Decision time!

[Afib12345]

Would be grateful for your views on my afib journey. Was diagnosed last November with paroxysmal afib, 2.6% burden. Burden up to 6% (from 7 day monitor in March). Have reacted badly to both flecainide and bisoprolol - fatigue, faintness, short of breath. Have been advised to have an ablation. However my resting pulse rate is 58bpm and 120 bpm is a high pulse rate for me - my problem is a very irregular heart rhythm.

Dr Sanjay Gupta is often mentioned on this forum and having listened to what he says about the pros and cons of ablation I am confused as to whether it is likely to calm my heart rhythm. Afib is negatively impacting my life, I was very active and sporty but now find I get exhausted and out of breath very quickly so I do want to improve things as much as possible (have made the lifestyle changes recommended by all on this forum). As having an ablation is not without risk and may not be successful maybe living with the afib as it is would be an option? Will, of course, keep taking an anti-coagulant!

Thanks, Sarah

[BobD Volunteer]

Ablation is best done before AF has become too established. I don't know where in the world you are but rest assured that if you are in UK and an ablation has been offered then the EP thinks it will help. There are no financial incentives for doctors in UK to perform procedures and resources are short so consider carefully.

OK it might need repeating but if you have problems with drugs then what options do you have? I had three over a four year period up to 2008 but no AF since then and worth every moment of the recovery. (There are two good fact sheets on preparing for and recovering from ablation we can sign post for you. ) AF is know to be a progressive condition of course . There is an old saying "When the pupil is ready the teacher will come." Just don't leave it too long.

[Afib12345 in reply to BobD]

Thanks for your reply Bob.

[mjames1]

What was the frequency and duration of your afib episodes before you were put on daily Flecainide and Bisoprolol and how symptomatic were you then?

Also how old are you? Are you seeing a cardiologist or electrophysiologist (ep)?

Jim

[Afib12345 in reply to mjames1]

Thanks for your reply Jim. Am 69 and seeing an EP. Episodes were pretty much daily, length varied from 30 mins to several hours but I wasn’t very aware of them. Became more aware of them when started on flecainide and bisoprolol. Not taking them any longer and episodes are now less frequent and shorter, particularly as I have worked out what the triggers are.

[mjames1]

Sounds like you have asymptomatic afib with a normal heart rate? So two options, ablation, or go on anticoagulants only and live with it, while working on your triggers, including blood pressure control and losing weight. Also, since you're undecided, a second ep opinion might make sense. If you do decide to ablate, look into Pulse Field Ablation (PFA). It's not available everywhere now, but might be worth the wait. Quicker and safer. It will probably put cryo and rf out of business for PVIs within 5 years.

Jim

[Afib12345 in reply to mjames1]

Thanks very much Jim, very interesting, not heard of PSA before.

[mjames1 in reply to Afib12345]

Sorry, typo. That was PFA for Pulse Field Ablation. Just starting to be available in UK and Europe. Should be available in US in 1-2 years.

Jim

[Afib12345]

Sorry Jim, my typing mistake! 🙄

[Nan1]

Sarah, I’m in similar position to you so can understand your dilemma. I have AF and i

on anticoagulant and Sotalol but AF not well controlled with two/three episodes a week. Have now failed two Pre Ops for total knee surgery as operation can’t be done till heart stable. Don’t tolerates meds well and now have to make the decision whether to change medications or go for ablation. Seeing EP next week. It’s a stressful situation to be in. Lots for us both to consider and I wish you well in whatever you decide.

[secondtry]

There is an alternative to Flecainide that has been mentioned on this Forum (sorry forgotten the name). Maybe best to quiz your cardiologist further.

Have you tried yournutritionshop.com/produ... & CoQ10 together. My Naturopath frowned at the Flecainide I had been prescribed by the cardiologist and mentioned his AF patients just get given those two supplements. The aim is to relax & strengthen the heart beat. Over 10 years I have adapted the dose but the aim is to have your Red Cell Magnesium (nb not the usual GP test) & Co Q10 levels at the top of the normal range.

Otherwise it looks like an ablation maybe for you but I would fully research the different types and connected procedures before a decision.

[wilsond]

Up to you,but you clearly are not responding especially well to medications. AF is progressive,sometimes quite quickly getting the upper hand ,as for me.An ablation offers the chance for AF to be stopped . If you are offered one in the UK,you should be assured that you are a good candidate. Not offered for dubious financial gain as in other countries.