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No Symptoms - AFIB 24-7 Would you advise Ablation?

bgzcle profile image
34 Replies

My Family think I should have an Ablation procedure. I am reluctant, although I have had confirmed AFIB for 4 years, I live life everyday without any symptoms or feelings of my AFIB. I travel international allot, 2-3 times a year, stay in 3rd world countries at times, but never have any symptoms that upset my daily life unless on a rare occasion I feel a great deal of stress, then I could go breathless for a short time until recovery. My family thinks I should have ablation, my doctor tells me I'm a candidate and I should, even though I don't have noticeable symptoms and generally does not interfere with my life. What would any of you readers do, Are any of you the same as me, without any nagging symptom? Would love to hear thoughts about this to share with family

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bgzcle profile image
bgzcle
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34 Replies
baba profile image
baba

Make sure you are taking anticoagulants if appropriate.

You can check here:

mdcalc.com/calc/801/cha2ds2...

Otherwise I would just count yourself lucky. In you situation I would not have an ablation, which is normally done for symptom relief and is not without risk.

bgzcle profile image
bgzcle in reply tobaba

Yes I have been 5mg Eliquis (morning and evening) and 25mg Metoprolo (morning) keep blood pressure stable 105/80 for the most part. Pulse generally 70-110

BobD profile image
BobDVolunteer

NO! Any and all treatment for AF is only ever for quality of life. Provided that you are anticoagaulated where appropriate and your rate is well controlled there is little reason to change anything.

I am a great advocate for ablation when a patient has poor quality of life but it sounds like yours is fine.

Here in UK doctors are paid a salary and not by procedure so if offered ablation you can be sure that the consultant believes it will help. I worry that may not always be the case on your side of the pond.

bgzcle profile image
bgzcle in reply toBobD

It is what I think too, thanks for the support

Billblue profile image
Billblue in reply toBobD

Good advice BobD

Totally agree with everything that’s been said. Always question the motivation of someone who may just want you to help line their pockets! As I understand it, access to having an ablation in the States is measured in days rather than months, so should your symptoms change at some time in the future, that maybe then it will be time to reconsider…….

Frances123 profile image
Frances123

No, I wouldn’t have an ablation in your circumstances. You enjoy life and are doing everything you want without any problems so just carry on. Agree with everything else that has been said. Gosh I wish I had your energy. x

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toFrances123

Hi Frances123Yes energy is my problem too.

But it showed to me that inflammation plays a big part after you have meds that CONTROL your BP and H/R.

Is it energy as fatigue or tiredness.

I say energy.. because I needed to stop for 1-2 mins before I can walk again. It is an elevated walk up.

When TVT Kit (johnson & Johnson rough mesh) removed some energy returned.

Yesterday I caught the free bus into Kaitaia Hospital for Pelvic Physiotherapy. I had tens.

I had lunch there and walked down a steep hill to pick up a library book. Waited outside for bus. Driver dropped me back home.

Then I slept 3.1/2 hours. Had to awake for feeding dog and me and dinner with pills.

cheers JOY. 73. (NZ)

Guitar335 profile image
Guitar335

My view would be to not have an ablation and find a way to avoid or manage the stress you mention. Change job or position or perhaps get some developmental support to change how you react to the stress?Being breathless sounds very worrying and no doubt frightening for your family

If you do not have an ablation what r u going to change?

Best wishes

How much do you trust your doctor? Get a second opinion from a good EP?I would have one. It doesn’t “cure” the underlying tendency for AF but my EP would say it helps prevent heart disease further along the track. AF is not good for the heart. Rarely disagree with Bob though

MummyLuv profile image
MummyLuv

Whether to go down procedure, surgery or meds route is very personal. This is just my view. Afib is progressive and can put strain on the heart. If your left atrium is not swelling, you have normal ejection factors, there are no signs of leaky valves and no other signs of strain you are in a good place with your control by drugs.

If your heart is showing signs of strain I would research well whether ablation would be successful given you have been in constant afib for Years. The success rate of a catheter ablation drops substantially 30-50%. An alternative in this case is a mini maze.

Sounds like you are in a fortunate position with lone afib that isn’t currently impacting your heart :)

bgzcle profile image
bgzcle in reply toMummyLuv

As far as I know there is no extraordinary strain on my heart and my left atrium seems normal of my last MRI in June

MummyLuv profile image
MummyLuv in reply tobgzcle

Excellent news 👏👏

secondtry profile image
secondtry

Ask your doctor for the reasons why he favours an ablation, don't be blinded by science and be wary if he is not prepared to give you time to discuss. Remember ablation procedures are improving all the time so there will be upsides to postponing an ablation as well as the downsides no doubt laid out by your doctor.

LaceyLady profile image
LaceyLady

I haven’t had an episode since October 21. The more episodes you have the more likely it will be permanent and if I understand right, the less effective the ablation is and could end as permanent. I have thought about an ablation also, but T2 diabetes arrived and recently a close bereavement so on the back burner.

From what I’ve read I thought better sooner 🤷🏼‍♀️

TracyAdmin profile image
TracyAdminPartner

I am sure the Members of the Forum will offer you their great advice and support - but ultimately this is a decision that should be discussed with your doctor. They have access to your medical notes and will be able to provide the best treatment option for you on a personal basis. It is completely natural to feel anxious about any upcoming procedure, so please discuss and plan for support in the early weeks following. If you have any questions, please do not hesitate to contact our Patient Services Team heartrhythmalliance.org/afa... or download some of our patient resources from the webpage : heartrhythmalliance.org/afa...

Ppiman profile image
Ppiman

My elderly friend is 89 today and has had permanent AF for very many years, being treated only with an anticoagulant (warfarin / coumadin). He has very few noticeable symptoms and has never considered an ablation.

Steve

Samazeuilh2 profile image
Samazeuilh2

I think that you should have an in-depth discussion with another EP, so that you get a second opinion concerning the pros and cons. It’s not clear from your post whether you have permanent AF but just don’t notice the symptoms or whether you have PAF. Certainly, if the former applies and you decide against an ablation now it might reduce the chance of success later. I think it’s a case of finding an expert you trust.

Hi there, I'm sure you'll come to the decision which is best for you. And you can always change your mind if you decide not to have an ablation.

I'm intrigued, though, when you say you don't have symptoms. I didn't realise it was possible to not even feel your heart going crazy during an AF episode? Is that what you mean, that you can't feel anything at all or simply that you've managed to ignore it? Also, are you in permanent AF? People who have Paroxysmal AF (like me) might have attacks which last a few hours up to a few days, but it takes it out of you. I personally have felt wiped out after an attack, though I realise everyone is different. Do you not feel tired afterwards? Sorry for all the questions! I'm just very interested in how well you seem to be coping with your condition. Thanks and good luck.

Kennyb1968 profile image
Kennyb1968 in reply to

I am also symptom less - I have PAF and the only thing that indicates an attack is a slight feeling in my chest and the HR monitor on my watch. My PAF is characterised by 60-80 bpm and rhythm is fairly steady with NSR interspersed with skips and ectopic clusters. The longer it carries on the less I will notice it. I feel perfectly fine during and after. I am medicated with daily flecanide and Bisopropol.

in reply toKennyb1968

Thanks very much for this. Wow so your heart doesn't go over 80 during an episode? I thought the heart rate was always raised in addition to arrhythmical. There must be plenty folk who have no clue they have AF if their heart is not beating really fast. That must be it then - my heart has gone to 170+ during an episode so I guess you're much more likely to 'feel' that...!

Kennyb1968 profile image
Kennyb1968 in reply to

My heart rate used to jump to 150bpm before medication

bgzcle profile image
bgzcle in reply to

When my heart rate exceeds 125, on occasion, yes I notice it, but it does not stay elevated lone and does not occur often. The best chance for that to occur is if I fell under some great deal of stress

bgzcle profile image
bgzcle in reply to

Yes I am in active AFIB 24/7 I probably do feel more tired then someone whos does not Have active AFIB, but I can say for sure. I don't nap during waking hours, but then again I don't sleep soundly either, briefly waking several time a night. Maybe just old age at 76.

in reply tobgzcle

Thank you for explaining. You’re doing so well with your condition.

bgzcle profile image
bgzcle in reply to

Thank you!

JOY2THEWORLD49 profile image
JOY2THEWORLD49

HiWhat is your avge heart rate? Day? Night?

I have no chest pain, pounding etc but I have persistent rapid H/R with AF.

I do have a 'bad' ribcage and my heart has pushed over to left to have more room.

My heart is enlarged so NO ABLATION or Cardiconversion.

You should take anti-coagulants when in AF. The least the better.

New rules for Anti-Co.angulants.

Check out them with your Radcliffe Research team.

cheri JOY. 73. (NZ)

bgzcle profile image
bgzcle in reply toJOY2THEWORLD49

My age is 76. I'm in Persistent AFIB 24/7 but never feel any symptoms of rapid H/R, blood pressure meds, help relieve that. On occasion when heart rate exceed 125bpm I will feel and can become stressed or anxious and can loose my breath for a short time until I can get fully relaxed. I do take Eliquis for anti coagulant!

Kingdaddy profile image
Kingdaddy

I developed AFIB March 8th out of seemingly nowhere, when my Apple watch alerted me. I'm 58, male. And my AFIB, like yours, was early persistent - meaning, 24 X 7. NOTE: ablation works best with early persistent if done within the first 6 months.

So I'm going to disagree with a lot of the feedback here, and here's why. AFIB is known to be like cancer, and the phrase AFIB BEGETS AFIB applies here - meaning, if it isn't treated, it will progress until it becomes permanent, and nothing can be done.

So back to my story. In April, I had a cardioversion, and it worked - but only for about 6 hours. Then back into 24 X 7 AFIB. So my EP put me on Multaq for a week and decided we would try a cardioversion again to see if Multaq would help it sustain NSR. No luck - right back into AFIB after the 2nd cardioversion.

I decided I would find the best heart hospital I could that would accept my insurance, and get an ablation. That turned out to be the Cleveland Clinic (#1 in the US), and I was lucky enough to get into the Aferra clinical trial for Pulsed Field Ablation (clinicaltrials.gov/ct2/show.... I had the ablation May 25th, and I have been in NSR ever since. I'm now 3 months post ablation, and still in the blanking period, but I have not had any issues since.

I developed the graphic below to help me understand what I was dealing with and to help ensure when I talked with doctors we were on the same page. It's stratified into 5 horizontal swimlanes and 4 pillars. You might find it informative, I haven't seen anything like it. I wish you the best of luck!

AFIB
bgzcle profile image
bgzcle in reply toKingdaddy

Congratulations! Me I have passed the point of no return, when first diagnosed, laying on a hospital table waiting for a colonoscopy. They hooked me up to EKG. AFIB discovered, procedure cancelled, saw cardiologist wore a monito for 6 weeks and told me I was persistent AFIB, immediacy went to Eliquis and blood pressure meds, re-scheduled colonoscopy stopped Eliquis 48 hours had procedure and they also found non malignant polyps, back on Eliquis for life now. You can't always find AFIB early, but I agree if you can treat it before it become persistent, because more then likely it will

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toKingdaddy

HiAFib like cancer! No way!

On examination of a stroke (Embollic) I had Rapid Persistent H/B with AFIB.

4 days in and a Carotid Scan of my neck showed Thyroid Cancer.

4 months later with triage 2 for to have op a.s.a.p nd Encrinologist my Dr on the stroke Ward she said wait 6 mths, I had total thyroidectomy and 12 lymph taken with 2 infected.

It is established that the thyroid problem and anxiety about Johnson & Johnson TVT 1mm away from damage, produced the Af which took me down the stroke route.

Afib is produced by rogue electrical responses within the heart.

Ablasion procedures isolate areas and burn out/freeze out - kill areas in the heart which includes these rogue signals.

Then the heart is scarred - and the 'waiting period' is to rest and heal but the heart remains scarred.

Awful when you think about it.

Your heart is no longer complete.

I am waiting along with my triage team for my heart to settle back to normal beat and also loose AF. They are not holding their breath but I am. 3 years in September since the atroke. 1yr x 2 neck scans and pleased to say all clear.

I am now CONTROLLED with CCB Calcium Channel Blocker. 77-88 H/R day. 47 H/R Night

cheers jOY

Kingdaddy profile image
Kingdaddy in reply toJOY2THEWORLD49

AFib Begets AFib: An Electrical Cancer of the Heart

draseemdesai.com/afib-beget...

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toKingdaddy

HiWell I cant think of anything worse than calling it a CANCER because it is not.

As you have read that AF came along with the stroke and thyroid cancer.

Rapid, persistent H/R with AF.

It cant be removed like cancer, to fix one.

Thyroid problems can cause it.

But I read Drs are tampering with TSH levels below 10 when they say usually the thyroid returns to normal if you are patient.

1 in 5 USA patients have AF but not all of them need attention.

CANCER come on. Gets worse ... not necessarily and my AF was already persistent and I cant feel it. I dont get anxious.

Another reasonable solution is it happens when there is too much inflammation in the body.

Cheri. JOY

Cancer is limitated by radiation and chemo. I'm not putting that near my heart or anywhere else.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toKingdaddy

HiLet's call it something else.

Cancer is a scary condition. Apparently cancerous cells are in everyone's body. Our immunity needs to fight them to normalise.

The pathway of cancer is different.

I wonder what cancer society would say if I joined their group!!!!!

Food for thought.

Just call it 'abnormal electrical signals in the heart".

Joy

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