Grateful for any Feedback on PVI Ablation Please

Hi,

My background is:-

Developed Atrial Fibrillation in November 2021 (persistent from day 1). Had a cardioversion in February 2022, which lasted about 7 weeks and then back into persistent AF, looking back I carried on as normal after the cardioversion and perhaps I should have been more careful.

My NHS EP/cardiologist has suggested a pulmonary vein isolation ablation using freezing. He says it is a relatively simple procedure although there is a possibility I may need a follow up of the procedure. There is also the possibility of needing a pacemaker in normal sinus rhythm as my resting heart can drop down to 40 at times.

He considers the success rate of the procedure is 60 to 80% and recovery from this particular type of ablation is fairly short and can be counted in weeks as opposed to months.

My persistent Atrial Fibrillation doesn’t cause me any major issues although who knows if that will change for the worse in the future, I don’t have a problem of having a pacemaker fitted and at 72 years old and see this as a benefit in the way my heart rate can drop at times.

I know very little about ablations and therefore would appreciate feedback from those with a much greater knowledge of such matters. My questions boil down to is it a good idea to proceed, does the recovery time seem realistic and is the success rate over optimistic.

My fear is if I go ahead could I end up back in persistent AF with worse symptoms then I have now and if I don’t go ahead I will i regret not having it done, for the rest of my life - a real dilemma.

Thank you in anticipation.

[Gowers]

I had my 4th ablation in April (4 ablations in two and a half years) and had 3 cardioversions which, like you only lasted a few weeks. AF for me was getting more and more difficult to cope with & as we all know is unpredictable. After the 1st ablation I felt quite poorly so in hospital for 3 nights (combination of Bisoporal & Flecanaide didn't agree with me). But, I went on to have 3 more as I so wanted to feel well & be able to enjoy life again. I'm now in NSR although it has felt like the AF was making a comeback on times! One of the things I found difficult was being taken off the high dose medication - didn't think I would manage having been on it for 7years plus! Still. take blood thinner & statin. Do let us know how you get on

[Hidden in reply to Gowers]

Hi,

Glad to hear you are in NSR, hope you stay that way. Yes I will let you know how I get on although I don’t expect it to happen to the new year.

[BobD Volunteer]

Cryo ablation tends to be a first line attempt these days as it is realtivey quick but does have limitations since it relies on the balloon fitting the four pulmonary veins. It may well be that a repeat RF ablation may be needed at a later date so please factor that in to your thinking.

It is important to understand that any and all treatment for AF is for quality of life as provided rate is well controlled there is no difference in morbidity for any of the treatments.

I'm a great fan myself but then my AF was highly symptomatic and limiting.

[Hidden in reply to BobD]

Hi Bob,

Thank you for the information, yes I anticipate a return visit will most likely be necessary at a later date.

My rate is well controlled and I do not have too many problems which is my dilemma in deciding wherever to go ahead or not.

[BobD Volunteer in reply to Hidden]

As a wise man once told me "When the pupil is ready the teacher will come." I first refuse an ablation but within six months I was banging desks demanding one bu AF was so bad.

[Bunnyuk]

I can relate to your dilema. I too was very hesitant about having an ablation. I had very debilitating PAF about 3 times a week which was exhausting and distressing, and really limited what I could do. Medication didn't help. I was offered a cryoablation on NHS, with 75% expected success rate, although there was a chance I'd need an additional ablation later.. like you I was very concerned I might feel worse and put it off. However, in September I decided to go ahead and so far I'm very happy I did! It's transformed my life. It's early days yet but I'm so happy I took the leap of faith! I'm 73 by the way. Good luck, whatever you decide

[Hidden in reply to Bunnyuk]

Hi,

Glad to hear that your cryoblation has gone well, long may it continue.

It’s good to see the expected success rate you were advised is similar to what I was told, as I was wondering if the EP was being over optimistic. That gives me confidence in the procedure.

[mhoam]

Hi DenBoy70,

I had a cryo-ablation at UHCW in Coventry at the start of June and it has improved my QOL a great deal. I was in persistent AF and struggling with daily life as I was quite symptomatic so of course I was pleased to get it done after a 45 week wait!

I am a similar age to you and first diagnosed with PAF about 10 years ago. I was put on the list for a PVI ablation back then but due to other medical problems it didn't happen at that time.

With the benefit of hindsight I wish it could have been done 10 years ago It is a straightforward procedure and sounds scarier than it is.

I was quoted a similar success rate and so far it's working well for me.

Good luck with your decision

cheers

[Hidden in reply to mhoam]

Hi mhoam,

Thank you for the information that is very useful, glad it’s made a positive impact on your QOL.

[Keano99]

I had a Cryoablation in May, after being diagnosed with AF in Oct 2020, persistent since Oct 2021. My EP said “I can’t guarantee I can make you feel better”, but he did. I’ve been in NSR since and feel oh so much better, I was golfing after 10 days. Bit recovery isn’t straightforward, ups and downs and you eventually establish how much you can push your self. I play golf 2/3 times every week, but still need a rest day after. I still feel minor pain in my back, from where PVI was, and I do have the odd palpitation and can sometimes feel some underlying quivering, which is odd whilst my pulse is nice and strong. Funny things go on in different ways for us all during the healing process. Whatever any medic tells you about recovery time, just double it…good luck with your ablation😀

[Hidden in reply to Keano99]

Hi Keane,

Thank you for the feedback that’s very useful, glad it’s worked for you.

My AF was persistent from the start so I’ve probably had an easier time then most people. Point noted about recovery time, feedback does suggest it’s shorter with this type of ablation.

Enjoy your golf, I always wanted to take it up but never got round to it.