pace and ablate and the rationale of doing it

[Hardjuice]

I’m due to have a pace and ablate done

Pace maker on the 21 st of December

Followed at some point by the ablate

the reason behind this action is so I can come of drugs and my legs swelling will ease or disappear

but I don’t suffer from AF other than odd tiredness and swollen legs ( made worse by my job kneeling a lot )

To take this drastic action of burning my natural pacemaker seems difficult to justify

I’ve seen many posts of people swearing by this but I’m sure they are struggling more with AF than me to drive them to do it

what I don’t know is if my heart will suffer by not doing it

Also can my heart issues improve by lifestyle changes enough to delay surgical intervention

Or mayb avoid it altogether

Drugs I hate them swollen legs I hate them

burning my natural pacemaker I hate even more so final

another troubling factor is my Dad died at 68 of a heart attack New Year’s Day

I’m 68 in January

My pacemaker is due to be implanted 21st December

I think it’s best to delay this procedure

Until I’m in the right head space

[jeanjeannie50]

It's a big step to take isn't it. I think in your position I'd feel the same. CDreamer has had great success with just a pacemaker, she found that she didn't need the ablate bit. My putting her name here will alert her to your post .

Jean

[lovetogarden]

This is a tough decision. I’ve heard others say it was the answer for them, but we’re all different. I agree though, being in the right headspace is important.

[Buffafly]

I assume you’ve got swollen ankles because your heart is being damaged by the AF whether it bothers you or not and your meds aren’t effective. The longer you leave it the worse the damage will be. I don’t think you would have been offered the procedure if your doctors thought there was a better alternative. I think you should ask them to explain more fully why they think it’s the best thing for you.

[Hardjuice in reply to Buffafly]

I was offered this procedure a few years back as an alternative to drugs but thought I wasn’t ready then

Being asthmatic I’m on diltiazem and I assume leg swelling is related to that I asked did I need the pace and ablate and was told no

But it’s a way off the drugs

Hard commitment to make I need further discussions with the EP I feel

[CDreamer in reply to Hardjuice]

Hi - I tend to agree with Buff - leg swelling is an indication of your heart struggling to pump oxygenated blood around your body - the pacemaker will help your heart and bypassing the hearts’ natural pacemaker will mean you will have a regular pulse, so I can absolutely understand why the suggestion of pace & ablate. I too struggled to get my head around this but retrospectively it was the best decision to have the pacemaker.

As Jean says, I went for this as I couldn’t tolerate any of the drugs and the pacemaker alone made such a difference and stopped my AF so I cancelled the ablate of the AV node which was to be 6 weeks following the implant. 4 years on I am very happy with my decision. May I suggest that maybe you talk further with your doctor about the rationale and options before you make your decision either way.

Best wishes.

[4chickens]

I know where your coming from I was offered another ablation ( no 5) or pace and ablate. Despite it being a god send for others and massively improving their lives, I felt it wasn’t for me yet, therefore I explored the option of a hybrid mini maze, I’m due to have my surgery which in fact will be a convergent hybrid mini maze on 15/12. If all goes well I will be medication free after recovery. I’m sure you will come to the right decision for you, it’s not always easy and everyone is different, my advice is go with your gut feeling. Good luck with whatever you decide.

[Barb1]

I had persistent AF and after the 5th ablation which did not put me back in SR, I had a Pace and Ablate. I am now in permanent AF but with a regular pulse and the AF not affecting the rest of my heart. I have just about manged to come off the BB but am still on a diuretic and of course an anti coagulant. Unfortunately it has not given me the new lease of life I was expecting and am still fatigued, breathless and sleeping poorly. We are all different.

[Afibflipper]

Hello Hardjuice, sorry you are feeling so worried and obviously you’re suffering side effects too.

I personally would get all your questions together and maybe call the consults secretary. Tell them your pre op fears and say you’re struggling whether to go ahead or not and could they possibly pass the questions on to consultant team to be answered asap before your op.

Then armed with information from Drs and people who’ve been on here from people on here who’ve been in your shoes then do your pros & cons list

Not everyone feels their AF but it’s obviously taking some toll, tiredness and legs which if they’re very big & heavy add to the strain on the heart.

I wish you well whatever you decide x

[Dippy22]

I’m interested in the leg swelling. Just revelry I’ve had several sessions of sitting in ED with bad episodes of AF (av 160 bpm/93% blood oxygen) and I noticed that my feet swell up to the point where I have to loosen my trainer laces. Then fairly shortly after the AF goes away I need to tighten them up again. So I wonder if it’s the meds or the actual AF itself that’s causing the swelling?

[Hardjuice in reply to Dippy22]

are you on Diltyzem

[Pacer22]

After many years and many AFib episodes, along with countless meds, ( which did not help ) I finally had pacemaker implantation in May, followed by AVNode ablation in September. I have been in sinus rhythm ever since, my energy level has improved so much.

Yes, it does make me dependent on the pacemaker, but AFib was dictating my life, so I feel it was a good trade off. Good luck with your surgery.

[ETFCfan]

Hello, I had my pacemaker implanted in June 21 due to Covid the AV node ablation was delayed until Dec 21. It should have been six weeks after. During the months waiting for the AV node ablation I felt exactly the same as before, I had been in permanent AF for a few years. I was tired, breathless, swollen legs etc. As soon as I had my AV node ablation I felt an immediate improvement, I lost a lot of weight immediately due to no water retention. It’s taken a while to get back to fitness but feel it was so worth it. Like you I questioned such a drastic solution but figured that the NHS would not be offering it unless it was really necessary. Also my consultant answered my questions fully but made it clear it was just about quality of life . Good luck whatever you decide x

[Hardjuice in reply to ETFCfan]

do you 2021

[Hardjuice in reply to ETFCfan]

sorry do you mean 2021

[ETFCfan]

yes sorry, brain freeze tonight !