I follow this group everyday and you are all so helpful. But i need some advice now.
I was diagnosed with PAF February last year after trying to catch it for 2 years (long story). I take 1.25 Bisoporol daily with Apixaban. My PAF has got worse and i now have episodes everyday with heart rate anything up to 130. But its more associated when I walk the dog. It only lasts about 20 mins if I stop and let it pass. I am symptomatic with it as I get dizzy and breathless and I can feel it rising up my neck into my mouth. Some days i have to stop walking dog. I have a cardiologist phone appt on 25th July and my GP has suggested catheter ablation. Am I a suitable candidate for that? I've read that sometimes they can't find the AF during procedure. Just want rid of PAF as its affecting my quality of life now. Any advice appreciated. Thanks
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Youngest
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They will trigger it if you're not in AF at the time of the procedure.
It’s been a while since we have been asked the $64m dollar question so here goes! Although an ablation can help control AF symptoms, it doesn’t necessarily cure AF and it does come with certain risks which are considered as being quite low by the medics. As far as responses from forum members are concerned, once the “blanking period” has passed, the vast majority seem pleased that they have had their ablation. Bearing in mind that most forums tend to attract bad news, this is quite encouraging. However, everyone has to remember that the procedure either burns or freezes the tissue which causes the rogue impulses to occur and it takes time for the scars to develop which stop these impulses. It is therefore, not always instant solution that some expect and certainly hope for.
You are relatively young and the success rates tend to be much better for patients with PAF so there is a very good chance that an ablation will be successful and minimise the need for heart medication. Don’t worry about not being in AF at the time of the procedure. This is very common and medics are able to induce AF so that they can identify the rogue impulses and treat them. As with anything medical, something may happen which prevents them from inducing AF but this is very rare.
I’ve had two ablations and I would certainly have a third if it was necessary but listen to what others have to say. There are lots of things you may be able to do to reduce your AF burden such as diet, exercise and various lifestyle changes and others are better at explaining that but I hope you find this helpful……good luck
There is one thing to add. If your discussion with the specialist results in you being put on a list for an ablation, take it. The waiting times in some areas may be up to a year so there will be plenty of time for you to reconsider your position if necessary…….
Thank you FlapJack for such a detailed response. I think if I'm offered it I will say yes and like you say will have at least a year to decide. I do have episodes outside walking dog. Can wake with it for no reason and out blue during day or night. No triggers I can find. I'll see what cardiologist says.
I was on the list and after doing all the research on here and elsewhere about long recovery and probably needing it done again and again I declined the offer.
Personal decision but for me the cons vastly outweighed the questionable pros and if you are mainly only affected when walking the dog and not so bothered other times I would hold off.
You’d have definitely held off walking my dog. AF or no AF.!!I once took in a jack Russell from a elderly neighbour who was struggling,
Lovely little dog in the house but soon as it’s leash went on and stepped outside it turned into a gorilla.!
Snarled at anything that moved. Went to bite people, tried chewing tyres off cars, started chasing it’s own tail and would get completely tangled up with its leash.
I once took her into middle of nowhere and let her off thinking we were safe.?
She gazed at me for a few seconds with loving little beady eyes and little tail wagging then shot off like a ground to air missile all the time barking at nothing until her barks got fainter and fainter until nothing.!!!
2 days later it cost me £45 to collect her from a dog compound 12 miles away😡
I never let her off again.!!! I just walked her local, complete with Hannibal leckter muzzle.
🤣 My daughter eventually gave in to her family’s pleas for a dog although she is not at all a ‘doggy’ person and her husband and son have allergy issues. I told her my family have had lots of dogs but in a ‘huntin, shootin, fishin’ environment not a smallish suburban house and garden, also suggested some smallish dogs to consider. So - she chose an Australian labradoodle……when I went ‘er…’ she told me to mind my own business. The puppy is a nightmare - just destroyed her lovely new outdoor sofa amongst other things. Never going to say ‘I told you so’ of course but she knows what I’m thinking 🙄
Wilsond I have just read your story and you kept me amused during it all. But thank you for such a detailed account of the ablation. Not sure i would want to be awake during procedure. I think I'm still in denial that I have it, even though I know I have if you know what I mean. I can't remember a time when I wasn't hearing that thumping etc. I just want to be back to 'normal if there is such a thing! I also have osteoarthritis in my hip and knee (waiting until I'm 60 for knee replacement). .. but its AF that affects me worse as I just manage my arthritis although can't take anti inflammatories (found nature's kiss which is brilliant and natural). But your story has given me hope. Thank you
HiI'm having an ablation next week. But having said that I have been followed by a cardiologist and have seen an Electrophysiologist ( EP - experts in heart rhythm problems). You really need to see a specialist - not Just a gp . Also as your episodes might be exercise related perhaps an exercice test may be the way to go. Only a Cardiologist can advise you but try not to worry - so many options are out there to help you deal with this. Perhaps your current medicine doesn't suit you? Anyway we are all here to help and support each other but only a Cardiologist or EP can help you with your decision to have an ablation.
May be a bit soon to jump to ablation as you have only had the most basic of drugs at the lowest dose! The cardiologist should do tests to check the physical state of your heart - echo etc which would show if there is a physical problem such as furred arteries or valve problems. If not you could be prescribed an anti arrhythmic drug but if that wasn’t helpful then an ablation would seem a good idea to prevent you going into permanent AF when things get much more difficult to fix. As you are having the symptoms you are at quite a low rate do be careful about exercise until the cardiologist has given your ‘plumbing’ the all clear ❤️🩹
Hi I recently had an ablation for what I thought of as a fib.During the procedure they found atrial flutter which they stopped.Still not clear if I ever had a fib or fluttervand lots of ectopics.Have to wait for my 3 month followup .Very pleased I had an ablation though as I was teetering shall I shan't I.Would defo have another if needed.
Unfortunately the question is hard to answer as you need a really good assessment by an EP but I don’t regret my ablation and you don’t have to be “bad enough” or in AF, or not on high meds you just need to have a heart that is likely to benefit and the younger and sooner the better. Get that assessment!good luck
Thank you everyone for your replies. I will see what the cardiologist says on 25th. But I think if he recommends one then I will say yes and then research while I'm waiting. But it sounds more positive than negative.
I was the same as you I have pushed through the breathlessness and got into cycling. Building up to 100 miles a week and got used to symptoms. I went to the hospital feeling a bit of a fraud that I wasn’t “unwell” Had my ablation last Wednesday 29/6. And have to say walked out of hospital in sinus rhythm and feeling better than I had for 3 years. Also astounded at the list of things that have improved that I had no idea were down to PAF.
Nor could I to start with. I could barely do 2. Despite the cycling though wit AF walking was difficult and stairs resulted in a lot of breathlessness. All now ok after ablation.
Unbelievable difference. Not out of breath, eyesight better, skin not dry, stomach not bloated, ankles and wrists not swollen. looking forward to getting back on the bike. Might even do the London Marathon again.
H Youngest. I’ve read some of the comments here and would like to add my thoughts. I am a similar age to you at 59 and had suffered PAF for a year or so and then in March 2021 was admitted to hospital for a couple of days which was controlled by bisoprolol and Fleicanade but then developed atrial flutter in June 2021. I was hospitalised for a week until they could find me a catheter ablation slot which ironically was 12 months yesterday. Had the procedure and was discharged the same day then spent a couple of weeks convalescing but would have the procedure again tomorrow if I had to. I have been PAF and flutter free for 12 months now and leading an absolutely normal life walking dogs and even back to playing five a side football weekly. There are risks as has been mentioned already but for me the benefits have far outweighed the risk.
Hi Spitfire1863. Thank you for this. I have episodes every day now but not severe as they were when first diagnosed. Can I ask how you tell difference between AF and atrial flutter? I have ectopics near enough all day everyday and wondering if thats flutter? My kardia and watch always say inconclusive whatever that means! Like you I would love to walk dog normally. I've forgotten what normal is like! So pleased for you and hope it stays that way
Flutter is very fast and regular,Fib is usually but not always fast heartbeat,and all over the place!My fib was slow and pulse very thready and hard to find x
Apparently fibrillation is a fast irregular heartbeat and flutter is a fast regular heartbeat but to me they felt very much the same with my average heart rate around 120-130. The medication wouldn’t bring the rate down and they tried a few different ones with catheter ablation being the only final hope. The consultant diagnosed flutter with a quick pulse check and did say that it was very difficult to control with meds. I believe that the ablation area for flutter is always in the same area so they’re are confident of a first time fix but with fibrillation the areas can be in different areas so not always confident. I must also add that I have now gone teetotal as apparently alcohol can affect and trigger it.
Good for you for questioning and researching the procedure that you are facing. I faced the same dilemma approx 6 years ago. What I find baffling in the current climate is how many people have accepted a certain procedure without asking questions
Hi, the amount of Bisoporol seems very low, as its used to control your heart and BP it sounds like you need a bigger dose which should be more effective. As far as I know apixaban doesn't control heart rate only thins blood. Talk to Doc about dosage and perhaps a cardioversion which I would try before an ablation. Reasons in my case, more effective, requires little time in hospital, a couple of hours, and as a result should be more available than ablation.
Thanks 2learn, I was put on 2.5mg bisoprotol but it made me ill and really low heart rate in evening. Tried different times of day same affect. My resting rate on 1.25mg is usually about 55-60 which is perfect if it wasn't for everything else. Cardiologist at time changing it to 1.25mg said next stop ablation but that was over a year ago. I'll have to wait and see.
I never fully realized the emotional burden I was carrying around during my 5 years of PAF--until I had an ablation and was physically "cured." The difference it makes in one's life to have that stress removed and return to normal thoughts, actions, and life in general is the true miracle of the procedure.
I was diagnosed with lone PAF in 2009 and finally cried 'uncle' and had an ablation in 2014, if only to try to make all the anxiety and cardioversion/ Warfarinisation lottery stop.
It did for a bit and the cardio was quick to declare victory. But it came back. And kept coming back.
Until a comparatively quiet spell recently (more quiet than the six months after my ablation in fact), following my renewed commitment to lifestyle and joined-up supplementation (notably B vitamins, NAC and ALA, plus dietary change and focus on gut health) .
Too much to say about that. But maybe see another post of mine today. And make sure you have all relevant conditions tested - lone AF is a diagnosis of exclusion (thyroid, insulin, B12, homocysteine, gene markers etc.,).
Anyway, with regards to ablation, an uppermost issue for me was the duration of x-ray fluoroscopy. It could be hours with some cardios, but mine got it down to minutes (she too was unfond of x-rays, and wanted to have children some day).
Also, her pet theory was about ablating vagus nerve endings (I have predominantly vagal AF). And that combined with a 'soft touch', which I was also keen on, may have affected the result. Who knows? Some cardio will 'ablate the cat'. But they can all be reticent to provide much blow-by-blow post-match detail - mine changed the subject entirely. I am sure I can 'feel' the scarring still, like when swallowing, but it may just be a vagal thing.
And I would have been happy to have been awake throughout, but I gather there was something of an anaesthetists' 'closed shop' operating at the hospital. Thrift may mandate things differently on the NHS.
No one can know what the long-term consequences are of ablation, of course.
And there is some research to suggest that the underlying AF substrate is refractory to mechanical (and even pharmaceutical) intervention, with a naturally degenerative prognosis.
Which is none too encouraging. And one reason I have been keen to get out of the tunbril and address genetic and other dysfunctions and co-morbidities to confound and dispel this pessimism.
I may be wrong-headed, and no doubt I shall learn, perhaps the hard way. But I simply have to understand why this is happening to me. I don't think it 'should'!
And the thing that stands out is that most cardios, and all the ones who do ablations, have largely given up even wondering. To a child with a hammer everything is a nail.
It is a pervasive problem of our medical system that there is a threshold of significance: "Good news, Madam, it's serious!". Which is all to the good if it really is of course. But it means that a lot that is not, but will become so, is ignored.
And a lot that just is not that serious, were it treated more sympathetically and in a joined-up way, just gets blown away by industrial-strength interventions, for a patient having in wholly understandable desperation crossed some medic's cross-hairs. These program problems are elusive and the temptation is to reach for a hammer. No one can get them for that!
There is no doubting the virtuosity of catheter ablation. But the business-end is still straight out of medieval times - burning, freezing etc.. And it may just be a band-aid fix. And, worse, cover up what your body has been trying to tell you.
Maybe the way to deal with a fire is not just to shut off the alarm (nice as that is!).
Anyway, not to divert you, but to place my own reflections candidly before you.
I would say go for it as I had 2 catheter ablations. The 1st one only took for 1 year and then I am on my 2nd catheter ablation and it is lasting for 3-1/2 years. I have not had an episode (knock on wood) and I am not planning to have one as I have changed my eating and drinking habits. I have quit caffeine, sugar and alcohol and I have included going to the gym and swimming quite a lot. My surgeon advised me that my catheter ablation will last at least 10 years. When I need another ablation procedure, I will be the first one in line. I recommend it to anyone since my AF episodes would last anywhere from 2 hours to 24 hours.
Great news about the effectiveness of your second ablation! Where did you get your second? My first one lasted about a year as well and am considering another. Will also need a valve replacement some day since mine is bicuspid.
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