I’ve had AF for 2 years, about 1 episode about once a month lasting about 4 hours. I couldn’t tolerate the meds for it but this group helped me a lot by suggesting I start with small doses and try to work my way up to full doses. That approach was successful and I have not had an arrhythmia since, ie, for 5 weeks (not a long time). Meanwhile, I scheduled an ablation for. 4 January. But now my cardiologists say I should probably cancel the ablation because it seems the meds are working.
My questions are: Has anyone regretted having an ablation? Has an ablation made anyone’s AF worse in the long run? And if so, how often does that happen? I can’t reach my electrophysiologist til next week. Thanks in advance.
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Gersky
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To be honest, after having 3 ablations with the first two making my AF worse. I now wish I'd tried an additive free diet before undergoing any of them. I was so convinced that my first ablation would be a success and I could lead a normal life again. I'm now in constant fairly low rate AF, though my third ablation did help and I've not had to be hospitalised at all since then.
Having had AF for 17 years, three ablations and numerous cardioversions my advice to everyone diagnosed with AF is the following:
1. Be Aware you are most unlikely to die from AF. I used to think that the way my heart bounced around I would surely be found dead next day. Still here though!
2. Changing your diet to a more plant based one, avoiding any foods containing artificial additives, not allowing yourself to become dehydrated, cutting back on sugar, alcohol and caffeine, also losing weight (if it's needed) will all have a beneficial effect on your AF. Artificial sweeteners were a sure trigger for my attacks. How I wish I'd known all of this before having any of my ablations. Would I have listened if anyone had told me? Probably not, because I believed ablations would cure me - three didn't! They have helped some people though and my AF now is not so severe.
3. This is a hard one, but looking at gadgets that show your pulse and AF will make you anxious and anxiety feeds AF. I was obsessed with what my heart was doing for about the first ten+ years of my AF journey and my attacks were so debilitating I'd end up in a hospital ward, it has taken me a long time to take my mind off this subject and get on with living. The less I think about it, the better I feel. Now I used to feel cross with people who suggested I stop looking at my pulse rate machines, I thought that their AF couldn't be as bad as mine and they didn't understand how poorly attacks made some of us feel. I would get cross with anyone who said they could still go on holiday and carry on life as normal. They made me feel evil, by not understanding how ill I felt! In our minds AF is only as bad as we have experienced, for some attacks are mild for others they're more severe.
4. Make sure you don't slouch, or unwittingly do shallow breathing while watching tv or online. If you do your heart will protest. Also avoid tight clothing around your waist.
5. Try supplementing with magnesium, any type except oxide (I use glycinate from YourSupplements and also take vitamins B12, D3, K2, C and zinc). I feel really well and there's nothing I can't do now, despite being in constant low rate AF. Or at least I think I am, I don't check these days.
I only have to think about checking what my heart is doing for it to kick off abnormally. Have been sat thinking how lovely and calm my heart is and wonder what that good rate is for me, but before I can check off it goes full pelt. Certainly best to ignore what the rate is when heart is behaving. If it kicks off and I feel it's abnormal, checking only causes me stress and will make the beat even faster.
oh my god. Point 4. I never realised before how true this is. Jeannie you are a star. It’s affected me for years but I was blind to it until now. No more slouch potato.
Thanks Jean. And added to that list, which you and I commented on in the past, is sleeping in a fetal position -- something about the diaphragm pushing up against the heart seemed to give me palpitations that ended up as an a-fib episode.
Yes, but I guess that mainly applies to people with fat stomachs. After all, the foetal position must surely be a natural one. Mine will be that way if I keep on eating chocolate and biscuits the way I have lately over Christmas! Discard your bra too when indoors. I'm master of doing that now, wear a scarf and gillet and unsupported boobs are concealed.
You had me laughing, re the boobs! Well I'm thin, so the fat-stomach-theory doesn't apply to me. However, I had fibroids -- and later a hysterectomy -- which caused internal adhesions, so I assume those had something to do with problems laying in a fetal position. I'm sure everyone is pigging out on chocolates and biscuits over the holidays!
It's a tough call to make. I'm going to step back on this one and let others reply who have had an ablation. I'm just going to add my personal take but remember I'm not a medic.
Any treatment for afib is about QOL. If your meds are working then it might be a good idea to carry on down that route. However an ablation is likely to be more successful to have done sooner rather than later. I feel the only person who can really answer your question is your EP. You don't have long to wait before you talk to (s)he. Why not hold fire on making the decision until you do?
The internet is, by its very nature, a heavily skewed and deeply flawed source of information, where even the science isn't of the quality it is made to seem. That's a shame as it means using it to help make a decision isn't easy nor even, sometimes, worthwhile.
When I had my ablation (for flutter) I felt it was a godsend and I don't think I could have managed without it since no medicines reduced the symptoms I was suffering. However, looking back to early 2019, I am now not so sure how much of what I felt then was anxiety related since I couldn't walk far without experiencing severe palpitations and a sky high heart rate that sent my fears through the roof. I just can't tease out the actual from the imagined and I can no longer recall just how bad I felt.
What I do know is that it wasn't really until I had had a cardiac stress MRI and further echo scans that revealed my heart was otherwise sound that my whole attitude towards my illness changed and I began to feel much better. This was after the ablation, however, so I remain none-the-wiser what I'd have felt had the MRI been done beforehand.
If I were you, if the episodes are few and far between, and the medicines make you feel well enough, then I think that I would cope as I am. However, since, in the USA, an ablation is such a safe and easily available option (there's a 12-18 month wait in the UK) it is hard to ignore it. The US based FB site I am a member of heavily "promotes" ablations, but I never feel so sure looking at the long term studies on their success. Also, of course, you might need two (or more...) to give a relief period of being AF free. My son's colleague has had, I believe, six procedures and he's now suffering once again with arrhythmias.
The problem in the states is, they offer ablations maybe too many, because the insurance companies are paying. I'm always suspicious when a company or hospital for that matter, tries to push a process or product
Science not being of the quality it is made to seem is nothing to do with the internet . It was happening when studies were published in paper only journals that you had to have a subscription go in order to read. Example - Ancel Keynes' work on cholesterol. It is to do with scientists running after grants , prestige and money rather than truth.
As for ablations I am very reluctant go go down that route. My afib has taken a turn for the better recently and I am worried an ablation might actually make it worse!
Wise words . I used to think that true science was done in universities but even they are in thrall to the great god Mammon.
True science is alive and well though since the scientific method, where followed, can’t be faulted. This morning’s newspaper brings news of gene therapies that are transforming the lives of many people with cancer. We can live in hope.
If you type into the Search box at the top, there are quite a few previous questions on metoprolol on this forum, but I had a quick look and couldn't find a thread that was especially better than any other. Have a try and see what you think.
About the drug, I know only a little and that it is a very commonly prescribed beta-blocker often given to try to help atrial fibrillation and to slow a racing heart. I believe that it is the preferred beta-blocking drug in the USA, whereas in the UK, doctors more often prescribe bisoprolol.
Forums on the internet naturally can attract negative reviews of drugs, so some care is needed in interpreting what is written here in my experience. There's also another useful website called drugs.com that has patient reviews for almost every drug available. Below is a link to the section on metoprolol when given for atrial fibrillation. You might find it useful.
Hi, don’t know if can make things worse, I’ve had 3 ablations since 2007- 3rd one 5 weeks ago found gaps in the old treated areas and some new areas of escape (this could happen in future that new areas develop) Consultant said, it goes a lot on how you currently feel, your symptoms & how it’s impacting on your life currently. Can you live with it now as it stands. If so you may choose to watch & wait. If not they should guide you with all the options so you can decide best option for you - I agreed try meds change then ablate - still in NSR so currently happy. Good luck
No easy answer I'm afraid. For me ablation was the best , I couldn't get on with Bisoprolol and Flecainide so researched and opted for procedure. 7 years on no issues (touch wood). I did have to have a quick touch up ablation as the first only lasted 3 weeks but wouldn't hesitate to go again! This has probably hasn't helped you at all so research your EP and ask, ask ask away. Knowledge is power.
Nothing touched my very symptomatic AF till the third ablation in 2008 since when nothing as far as I am aware. Just be aware that it may need multiple procedures to finally crack the code. As others have said do adrresss all life style matters as well.
Did you find that the first two ablations helped at all?
I was vexed to go into persistent AF about 8 weeks before my ablation. I was in sinus rhythm for almost 2 days, but have been back in persistent AF since then. I’m only two weeks into the blanking period, but feeling down-hearted that it’s back in such a persistent manner.
On dronedarone, but it doesn’t seem to do much. I suppose it stops the rate shooting up, but that’s about it. Doesn’t do my liver much good either. Having a low resting heart rate doesn’t seem to help much, if I need to end up with just rate control.
I have noticed that I feel a bit less dizzy going from sitting to standing, and trying to hang on to some hope right now. My GP has told the EP - but it’s so difficult to stay positive.
I guess I need to possess my soul in patience until the 3 month check.
The first seemed to aggravate the old pump so I had a second a year later. That worked fine, no AF for about nine months then started getting odd events so a third the following year sorted it all out. I then developed a different arrhythmia for which I had a fourth ablation in 2019.
Like Bib, I too have had 4 ablations (despite feeling quite ill & in for 3 nights after 1st one) I wish I had the ablations earlier as I spent over 4 years on/off various medications. Went through different side effects, some stopped working, some made me feel very unwell. Don't regret having ablations/cardioversions as it's great to be in NSR. Recovery each time took a while along with disappointments when AF returned but, I just wanted to feel better so no regrets. This site & the advice & shared experiences of others is amazing
That is good to hear. I’m not sure what they will advise, but it’s such a roller-coaster when it doesn’t seem to have worked after all the build-up. (Even though I’ve read the fact sheets!)
Only diagnosed last February - wish I had a watch to detect it sooner! So episodes were already a few days long, then a couple of shorter episodes in the summer. Usually about one month apart. Then, wham, a never ending episode hit mid October. (I had Covid early October - heart steady throughout - but can’t help but wonder if something changed then.) I notice the symptoms far more - loss of energy is the worst thing - especially going uphill or up stairs. Then dizziness - which I had gone to GP about a few years ago, so it could have been AF then.
I’m glad of the anti-coagulant but the other medications seem ineffective. Back on dronedarone now, and my liver enzymes have already started to rise again like last time - yet it hasn’t kept me in rhythm. Flecainide didn’t work either, as PIP or daily.
I’m glad it’s worth persevering, and guess I need to wait for what the EP says. It does help to hear that others have found it worth sticking through more ablations.
I had my first ablation on 2015 with extraordinary results, I was in sinus rithmyn for 7 years and my life was so plenty as if I never had AF. Then last year AFIB came back again, maybe to much drinking, to much stress because both of my parents passed away with only 4 months one from another, COVID-19, etc. I had a second ablation 6 weeks ago and so far everything perfect. I would recomend you with no doubt to go ahead a make the procedure. I know that people has different response to treatment, but I think you should try it. I hope if you do, you will have an improved quality of life.
hi Endu, great to hear you were in NSR for 7 years. How long did it take you to get back to full cardiovascular performance post ablation, assuming you did?
Hi Keano, at that time (2015) my doctor ask me 3 month of low activity, after that I was gradually starting more activities until reach my full performance in 6 months . However this time, the doctor let me start my physical activities after 15 days (running, gym, biking, swimming). The only thing he asked me was to maintain maximum heart rate no more than 120 pulse for now.
A priority is to stop the episodes as otherwise the odds are they will increase over time.
I consulted an EP and he said immediately ablation has a 70% chance of success and likely to need a second. I turned down the offer, partly due to concerns over the procedure.
My cardiologist put me on 200mgs Flecainide and the episodes stopped.
I also consulted an experienced London Naturopath, who frowned at flecainide and said he put all his AF patients on a Magnesium compound and CoQ10; so I started taking that as well.
In my heart of hearts (sorry no pun intended), I think if you catch it at your stage there is a chance all other things being favourable to stop it with supplements and lifestyle changes; but that is unlikely to include the majority of people.
I am very satisfied with my QOL on a hybrid treatment (pills & other) whilst postponing the ablation, which if necessary later will no doubt be more efficient and less invasive.
I presume you are referring to sudden tachycardia or do you know another risk?
As I understand it Flecainide, whilst not suiting all, is one of the older tried and tested AF drugs; less dangerous if you are under 70, active and no aggravating comorbidities. That said most medics prescribe a BB or CB to accompany it to be on the safe side, which come with their own QOL issues.
I was dead against it and gave myself max 6 months to wean off it. However.......8 yrs later still on the same dose. I would dearly like to stop it but gut feel says if your QOL is excellent and some here have been on it for up to 35 years better not 'to wake the baby'.
Flecainide is generally safe and well tolerated. It has to be otherwise it would have been banned ages ago. However long term use has been known to cause irreversible bradycardia and heart block. Like all medications and procedures patients have to weigh up the risks. All the best.
Hi Tapanac, As with most all drugs, the dosage of flec is key. For 4 years, flecainide at only 150 mg (taken when AF starts, not daily) has been wonderful for me at stopping episodes. It has never failed, no side effects, and I have not needed to raise the dosage. Plus, metroprolol 25 mg has gotten rid of PVC's. So I am not considering ablation. It works well for some, but I fear that, in the future, we will look back at burning & freezing heart tissue as we look at the old lobotomy procedures--but I also know the desperation we can feel, to try whatever has a chance, so I pray it works for those who have it! As everyone says here, it's all about your own personal comfort level. Maybe you have, like me, still a lot of supplement and lifestyle changes to try first-- exercise, breathing better, vagal stimulation, dietary changes (esp. my cookie addiction ) and seeking a functional/lifestyle medicine dr. here in Ohio/Kentucky (because I have an inflammatory bowel disease that is driving the AF). I am going to keep using other interventions as long as I feel healthy enough re QOL. Hopes for lots more NSR in your future! Diane S.
I truly don’t know. It was very lax in the hospital. The consultant didn’t even come to see me afterwards or explain anything at all like what I had had done
Then at the check up a couple of months later he had left so I just know that whenever I had an ecg or BP at the health centre etc done I was always told they my heart rate was very low apart from the episodes of tachycardia it used to be a normal 60-65
I think it's about how the AF makes you feel. I had my episodes typically every two months, despite being on medication. The burden felt quite high for me as my AF is very disturbing and I couldn't work. Between episodes I usually felt fine. I chose to have my ablation to improve my QOL as I still need to work and the AF also made me feel very anxious. I definitely feel better, more confident, have more energy and - crucially- am enjoying life post my 2nd ablation. I've also had no AF for almost 8 months. So, for me it's a win. I'd also take into account your general health, fitness and sense of well being and how you hope to be in 3-5 year's time. I think our age is a factor too.
It sounds to me that your "AF burden" is very light. But you may feel differently. I think it really depends how much it is effecting you. I've had 3 unsuccessful ablations this year but I was 18 years down the road and in persistent AF. I felt I had to give it a shot as its impacting my health not just QOL. I knew the likelihood of it not working.
The results are much better when done sooner. I think it's a discussion to be had with your cardiologist and/or EP so you can make a well informed decision that feels right for you.
I had PAF with debilitating episodes 3- 4 times a week. Had ablation early September which has transformed my life. I was very reluctant to have the procedure but am so glad I did. I know its early days but I've no regrets 🤞❤
I did a similar post a few years back and you may be interested in reading the replies. What is interesting is that many in the UK think that ablations are encouraged by EP’s in the States more than they are here. This is probably due to the different treatment systems in operation in both countries, so it’s interesting that your specialist is encouraging you to pursue the medical route. I wonder if he is an EP……
Had an a PVI CRYOABLATION for afib 5 years ago no afib since. Developed reentrant AFlutter (right atria) a week later owing to the flecainide I was still taking for the afib during the blanking period. Had a flutter ablation within a month. No flutter since.I stopped taking all drugs May15 2018.
If I got afib back tomorrow morning I would have another ablation tomorrow afternoon, for another 5 years afib and drug free.
Note: I was fit and healthy and had no co morbidities at the time.
I’d go with your EP’s advice. You can change your mind anytime, not so easy here because there’s a long wait and if you don’t go ahead you may go to the bottom of the list again! I think the advice to have an ablation early applies more to younger, working people. I had one ablation which worked for two years before AF came back. I could have another ablation but because I am mostly stable on meds that don’t have bad side effects and I have a leaky valve and slight Sick Sinus Syndrome predisposing me to arrhythmia I’m not keen on rocking the boat - but I’m 78…..
Started with AF 3 to 4 years ago. At first only had an episode once every 6 weeks but that increased to Almost every day in the last 6 months. Bisoprolol made me very tired and not too effective. Insisted on an ablation in early Sept 22. Procedure has worked well and now so much better. But I have kept myself strictly off any Alcohol whatsoever and all tea & coffee (decaffeinated). It is a small price to pay.
Heh Gersky - lots of replies already, so I"ll be short. I was in exactly your situation about 4 months ago. Taking Flecanide, controlling things generally ok. But I thought Flec wouldn't work forever, so I decided to go ahead with an ablation and not wait.. Could not be happier. My heart works so much better when I work out (and I do, a lot), and I feel better not taking chemicals. So all good, and so happy that I went through with it. Hope this helps. HNY.
I do kinda of … I also couldn’t handle medications (think the betas cause me to develop diabetes) my ablation was awful it didn’t help at all. I still get afib 20% of my week lasting anywhere from 10-24 hours long. My ep wants to do ablation again but doesn’t think it will do much… I have it scheduled but am seeking a second opinion. Considering I had an awful experience my first time don’t really want to go thru that again.
HiI think you perhaps need to find an EP that only does RF ablations and get a second opinion to confirm whether it is or is not worth trying a second procedure. Perhaps your EP prefers doing Cryroablations and has less experience with RF?
my ep does both. He picked cyro due to my age but it didn’t work. He wants to redo reluctantly rf says he doesn’t think it will do much else and that my af must be coming from somewhere else. My second opinion dr specialty is complex arrhythmias so hope he will give me some insight on next steps. He’s kind of my last hope really bc I’ve tried medication, cardio version and ablation at this point nothing has worked.
HiWell you haven't tried an RF ablation so don't give up yet. 🙂 As your second opinion dr specialises in complex arrythmias it would interesting to know if he shares your first dr's opinion. As you know my post ablation period was very bumpy and 2 cardiologists said it had not worked. I have been off all meds for over 2 months now. And keeping my fingers crossed for a long respite!
I've had 3 ablations and do not regret any of them. I could never be converted by meds, cardioversion only thing that worked for me. After 17 or 18 of them, it gets to be a bit much.I've been with the cardiology group I'm with now for about 2 years. I think the EP is a genius. It was pure luck that he saw me in the hospital about 2 years ago, and I now see him or his partner and they're both terrific.
Think the last one did the trick, as I've had no afib for over 6 weeks. I also now have a pacemaker, so do think there's something to be said for "pace and ablate."
I don’t want to sound discouraging but what I didn’t know until after my second ablation 10 years ago is that there is no cure for A Fib and over time it usually gets worse. Medications, ablations, cardio versions and lifestyle changes are ways of managing it. For some people that management is easier than for others. The Electrophysiologist I had in Atlanta had a very good video on the Piedmont Heart Institute website. In his realm the word cure wasn’t used. After two ablations I had a good 6 year run of no episodes. That management plan included Flecinide and beta blockers. No terrible AFib symptoms during that time but there were Flecinide side effects. Eventually the Flecinide became ineffective. A third Ablation revealed the first two were holding strong but there were new “rogue currents”, one easily ablated but the second in a location deemed by my current Electrophysiologist in Washington State too dangerous to attempt to ablate. Newer anti-ayhrthmic drugs did not work plus I developed Atrial Tachycardia. In order to have some quality of life I opted for the AV Node ablation last March. I’m older so I think the best choice for me. And I’m feeling very well….almost like having a new life. I’m not saying my experiences will be yours as we are all different. I always want to know what I’m dealing with so the information reduced my frustrations and changed my expectations. Unfortunately there is no magic bullet cure. My heart goes out to all who are struggling to live with and find management for AFib
hi gersky, Iv had three ablations and I’m a lot better than I was. Iv made a few little lifestyle changes over the years too, nothing drastic. But Iv no doubt that one day it will be back.? I’m beginning to think that once you start with AFIB then it’s a road you seem to stay on.? There are places to pull up for a break but eventually you get back on the road.? I say this because my EP said I was the perfect candidate for ablations, young at the time. 45 ish, Fit, muscular physique, Perfect echo, flew through stress test, heart structure spot on. BMI normal etc etc. but every few months I do get a short bout of self terminating afib.!!!!
I was offered a fourth ablation a few years ago if I really wanted it but EP reckoned I should hang on and see how I go, the odd events I get haven’t seemed to progress in duration or amount at the moment but I’m not holding my breath.? I consider myself to be doing good after the ablation’s and hope I stay how I am. But I know that my Afib companion is still travelling with me even though he’s very quiet he’s still there.!!
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) and seeking a functional/lifestyle medicine dr. here in Ohio/Kentucky (because I have an inflammatory bowel disease that is driving the AF). I am going to keep using other interventions as long as I feel healthy enough re QOL. Hopes for lots more NSR in your future! Diane S. 
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