for it to revert. I was out in the fields lamping last October when one came on so I couldn't rest but apart from the fatigue I was fine and my last episode happened just as I started my workout at the gym .I just carried on carefully doing my strength exercises and went home to wait for it to stop which it did as usual.

Don't know what to advise as your attacks aren't severe. If you click on the links I've given you, read the posts of the people I've suggested, go right back to their first posts. You may be interested in having the same procedure as them. Mummy Luv is in the U.K. and Bambi in the U.S. If I were you I'd want to consider all the options. After three RF ablations, none of which cured me, I'm now in constant low rate AF between 70-90bpm.

Jean

Sorry to hear that but I guess there will be as many successful outcomes we don't hear about possibly. I'll certainly enquire about alternative procedures so thanks for the information 🙂

BobD profile image
BobDVolunteer

Personally I would go for it. I had three over a three year period before my AF was finally terminated in 2008. Best thing I ever did.

Hammerboy profile image
Hammerboy in reply to BobD

Thanks Bob , it's how I'm feeling at the moment .I guess it's just the recovery that's bothering me a little ,I hate sitting around and doing nothing . In your opinion and experience what is it like after the RF ablation compared to the Cryo version as regards timing for walking and daily tasks .

BobD profile image
BobDVolunteer in reply to Hammerboy

Same as any type

Hammerboy profile image
Hammerboy in reply to BobD

Thanks , I just imagined it was a little more intensive and longer procedure therefore a slower recovery period.

Singwell profile image
Singwell in reply to BobD

Ooh glad you've shared this time frame Bob. Because when I saw my EP for the 3 month review post ablation #2 he seemed quite happy to offer a 3rd should it be needed. Idea being - if it all comes back when you start cutting down the meds we'll bring you in again.

I would go along with the RF ablation and hopefully see the end of your episodes . Personally I wouldn't bother with the mini maze procedure with your symptoms, that's even if you found someone willing to do it. You are lucky that your episodes resolve in a short time.

Good luck !

Hammerboy profile image
Hammerboy in reply to Jalia

Thank you

If it’s any help, I was in exactly the same situation back in 2016. My EP had difficulty treating one of the pulmonary veins and said that it was possible I would need an RF ablation to sort out the missed bits. I had the second in 2018 but after 7 months I started to get very mild episodes which were quickly stopped with a PiP. I was actually put on the list for a third but I was diagnosed with an overactive thyroid and soon after, the episodes stopped. I’m due for a review next month and I’m half expecting to be discharged back to my GP which I will try to resist……I would certainly go for it, but we are all different.

Just to add, as Jean says, it would certainly be worth asking you EP about a Hybrid MiniMaze procedure, there is limited availability here in the UK and as I understand it, they tend to be offered to patients with persistent AF but if you don’t ask, you don’t get!

Hammerboy profile image
Hammerboy in reply to FlapJack

Thanks I'll ask the question 🙂

Hammerboy profile image
Hammerboy in reply to FlapJack

Just a quick question , my follow up is supposedly an RF type . I was informed at the time I was put on the list that it would be done under GA due to the extra time taken and the nature of the procrdure .Reading my invite letter it says I'm going to have an Electrophysiology Study and/or Ablation and the blurb basically describes sedation as per my previous Cryo procedure .

How was yours done and how different was it for RF .

Thanks

FlapJack profile image
FlapJack in reply to Hammerboy

Because the two procedures are very different in terms of the equipment used, I think most EP’s prefer using a general anaesthetic because it’s important that the patient doesn’t move during the procedure.

It was very different to the Cryoablation and in many ways much easier. No strolling down to the cath lab with a pillow under my arm, no discussion with the EP prior to the procedure and obviously totally unaware of anything that had go on until regaining consciousness back in the ward. I had never had a GA before and I did experience a good bit of vomiting in recovery but fortunately that passed fairly quickly. General recovery was much the same as the Cryoablation and I don’t remember experiencing any other forms of discomfort. Good luck and please let us know how you get on.

Hammerboy profile image
Hammerboy in reply to FlapJack

Sounds fine , I've had a couple of same day procedures in the last few years , gall bladder removal and an anal fissure repair(ouch) and both were drama free as regards to GA and I seem to tolerate it well thankfully .My recovery from the Cryo was fine although I was plagued by AF for weeks after until it settled down .

I'm just hoping I get the option of GA as I suffered quite a lot of pain during the procedure so they ended up knocking me out and I've heard of sedation being used in RF if pain is well tolerated.

I'm sure I'll get the chance to discuss it beforehand so I'll let you all know how it goes next month.

Thanks again 👍

Singwell profile image
Singwell in reply to Hammerboy

My advice? Insist on a GA. My first didn't work due to paun response even when unconscious. Not worth it IMO.

Good morning Hammerboy, When I was going through my episodes it became a choice, either give up golf for a period and have the procedure to control my persistent AF.

The choice was simple really, procedure first

Best of luck

Dave

Hammerboy profile image
Hammerboy in reply to Golfer60UK

I understand your quandry lol . Seriously, I plan to have the procedure but my hesitation was more that I'm not suffering that much with AF but concerned it may progress and while I'm still relatively young and fit at 67 should I wait a while

Golfer60UK profile image
Golfer60UK in reply to Hammerboy

Difficult decision, I am 77 and feel fit and reasonably healthy too. I play golf 3 x times per week plus also for the Seniors Team, so its quite an important time for both exercise and social interaction.

There is no one decision for us all, each one is specific to that person

Dave

Personally if you trust the people who did your cryoablation, I would have it while it's available. You never know what will occur later.

Hammerboy profile image
Hammerboy in reply to KMRobbo

Many thanks

This is a difficult one to answer as only you can decide. We are all different and recovery is on the individual, however I can give you my personal thoughts as we seem to be on a similar journey. I too had a cryo ablation (2021) improved things slightly but AF returned and therefore back on meds. 3 weeks ago I had RF ablation. The procedure only took approx an hour as it was basically a touch up. The recovery was much quicker I felt completely back to full fitness in about 10 days, and so far (4 weeks) there as been no AF. I was told to come off the flecanaide straight away but to continue taking bisoprolol 2.5 mg and Edoxaban. I get a few flutters and on occasion get extremely tired due I think to taking beta blocker without the the flecanaide. I live in hope and I feel the 2 nd ablation as given me more of a chance of been AF free for a lot longer. Success rates for a 2nd procedure go up to around 92%.Good luck with your decision.

That's very helpful , I'm hoping that as my episodes are lighter than before my cryo I too will only need a touch up as you say .My recovery from that procedure was fine although as you say tiredness was factor which I guess is built in to the healing process.

Can I ask how old you are out of curiosity .Just wondering if that makes a difference .

I'm 67 .

I am 58, also would like to say I had light sedation and was chatting to the EP and the team all the way through the procedure, it wasn’t as uncomfortable as the first time surprisingly. Best of luck. Ps sorry you have lost Sonny Perkins I believe he may be coming to my club Leeds 😁

I'd like to wish him luck but he's a silly boy wanting the wages of a first team player. He may well come good but what I've seen of him he's lightweight and not ready. Probably agents looking for another payday have turned his head. We've lost 2 before in the same situation and neither have made it. I'll let you know how the ablation goes 👍

As my EP told me, one person's mild a-fib experience is another's horror. I personally found the waiting-it-out for each episode to end, a waste of my precious life. You seem to endure it well, and are reluctant to temporarily put your gym and walking activities on hold during recuperation after the procedure, but as you know, episodes historically increase. Just a thought!

Hammerboy profile image
Hammerboy in reply to Snowgirl65

Yes it's why I asked for others thoughts I've decided to have it done so no going back now 🙂

Snowgirl65 profile image
Snowgirl65 in reply to Hammerboy

Good for you! I hope everything goes smoothly and you're happy with the results!

I had my first ablation (cryo) 11 months before my second one (RF) which was just over 2 weeks ago. Inbetween I was having a PAF episode every week and the symptoms, as ever, were debilitating. My experience of this second ablation has been so much better and easier than the first one. I was in surgery for a shorter time, I felt far better after the procedure, my recovery has been smoother with no pain - and crucially I've had no AF since. So far I'm really glad I went for the second ablation - that's all I can say!

You've had it harder than me so I'm glad you've had a positive result with your second ablation .Thanks for the reply 👍

I'm getting episodes of PAF virtually every day but only for a few seconds or minutes. It generally self resolves after a few minutes and doesn't really bother me. Should I consider having an ablation?

Hammerboy profile image
Hammerboy in reply to Ruby40

I'd speak to your GP and get referred to a cardiologist if it was me , that's how my AF started .

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