pace and ablate: I have been in AF for... - Atrial Fibrillati...

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pace and ablate

Gertsen profile image
12 Replies

I have been in AF for seven days now. The longest, lately it has been 5 days and then 26 hours in NSR so it is progressing. My heart rate is under 100 at night but during the day it does up to 130 sometimes I don’t feel bad but do get tired,. My EP wants me to have a P&A I have been resisting. One reason is that I am a carer to my husband who is bedridden and has Alzheimer’s and our son lives in the USA. But he will come back and help me . I am also scared. I have spoken to tge arytmia nurse today and she will been a face to face appointment with the EP so we can discuss in detail. Am I being silly for being scared?

sorry about the long post Britta

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Gertsen profile image
Gertsen
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12 Replies
Czech_Mate profile image
Czech_Mate

I'm sure others here will also tell you, but I don't think you are being silly. You have real concerns to work through. I can't give you medical advice, but I can send you wishes that your discussion with the EP helps you work things out.

Gumbie_Cat profile image
Gumbie_Cat

It’s such a decision isn’t it, though your EP will have your best interests at heart, especially if you are being offered this in the NHS.

I don’t have personal experience of pacemakers, but there are many people on here who have greatly benefited from them.

I have had an ablation ( not the AV node type that you get with the pacemaker). This was actually a longer process than the one for ‘pace and ablate’. It was nothing like as scary as I imagined. The sedation really did knock me out, and I was only aware some of the time. The whole team were absolutely lovely and really put your mind at rest.

You would need that time to recover from both procedures. I can imagine that the restriction of arm movements following the pacemaker insertion must be a nuisance. You would need to go easy on any exertion after the ablate part as well. So it will be a disruption in your ability to care for your husband, but could put you in a position to be feel much more able after your recovery. It sounds like you would need help in that interim period.

Lots of things to take into account, and it’s completely natural to feel scared of course!

MummyLuv profile image
MummyLuv

hi Gertsen, you are not being silly at all, any medical procedure is scary never mind one on your heart, sending you a gentle virtual hug.

Your EP will have his/her reasons but I’d be asking them why they are moving straight to pace and ablate rather than ablation? Depending on where you live I’d also suggest exploring mini maze (especially if you are lone afib) before having your AV node ablated.

I am carer to two disabled teenagers and I had to have help for my first two weeks of recovery, first week I had total help, so good that your son can come over for some time, whatever route you go down you will need some recovery time.

Dippy22 profile image
Dippy22 in reply toMummyLuv

I’m in the same boat! cardiologist now says I can’t get an ablation procedure for 12 months!! That’s gone up from nine months. I’m in Devon in the U.K. It’s terrible here. Someone told me there’s only ONE doc doing ablations in our massive local hospital - and he was on holiday last week. So my (privately paid for) cardiologist is recommending going straight to a pacemaker and ablation. I’ve got a healthy heart for a 65 year old, but won’t have the opportunity to see if a more simple ablation treatment can help first. Once again I’m being screwed over by our failing NHS.

Gertsen profile image
Gertsen in reply toDippy22

don’t blame the NHS blame the government and their lack of funding 😊

Dippy22 profile image
Dippy22 in reply toGertsen

Sorry, it’s not just funding. I’ve worked in the NHS and it’s needs a bloody good strip down and rebuild - from the foundations up. I suspect that what the Government knows and that’s why they’re not throwing good money after bad. Can’t do a strip down rebuild though as they just close ranks in there and nothing gets changed. I’ve seen it happen.

Gertsen profile image
Gertsen in reply toDippy22

Under funding has a lot to do with it I was on the board of one of the largest NHS trust for 10 years and saw what was going on .

Golfer60UK profile image
Golfer60UK

Good morning, after going in with AF 2020 and two fainting episodes plus loss of energy and a couple of attempts to put my heart into NSR, agreed to have a pace and ablate.

Procedure carried out 2022 and now am back to my previous normal and only on Apixaban to help prevent clots, Play golf three times per week and energy levels pretty good for a 78 year old.

Works for me

Best of luck with your decision, but if you go ahead the results of improvement show quickly

Dave

Rainfern profile image
Rainfern

Hi Britta, I'm in early stages of persistent AF, and as yet a good distance from needing pace and ablate. But one thing I've got from this forum is a positive view of pacemakers should I ever need one. As Gumbie Cat says, lots of people here have benefitted. Obviously your EP is the best judge on this and will be able to explain why he/she recommends this procedure. My guess would be it will improve quality of life and reduce the strain on your heart.

Sorry to hear about your husband's condition - that must be so tough. And right now you must put yourself first and take whatever respite and help you need. Your son sounds a gem, certainly don't be afraid to call on his help if you need it! It's normal to find AF scary. Hope you've got some good coping practices (breathing exercises, relaxation etc) to help. Good luck and let us know how it goes!

Gertsen profile image
Gertsen in reply toRainfern

me to in early stage 8 days so just in I am not very symptomatic so will have a good chat with the EP I would prefer boy get the rate down for now

Gumbie_Cat profile image
Gumbie_Cat in reply toGertsen

This is more or less the position that I am in. My ablation failed, and I have been recommended rate control with beta blockers only, plus the anticoagulant. I was told that pace and ablate will only be offered if the rate can’t be controlled.

In many ways I would prefer pace and ablate, as I feel slowed down with the beta-blockers. Although I guess that I might get used to them, and pacing technology seems to be progressing.

Part of me does feel a bit ‘written off’ at 68, while the other half is telling me that it’s right not to pursue procedures that are unlikely to work.

Dippy22 profile image
Dippy22

Not at all!! I’m in the same boat. I’m 65 and my heart scans all came back as excellent - for someone my age. I’m slim and eat a healthy diet.

Saw the cardiologist yesterday again for him to explain again(!) the benefits of having a P and A. My PAF is happening 2-3 times a week and no drug has been tolerated, nor made the slightest difference anyway. He’s says it the last resort. However! He said the AF will continue to happen, but I just won’t be aware of it. There’s also the risk of longterm damage to my heart as the AF continues to rattle away unnoticed by me. There’s the longterm risk of a stretched ventricle. He said to just keep an eye out for swollen ankles and breathlessness 😟.

I’m booked in for Thursday 27th and I’m not happy about it.

So you have my deepest sympathy. xx

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