pace and ablate

[Spin-off]

After my recent bout of AF, pace and ablate has been suggested by the cardiologist. I’m only in my mid 60s and apart from my AF I’m fit and active. Unfortunately i was in hospital for 6 weeks in 2020 when my pericardium was punctured during the last ablation. The thought of another surgical procedure is not at all attractive! I’d be very interested in the experiences of others.

[CDreamer]

I can imagine that you are hesitant about another catheter procedure but thought you might find this thread useful. I went for P&A but the pacemaker on it’s own worked so well for me that I cancelled the AV node ablation. I have had a few episodes, but they have not been very symptomatic.

healthunlocked.com/afassoci...

[Spin-off in reply to CDreamer]

Thank you so much - I really am grateful that you’ve responded. I’m going to spend a few hours reading that thread and others. I was cardioverted in August(after 24 hrs in AF) and back in SR immediately but 3 weeks ago went into AF again. After 7 hours (pulse 150-170) I felt my pulse slowing and was actually delighted - it never usually reverts without assistance. But then the pulse dropped to 40 and I collapsed and it was all horrible. I live in France. Cardios do not see much of a point doing more cardioversion and, given what happened last time, are as reluctant as I am to do another ablation. Despite having had an adverse thyroid effect on me before I have decided to take amiodarone (I can’t take Flecanide)with regular monitoring - at least while we all try to decide what to do next. The drug has worked and I’m in SR. It’s all rather knocked me for six and I’m only just getting on top of my emotions about it all. Pace and ablate sounds so scary - I’d worry all the time that the machine would fail! I currently do not have any heart failure. But clearly things aren’t getting better.

[CDreamer in reply to Spin-off]

My PM has an app linked to the clinic and my smart phone and reports constantly. Others have a monitor they download connected to phones to report & you go to clinic x2 year to have it checked to see that all is working as it should. These are very sophisticated machines nowadays and my cardiologist told me he had never known or heard of one failing.

Worrying about PM failure was my concern in the early but 4 years in I can look at the status on the app, know I have at least 8/10 years if battery left before I need a replacement so no longer even think about. There is a link in the thread to a Pacemaker forum - there are many different types with different functions. Mine is a RSR- resynchronisation pacemaker - it’s just brilliant!

[Spin-off in reply to CDreamer]

Thank you. That all sounds very reassuring and I’m pleased it has worked so well for you. Reading all the contributions in this thread is so helpful.

[Desanthony in reply to CDreamer]

This happened to my wife's cousin earlier this year he was taken into hospital with AF and they kept him in promising pace and ablate as soon as possible. They popped the pacemaker in after about a week in hospital and he was as right as rain. Hasn't felt so good in years so didn't have the ablation part. His pacemaker is monitored via internet by the hospital so if anything changes they will change the programme (that could be fun). So that means he doesn't have to attend so many checkups in person I believe. He's living his best life for an old man of nearly 70 with all his little grandchildren.

[Spin-off in reply to Desanthony]

thank you. Another positive story - I like these!

[Hylda2]

79 and had the pacemaker fitted five weeks ago. Ablate 17/11! Like you full of what ifs but have small monitor at side of bed which reports to the mother ship each night.

[Spin-off]

Lovely to hear it’s going well, Hydra2 - and I hope as each day passes you feel more confident. I’ll be seeing a consultant in December to know whether I’ll be going along the pace and ablate route. So far, people like you have been very reassuring.

[Gumbie_Cat]

I have no personal experience, but did look up videos about this. (With a low resting heart rate but high AF, it did make me wonder if it could be down the line.)

Even if all the checks were somehow to fail, apparently the heart has a sort of ‘escape beat’, so you would feel pretty bad but it wouldn’t just stop.

Also, I believe that the ablation of the AV node is a far quicker and simpler one than the pulmonary vein isolation.

[Spin-off]

Thank you Grubie_cat. I’m already starting to feel calmer about the possibility of the operation. I’ve had AF for so many years and been through cardioversions, ablations and different drugs. I trust my cardios that P&A is the next step. They have said to stick with amiodarone, bisoprolol, Apixaban for as long as I can (my thyroid suffered last time) but the next AF episode will be the trigger for surgery. I’m having a bit of a problem with low heart rate (49) causing dizziness etc so I’ve just reduced the bisoprolol - but otherwise everything is fine.