Hi everyone again, last week I asked for advice on an upcoming abalation procedure I was due to have at some point this year...well a quick update on some questions I asked the electrophysioligist today on his opinions which others had concerns on also...the remodelling of the heart question was asked and his take on it is that weather its meds or abalation that is stopping the afib the outcome should be the same no remodelling or reverse remodelling if nsr is maintained long enough , so hope that helps the guys that were wondering the same question as me...although his take on lifestyle changes wasn't to convincing he added he thinks they can help but only fractionly and not have as big an impact as some people think...im not sure I agree on that one...my own situation is my afib seems to have settled right down since I dropped the intense training and sorted a better diet out.been afib free for nearly a year now...he said meds more likely to have more effect until I told him I'm only on 25mg flec x 2 a day then he didn't seem so convinced...anyway my situation has ended up with no abalation needed as yet due to doing really well on very low dose of meds but with option to go back on waiting list if it starts to get worse...weather I've made right decision to stay on meds or should have jumped right in for abalation, only time will tell i suppose , although that is wat electrophysioligist was leaning to anyway I suppose....
Abalation concerns update: Hi everyone... - Atrial Fibrillati...
Abalation concerns update
Thank you Andy. That's interesting.
Thanks for update. Yes, sometimes lifestyle changes don't work, however an ep tends to see more of those cases, so their viewpoint a little skewed. Glad you're doing well on flec 25, twice a day (bid). I dose between 50mg bid and 25mg once a day, depending on how I'm doing. For example, had five minute episode of aflutter (possibly afib) while on 25mg once a day, so went back to 50mg bid for ten days until things calmed down. Now on 25mg only at night and off diltiazem completely. Maybe not technically a reverse remodel, but I do think the longer you're out of afib, the less inflammation and therefore the less afib.
Jim
Hi Jim.yes he was convinced about the remodelling and reverse remodelling the longer your in nsr so that was quite reasurring.. the lifestyle changes I agree with many others on here they definatley help but probably to different degrees for every individual...all the best Jim.
That's interesting. I wonder how long reverse modelling takes.
He didn't really add anything else on the subject but just said that if you remain in nsr for a substantial amount of time any remodelling would be reversed....
OK thanks .It sounds as if very low dose meds work well for you so no need for an ablation it seems - at least for now. But Afib begets Afib so maybe an ablation is the way to go if you start getting more episodes. I regret not doing mine sooner but I was a bit of coward truth be told. But when I started getting episodes every 2 days it motivated me to do something before it became persistant then permanent.
So far it seems that way but we all know that can change ..although he said not everyone progresses to persistant or permanent just most do.. I think he was saying there no need to do anything just yet as I seem to be doing OK on such a small dose also its one less person to have to ablate i suppose lol.. he also said abaltion doesn't work for everyone and sometimes meds is a better option but he gave me option to go back on waiting list if it returns or gets worse as we all know it can...he did say though theres no set time on it progressing it could be a year , 5 even 10 as everyone is different and some just control it with meds all there life....its a maze this afib isn't it lol...
Also could I ask I remember last year following your post as you were preparing for your abaltion , has it worked now and your afib free with no meds needed ?
Thanks for asking. It was a very bumpy ride after and my cardiologist said it hadn't worked and put me back on meds ( Amiodarone !). After a follow up 10 weeks on the meds I was taken off them mid October to see and waited for all hell to break loose. Nothing happened.I haven't had any episodes for 4 months now although an ablation often doesn't last but any respite is great! I think the fact they took me off all my meds ( flec and Bisoprolol ) overnight after my ablation was the reason I had a tough time. The heart needs a helping hand while it heals.
I'm glad I did it and am crossing my fingers it lasts for a while 🙂
Good luck whatever you decide x
That is good news for you and long may it last tbh you mentioned you were a little bit of a coward when deciding about it and wished you had now done it sooner...im sort of a bit that way cowardly I mean lol... I was kind of relieved wen he said he didn't think I should have it done yet...but when the time comes if it does I will have to man up and go for it...all the best ....
I think it's the fear of the unknown and if your medication diminishes the length of the episodes or better still stops them why rattle the Afib cage. But Afib always progresses slowly or rapidly and is more difficult to deal with the longer you have it. I had it for 14 years very intermittently but it suddenly became far more frequent in the last couple of years so I "suited up" and had an ablation. I mainly came to the decision because of this forum. My cardiologist was a fan of medication and I had never even heard of an Electrophysiologist before I joined this site. That changed everything. To his credit my cardiologist supported my decision and recommanded the EP who did the ablation. But it does seem Flecainide works very well for you and you have a long way to go before you reach the maximum dose. So it makes sense to carry on as you are if you have no side-effects from the meds or Afib. I just wanted to come off medication.🙂
I think my son got it right as well , when discussing afib after I commented on the worry of it returning is always at that back of afib sufferers minds...he said you can't spend your life worrying about ifs and whens it comes back or the time you have been afib free is wasted and if its years before it returns if it ever does for sure then that's a long time you can never get back...true I suppose but also easy to say if your not an afib victim but it is a more positive way to look at it no doubt...so you enjoy your time being afib free lily as it could be a long time before it returns if it ever does... all the best.
Thanks 🙂
For what it's worth I think you're doing rather well. That 25mg X 2 is the tiniest possible dose and seems to be acting as a maintenance dose. I'd things continue well you might even be able to come off it altogether and use a PiP approach in the event if AF revisiting. Personally I think we're too often given regular medication for a condition that is intermittent, at least to begin with. You're relatively young so may be able to make further progress without ablation.As to lifestyle changes - I don't know your previous lifestyle - but my EP would disagree with your EP. He was specific when discussing ablation that recent research showed those who maintained a good lifestyle with moderate exercise, healthy diet and only occasional alcohol did better long term post ablation.
Yes that is what the cardiologist told me as well before he referred me to the EP. His stance was that abaltion is not always needed if nsr is maintained well on meds along with lifestyle changes and the meds are also tolerated well.. and I have read quite a few people on here have had an abaltion or two and still use the meds to keep afib at bay..so I guess every doctor will have a slightly different view on it all..
Your son btw made a wise observation! We cannot let AF control our lives. I admit it took me most of 3 years to change my own mindset on this. But I came to the point where I thought - its 8-10 days a year - what about the other 355 days? Are you going to spend them worrying about when the next AF episode will be? It helped. Enjoy the spaces in between
This is very useful thanks. I'm waiting for an ablation myself due around May, but not had an episode of AF since I was put on a maintenance dose of 50mg of flecainide twice a day back in October 22. At that time I was going into AF ever more frequently, sometimes twice per day, and the change has been quite dramatic. My current medication other than the flecainide is 1.25mg bisiprolol (reduced from 2.5 when I was put on the maintenance dose of flecainide), 10mg of lisinopril daily, and 5mg of Apixaban twice a day. The arrhythmia nurse advised me to stay on the waiting list for an ablation, and then discuss my options with the cardiologist when I'm called. At the moment I'm favouring cancelling the ablation, but I've been here before i.e the AF disappears for a while, but has always returned, that's why I was recommended for an ablation in the first place. Choices choices.
Yes that was my concern as well , but I went with the ep ,s advice and he basically said while I'm on such a small dose and have had no episodes at all for nearly a year that he felt an abaltion would not be of benefit at this moment in time..I was worried about coming off waiting list but he assured me I will remain on their books and can go back on it if needed.. but I do think my big lifestyle changes such as no more high intensity training for 10 months just moderate excercise instead has played a big part also .. there is also the very real prospect of pulse field abaltion being more readily available in the next year or two as well which is less invasive and with a better success rate so it seems , so that was also something else for me to consider ..and there's no guarantee I wouldn't need more than one abaltion either , so a lot of things for me to consider but I hope I've made the right choice ,,, time will tell ..all the best.
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