AF returns

[stoneyrosed]

Hi, Second ablation was on 7 th Jun this year. I had a couple of blips during the 3 month blanking period but nothing since September 5th. Last night I went into a very symptomatic AF which lasted an hour and self converted without any need of any meds. Question is once the AF starts does the AF beget AF and I can say that my second ablation has well and truly failed? I was pleased to be able to come off flecanaide and Edoxaban do you think after last nights episode I should go back on them? I emailed cardiac nurses last night but have had no reply as yet. Thank you.

[BobD Volunteer]

Personally I think it a great mistake to even think about stopping anticoagulation as best intelligence is that even successful ablation does not remove stroke risk. Regarding " has it failed" I think it still too soon. Many people are still improving at nine months or a year.

[stoneyrosed in reply to BobD]

Thanks Bob, cardiac nurse advised me to come off all meds 3 months ago he said “ May have a bumpy ride for a period but try to ride through it”. I am hoping to hear from him shortly. Now that I have gone into AF which I caught on Kardia 123 bpm, hasn’t the pathway now been established for more AF events?

[BobD Volunteer in reply to stoneyrosed]

Don't be so negative!lol 😁 I really feel you were given bad advice. MY EP always wanted me to remain on my antiarrhythmic drugs for at least three to six months to allow the heart to heal in peace. As I said there is no evidence that success removes stroke risk and I and many others here will never stop anticoagulation and I have not knowingly had AF since 2009.

[Goosebumps in reply to BobD]

hello Bob, can you clarify for me please. Your comment that “successful” ablation and putting people in NSR does not remove the stroke risk confuses me. Are you saying that evidence exists to show that Uncoagulated NSR ex ablation patients are in the category that is 5 times more likely to get a stroke when compared to those in natural NSR? Thanks

[BobD Volunteer in reply to Goosebumps]

If you needed anticoagulation for stroke prevention prior to ablation then yes your need remains regardless of any success or not. The point is that it is not necessarily the AF that causes the risk but the company it keeps.

[Goosebumps in reply to BobD]

ok. I’d like to delve further on this but won’t Hi Jack this thread.

[BobD Volunteer in reply to Goosebumps]

Pm me if you wish.

[Frances123 in reply to BobD]

Maybe Bob you could write a post as guessing many others would want to know? x

[Singwell in reply to BobD]

Bob I'd like to understand this too. Although I'm on meds for BP so I just accepted the idea of staying on anticoagulants for life. Would you do a post about this? I know the main issue is the atrial appendage when we get AF but I think people would appreciate the info re comorbidities and how those impact. Or is it just the Chad Vas2 rating?

[Ossie7 in reply to BobD]

I’m a little confused here Bob . I have a low stroke risk but have been anticoagulated post cardioversion for a good 3 months . Also always after ablation and when in persistent AF . However other times when enjoying lovely normal sinus rhythm I’m not on AC’s , as the lone AF has hibernated and I have no other cardiac health issues .

Did you mean if you have other cardiovascular stroke risks ?

[secondtry in reply to BobD]

I may be a bit slow on this but I am with Goosebumps in being confused. Many AFers are put on anticoags only because of the widely accepted x5 higher risk of a stroke compared to those not having AF. If you remove the AF (and are sure you are not asymptomatic) then my thinking goes you remove the x5 higher risk and the need for anticoags. What have I missed??

Of course if you have been prescribed anti-coags for another reason then I appreciate you would need to stay on them as any ablation would not remove that other issue.

[pusillanimous in reply to secondtry]

Yes I too am confused - I thought the AF, because the blood is just swirling around so to speak, and not flowing properly, caused clots to form which could break away and travel to the brain and cause a stroke - hence the need for the anti coagulation to stop the clots forming. So I thought once the clotting risk is removed, there would be no need to anti coagulate the blood. Clarification of the risk one NSR has been achieved over a long period would be appreciated.

[BobD Volunteer in reply to secondtry]

See my new post aas requested.

[secondtry in reply to Goosebumps]

I agree not clear to me, keen to know the point I am missing.

[Jetcat in reply to Goosebumps]

after my diagnosis of AFIB a few years ago I spent along time researching the subject and educating myself on this AFIB that I now had. My cardiologist told me to and said it would help me and him move forward with treatments etc and help me understand the condition and possible consequences etc.👍

And I do remember reading that even when you are in sinus rhythm and haven’t had any arrhythmia going on you are still at a higher risk of stroke than someone who hasn’t got AFIB. I read this on a few different studies published.

[stoneyrosed]

Ok thanks very much !

[Lenlec]

sorry to hear your Af as returned. Hopefully it was a one off ? But I know how you feel.

[Foxglo]

I am sorry to hear you had an AF attack. I will tell you what happened to me. After my ablation I had a few attacks quite soon and ended up back on Flecainide gradually weaning off it with no return fir 6th months. I had an attack when I had a UTI and another months later when I had food poisoning. 2 years in and I don't want to talk things up I am not on Flecainide but still take Apixiban. I think it has taken me probably 18 months to really settle down after the ablation. I do know worrying about whether one in back to AF is what we all do but worrying definitely was one of my triggers as was not drinking enough water. I hope things settle for you.

[stoneyrosed in reply to Foxglo]

Thanks foxglo that’s encouraging to read.

[SilverliningsForNow]

Hi there I had ablation 18 months ago and no AF since. I take 75mg Flecainide morning and night and Apixaban. What is success? I have occasional ectopics/atrial flutters when I over do it and thanks to everyone here I now know how to deal with it. The goal is to live without AF. Maybe you will control it with ablation and drugs, maybe you will go completely drug free but the advice here is solid. Everyone is different don’t worry, take it day by day and be prepared to try a combination of things before you find your success.

[stoneyrosed in reply to SilverliningsForNow]

Thanks silver lining.

[southkorea]

The same thing happened to me . I was advised to go back on warfarin. I had my second ablation 5 years ago and have only had three or four short episodes since which stopped when I took 150 m of flecanide. The episodes have been triggered by something I ate.

[stoneyrosed in reply to southkorea]

Thanks so much South Korea that is food for thought excuse the pun 😁. Thanks for reply 👍

[southkorea in reply to stoneyrosed]

you might also want to take magnesium taurate every day . It really settles the heart!!

[stoneyrosed in reply to southkorea]

Thanks, I always wonder why the cardiac nurses never mention magnesium. Perhaps blood tests show there is enough in the system, I’m not sure.

[Singwell]

I don't think it means it's failed even though technically you're out of the blanking period. Particularly as you converted without meds. See what your Arrythmia Nurse says. It could be a one off - and not uncommon. If you get a pattern of recurring events and if they need medication then that's more likely to be an indicator that the ablation hasn't been successful. My EP also told me - "you have a predisposition towards AF - even though we think this ablation has been successful you might get occasional bouts of it. Especially when under stress or ill. But they should be fleeting and not too disturbing." I've been in Sinus rhythm now for over 7 months and just starting to titrate my Flecainide. So it's good to be pragmatic and accept its a QOL improvement, not a cure.

BTW I agree with BobD re meds: keeping things stable is best for 6, even 12 months. Only after 7 months in continuous NSR did my EP say ' I'd like to see you off the Flecainide'. Fingers crossed you stay AF free over the Christmas period and beyond.

[stoneyrosed in reply to Singwell]

Thanks so much I will bear all this in mind 👍

[Keano99]

hi, I had an AF ablation back in May and I’m still in NSR. In July I met my EP and asked about coming off the meds, he said if I was 65 he would keep me on Apixaban, but referred me back to my cardiologist. He asked me what the EP said😀. Anyway, he went through my CHADS VASC score and reluctantly said I could come off Apixiban but would have to have a ZIO patch, easy just sticks to your chest, put on for 14 days to check out my rhythm….I said I check my rhythm with my smart watch, but he didn’t seem impressed, saying you can’t read the rhythm properly… I’ll update you in a weeks time….

[riffjack846]

I was weaned off of my antiarrythmics after my 1 st ablation and eventually my beta blocker but every cardiologist I've ever spoken to has said do not stop your anticoagulant (Eliquis) EVER. If that nurse took you off your anticoagulant you need to speak to your actual doctor about this. Russian roulette with the stakes being a stroke is not a good gamble.

[KMRobbo]

I came off A/C 3 months post ablation as my Cha2Ds2Vasc was zero.. I only went onto A/C 25 days before my ablation, despite being paroxysmal for over 2 years. I was 55 when diagnosed . I had no other comorbidities. I believe my medics followed the recommendations. However if you are nervous or your Chads 2 score is higher speak to your medics or even your GP if you can't get hold of the clininc. I dont know for certain but I expect he/ she could prescribe the A/C you were previously on as a temporary measure. If the A/C prevents you worrying about it it is worth it, because worry does not do anything good for your heart.Best wishes and I hope its just a one off.

[stoneyrosed in reply to KMRobbo]

Thanks Robbo, my chads score is zero. I hear what Bob says but my ablations were to come off all meds inc A/C. My cardio nurse as just been in touch with me and told me to continue off all meds for now but inform him if AF continue or sustains. Anymore AF for a continuous period I will def go back on the A/Cs. Thanks