Pace and ablate

[Dippy22]

Hi. Since October last year I’ve been having 2-3 sessions a week of AF, lasting 1-2 days. This was was exacerbated by recent spine surgery.

My private Cardiologist says we’ve run out of drug options (I reacted badly to all of them) and has recommended a pace and ablate procedure in 5-6 weeks time.

However! Since starting on Berberine last weekend and exponentially increasing my intake of magnesium, boron, calcium, potassium and sodium, etc., I’ve not had another AF episode since. I’m fully aware it’s only Thursday morning and I may be kidding myself into a false sense of security, but my iWatch is showing steady sinus rhythm at 60-70 BPM and I’m feeling good!

All the tests (echocardiogram and CT scan) showed I have a really good heart. Even the cardiologist said he was surprised just how good it is for my age (65) and considering that I’m a long-term (ex) smoker.

I’m just thinking that the only the only ECGs that I’m aware he’s looked at are when my heart has been in AF. I wore a heart monitor for a few days, way back in 2020 when the (mild AF) started, but I was refused to wear one again in January this year by my local hospital cardiology department. Told it wasn’t necessary as they had all the info they needed from the AF ECG’s taken over several visits to A&E last year.

My questions are: -

a) can there be something he’s seen that I’m not aware of (and he’s not mentioned), and

b) is it worth asking to wear a monitor for a few hours/days to get a full overview before undergoing a radical procedure like pace and ablate if I don’t need to?

I’m sure he’s been frank with me, but the last time we spoke was last week when the AF was running completely amok and I agreed to the procedure.

I have sent these questions over to him, but he only works privately on Mondays, so I thought I’d get your views/experience/opinions first.

I look forward to hearing your comments.

[BobD Volunteer]

You can always have the PM fitted and if your AF burden is still very low after the six week settling in period you can cancel the AV Node ablation . You won't be the first.

[Dippy22 in reply to BobD]

Thanks Bob and can you have the PM removed (if not ablated of course) if it ever proves to be unnecessary?

[pottypete1 in reply to Dippy22]

You can only have the PM removed during the first year according to my EP.

This is because the components embed themselves which makes it difficult to remove.

Considering you have only had a few days free of AF it really is too soon to conclude you don’t need the recommended procedure.

Pete

[SeanJax]

in the States pace and ablate is considered nuclear option or last resort since there is no way back. Have you tried to get a second opinion with another ep? Have you tried to see Dr. Hunter? Have you tried an ablation? Have you tried Pulsed field ablation? Have you tried amiodarone? Down the road you still have to take anticoagulants and can you tolerate it? Ask yourself all these questions before saying yes to the pace and ablate. Given your age still too young for this nuclear option. I never heard a patient who cannot tolerate any rate or rhythm control medication altogether. There should have a drug in the whole pharmaceutical arsenal to treat you . At the end still you personal decision since it seems you already made up your mind to go with the procedure.

[Dippy22 in reply to SeanJax]

Nooo! I certainly haven’t made up my mind. I’m horrified at the thought! He said “we’ve run out of drug options” and that it was loo long a wait for an ablation (9-12 months), so the pace n ablate was what he recommended. And quickly!!

Amiodarone is next on the list, but everyone says the side effects are aweful. 🫤 Personally I believe all these drugs are just sticking plasters over the real issue. I much prefer finding out the ‘why’ and trying to heal it naturally. But that’s just my opinion

I’m certainly not happy to have such an invasive procedure on what seems to be a perfectly healthy heart. I’d just like further investigation to see exactly how my heart is working on a daily basis. I don’t think that’s too much to ask.

In the meantime I’ve been taking berberine, plus hawthorn (both are powerful anti-arrhythmic compounds) for a week. After months of regular, very long(!) AF episodes every week, I haven’t had one since last Saturday-Monday! Result!!

Watch this space! 😀

[Auriculaire]

How much of each do you take?

[Dippy22]

I don’t know about the hawthorn because it came as part of a tincture type fluid with other ingredients (passion flower, yarrow, dandelion, ginger). I take berberine 500mg twice daily. Since starting those and exponentially increasing my trace minerals intake the AF has shut down like a trap door. 🤷‍♀️