Some input from the community

[riffjack846]

Just wanted to get some of you folks opinion on something. I started my Afib journey back in 1999 and after countless Cardioversions, homeopathic regimens, anti-arrythmia drug regimens, lifestyle changes nothing has worked until recently when my doctor put me on 200mgs a day of Amiodarone. This is the first time in years I've been Afib free for more than a few days. In the past the doctors have said I wasn't a very good candidate for an ablation but now it seems I am. Here's my dilemma. I have an opportunity to have an ablation done on Sept. 2nd but I am currently in NSR bliss. So, would you have the ablation done, or wait until the Amiodarone stops working or presents ill effects? I appreciate all feedback. Thanks for reading. Mike

[Becksagogo]

Hello. I'm pleased to hear that the Amioderone has done its thing and put you in NSR. To take it long term though may not be a good idea as it has devastating side effects for some people. I thought that the idea was you took it short term, had the ablation and then stopped taking it.Please research this drug as much as you can before you make any decisions.

[Hidden]

What Becks has said makes a lot of sense. I don’t know if they are called anything different in the States, but have you recently had an echocardiogram, a scan of the heart which determines how well it functions, whether or not it is enlarged and the performance of the valves. This would give a guide as to how suitable you might be for an ablation. Also, as you are in the States, it might be worth researching and enquiring about a Hybrid MiniMaze procedure which some say can be more effective for patients in long term persistent AF.

Here in the UK, if an EP offers an ablation on the NHS you can be fairly sure they are confident that it will be beneficial to the patient because they are salaried from the State rather than financed by insurance companies. You are relatively young and taking Amiodarone long term can be difficult for some so it is, understandable, a difficult position to be in but others here may help you to reach a decision……..

[BobD Volunteer]

Do it now. Amiodarone is horrid nasty drug and should not be taken long term. Don't miss the opportunity.

[secondtry]

No experience of the longevity benefit of Amioderone but my vote would be ablation now.

[healingharpist]

Hi Riff, I'd also recommend an echocardiogram to give more info on health of your heart. But my cardiologists in the US have said to use meds for as long as they give you a good quality of life, and save the more invasive methods (which have their own side effects and unpredictable outcomes) for "last ditch" or when you have no good drug options left. My EP also says ablation methods will improve in future years. 200 mg amiodarone is considered low-dose. It is reported that 100-200 mg amio causes few or mild side effects, if any, and I was glad to read the clinical studies that support this. Mom has been on 100 mg/day amiodarone for almost 23 years now, has never had another afib episode, and has never had any side effects; she was told by her cardio that low-dose long-term use is OK with periodic blood tests, as she does. Seems only common sense that more troubling side effects may appear if taking 400 -800 mg/day.

Thank God, I am still doing well on 25 mg/day metroprolol and hope that continues forever, but seeing my mom's experience (and another friend's), I am keeping low-dose amiodarone on the list. Just FYI, they also still prescribe dronedarone (similar to amio but without the iodine molecule) in the US for people who don't do well on amio. Wishing you continued good health on 200 mg! Diane S.

[riffjack846 in reply to healingharpist]

Thanks so much for your feedback. I was thinking along the same lines after some research on my dosage.

[healingharpist in reply to riffjack846]

You're welcome. I was also thinking, they schedule ablations frequently around here (Ohio/KY), don't know your State, but if you're near any big cities you'd probably have other opportunities should the need or desire arise. All good vibes. D. S.

[mav7 in reply to healingharpist]

Great info in your original post, harpist !

May I ask if you are in NSR and have paroxysmal or persistent AFib ?

[healingharpist in reply to mav7]

HI mav, I have had paroxysmal afib over about 12 yrs w/ some long gaps. Metroprolol is working, also got rid of ectopics which was so distressing, and I keep flecainide in reserve in case it appears again. My EP said "hold off ablation as long as you can" because he could see from my heart measurements on echocardiogram that I have not had any remodelling of my heart tissues in 12 yrs. If remodelling occurs, there is a higher chance of recurrence of afib. Are you also paroxysmal, mav? Cheers, Diane S.

[mav7 in reply to healingharpist]

Persistent.

Rate control with metoprolol since diagnosed 1.5 years ago is keeping control at present

Have not elected ablation, did have cardioversion which lasted for 3 days.

Thx for reply and best to you for good health.

[MummyLuv]

Great to hear Amiodarone has you back in sinus Rythm 👏👏

It’s a personal decision but I would have an ablation sooner rather than later as afib is progressive and catheter ablations have a higher success rate the earlier you have them.

Having been in persistent afib for a long time I would discuss both catheter and mini maze options with your cardiologist. The mini maze is surgery rather than a procedure but it has more success in long term afib.

[Rdiehl01]

Personally I would get the ablation. You got this