Hello
I was diagnosed with AF a month ago.
When asked, my GP told me that catheter ablation is not really done for Atrial Fibrillation.
Since many of you on this forum, and elsewhere, have had a catheter ablation, I wonder whether there were any special circumstances that made the ablation appropriate for you, or whether it was done privately rather than on the NHS (in the UK)?
Short answer he is wrong. Catheter ablation is done all the time for afib. You should be speaking to a well versed cardiologist or an electrophysiologist (ep) about catheter ablation. GP's have their limitations.
Jim
I live in a community where I would say at least half of us have AF and at least half of them have had at least one ablation. Your doctor is wrong and indeed I would be concerned about their advice on other aspects of managing AF if that really was their belief.
My neighbour had their ablation on the NHS only yesterday - they are 83.
May I suggest that you visit the AFA website and look at all the information about Catheter Ablation for AF - download it and present it to your doctor.
There is obviously criteria as to who may be suitable candidate for a successful outcome, but having AF is not one of them.
Hope that helps.
I’m afraid your GP doesn’t seem to be up to speed with AF. I had a catheter ablation last November. No special reasons, nothing unusual. It’s a very common procedure.
I’m afraid that your GP is completely wrong. Change GP? The earlier in the AF journey that an ablation is done, the better the outcome (if you are medically suitable). And the ablation is done with a catheter. You may have some specific medical conditions your GP thinks rules this out? Otherwise change GP. Mine told me no referral needed she would manage my AF in primary care with beta blockers. She has been re educated!
I suspect you may have misunderstood as I find it impossible to believe any GP would say that. It would be a ridiculous thing for anyone to say, never mind one with medical training.
You have more faith than me Mugsy15! 😂🤣 Over the years my GPs have said the most preposterous things so personally I believe Seafin. You clearly have a GP who is at the top of their game.... Lucky you.
Ablation IS a treatment for AF.
In the U.K. the NHS wait times are now so long for ablation (I was told 12 months), they’ll try every drug possible to control the AF. If that doesn’t work then you’ll be like me and be pressured into having a pace and ablate procedure because they can do those quickly and cheaply.
Change your GP before he does something seriously wrong!
I am very surprised to read this. I have had three ablations. Cryo-, RF, and a very aggressive vein of Marshall, including two other areas. They have all been done with the catheter. The third one was done that way through my neck, wrist, and femoral. How else would they do them? PS it is also the way they did my AV node as far as I know lol I was sleeping.
That is totally incorrect! Your GP us clearly quite ignorant of AF treatments. I suggest a referral to an Electrophysiologist or at the least, a cardiologist. Honestly, I am so annoyed on your behalf at this!Please do not accept this .
I totally agree with others, ablations are done all the time for Afib. I’m annoyed too that they’ve told you this. If you can afford it, try and get a consultation with an electrophysiologist nearby to you ( check google for their secretaries) it’s about £200. You’ll get seen quicker and if you do get offered an ablation they can often put you on an NHS list and also keep seeing you periodically ( under the NHS). You won’t need a GP referral either.
I also agree that you need to perhaps stop seeing this GP…there are no special circumstances either and it is generally felt that the sooner done the better.
Please can I ask - did she/he put you on any medication?
Teresa
I did exactly these actions, paid for a private consultation, with my NHS Consultant who placed me on the NHS waiting list.
I received my ablation after being on the waiting for about 3 months.
Many thanks for all your replies,
After the initial visit to my GP when I was diagnosed, opportunistically, and prescribed an anti-coagulant, I went back to discuss further treatment. By this time I had done a lot of research.
I had seen recent papers that indicated that the earlier you have an ablation, the more successful it is likely to be.
I had already found that the anti-arrhythmia and rate control drugs either interact with fludrocortisone (which I take for very low blood pressure) or were contraindicated for someone who has slow heart rate. I also found that the anti-arrythmia drugs can cause dangerous arrhythmias.
So when my GP suggested a rate control drug I mentioned the contraindications and interactions and brought up catheter ablation. This prompted his response that ablation is not really done.
I told him about the recent papers on using ablation as an effective treatment, and after some persistence I did manage to get a referral to a cardiologist, hopefully an electrop@hysiologist.
But I am aware that the NICE (UK) guidelines propose drug treatment first, then more drug treatment, and only when that has failed do they consider ablation.
However, I saw in many recent papers that cardiologists are calling for a change to use catheter ablation as a first line treatment e.g.:
britishcardiovascularsociet...
ncbi.nlm.nih.gov/pmc/articl...
I do not have other comorbidities - not obese, not diabetic, obviously not high blood pressure.
I wonder if others here have had catheter ablation when they have not been on these drugs? Also how symptomatic were you? I have symptoms, but it is hard to know whether some of them are due to the low blood pressure or AF.
Thanks again
My ablations were so long ago now it’s hardly relevant to procedures today. It took me 7 years to find this forum and get information about treatments so I had gone through drug therapy but like you, had very low BP so using vaso dilators didn’t help! 10 years it was MUCH harder to get an ablation and the cardiologists in my area were very anti. Luckily for me, my GP of the time was far better informed than the local cardiologists and although he disapproved of private health care, his patience was stretched beyond endurance with the cardiologist so suggested I go privately which I did but had to travel to London. That same cardiologist refused to treat me when I was admitted to Acute Cardiac Unit several years later, unbelievably his reply was well if she went privately she can go back to London to her private cardiologist. Thankfully the same hospital now has an excellent team of EPs who do amazing work with arrythmias.
Nowadays most major cities have extensive arrythmia clinics and my neighbour saw the cardiologist a few weeks ago, had the ablation last week, doing well so it does depend on the locality how long your wait may be.
You are correct in thinking the earlier after onset of AF the ablation is performed then the higher the likelihood of successful outcome.
Good luck and let us know how you get on.
Hi Seafin. I was diagnosed Afib last year and 4 days ago had a cardioversion (CV) and am now back in normal synus rhythm and feel great! . I understand from my EP Cardiologist that it's normal to give a CV before going down the road of ablation. I don't take any anti arythmic drugs, just an anticoagulant.
I went to a talk my brilliant EP gave on all the latest developments in treatment for arrhythmias. He explained CV is preferable to medication as treatment and as an indicator of whether ablation is likely to be successful. I was lucky, they caught my persistent Afib early. I know CV treatment isn't often a lasting solution, but it will indicate if I'm a good candidate for ablation at a later date.
My GP was slow to refer me to a cardiologist so I paid for a private consultation - my EP also works in NHS and you can link easily between the two. I wouldn't be able to afford an ablation if I ever need one!
If I needed advice on taking powerful anti arythmics I'd pay for another consultation if necessary. My GP is a super guy, but he's still a general practitioner - overworked, exhausted, unable to keep up with every fast changing development. But yours sounds a bit beyond the pale - good luck training them up!!!
I went straight to catheter ablation. Had a tough recovery but it worked for 18 months but AFib came back. Now pretty well controlled with flecanide
Perhaps your GP, in view of your very recent diagnosis, meant that an ablation at this early stage of the game might be rushing things a bit. After all, an ablation IS an invasive procedure, and there is some risk. It's not to be taken lightly, like "Ho hum, I think I'll have an ablation with my tea this morning". It's serious stuff, and your GP would probably like to see how you progress with medication/lifestyle before jumping the ablation gun.
Hi Seafin,
Thanks for the update.
It’s really good that you’ve been referred to a cardiologist, but I need to warn you that the wait might be long. I would still urge you to try and see an electrophysiologist. As for asking about others being offered and our symptoms, a year ago, I did see an EP for my afib which I’ve had for about 18 years, but infrequently, he told me I wasn’t bad enough for an ablation.
When I went back this year for a follow up,, so just a year later, I saw his colleague who said I could have an ablation if I wanted to, despite only having had one episode in a year. So things seem to have changed in managing Afib in the NHS in the past year.
I have always had normal/lowish BP., I’m not on an anticoagulant, but I’m on a very low dose beta blocker for afib (which takes my HR into the mid 50s as I never had a high heart rate before taking it).
I don’t have any comorbidities either, my BMI is 22 , I think I have what might be known as “lone afib”. So even I have been offered one. I’m waiting to see how this year progresses before deciding, ( and they’ve told me to call at anytime if things change or progress). Afib never goes away on its own. As Frazeej said, an ablation is not to be taken lightly. Bearing in mind what I’ve experienced you may still be offered one if you see the right person.
Hi
I beg to differ.
If your AF is due to hypo or hyper thyroidism then it could revert by itself.I am waiting.
I was told I can't have an ablation due to ECHO showing enlarged LV.
Also age, weight, comes into it and length of time had aF.
cheri JOY
Fingers still crossed. Diltiazem 120mg AM and PM 2.5 Bisoprolol keeping me
in check.
Hi Joy,
We are always led to believe that AF never goes away on its own, it usually needs help, to be suppressed in some way either with medication, or an ablation. I wasn’t saying it never goes away, just not without help of some sort.
Yes, of course all other aspects like age and weight come into it to being offered an ablation and also finding the root cause helps. For some very lucky people, AF does go away all by itself without any intervention or analysis, but I think it can be quite rare and dependant on so many things as everyone is individual. I wish you all the best Joy.
Hi
Since being given Diltiazem my H/R a year on it my 47 H/R Night stays low now until afternoon. So 62 at 2pm is great.
With the cancer removed I'm still keeping my fingers crossed. AF has changed my life.
cheri JOY. 74. (NZ)
Hi Joy,
AF certainly is a life changer, it certainly has changed mine as for most people on this forum I would think. I do hope it all works out for you.
All the very best to you.
Beware that your GP may be trying to keep you as his patient instead of sending you off to another more specialized one. That's what happened to me in my early stages of a-fib. My GP didn't want to refer me to a cardiologist, and later the cardiologist was reluctant to refer to me an EP! I'm in the US so of course conditions could be different there. Absolutely, catheter ablation is performed for a-fib.
You need to see another doctor.
GP's are great for general things (they are, after all, General Practioners) but you should have a specialist for your heart - a cardiologist or cardiac electrophysiologist (EP). I'm in the United States and my GP referred me to an EP as soon as he detected my atrial flutter (actually, he sent me to the ER because my heart was banging away). The EP suggested a catheter ablation for the flutter and again for the afib that popped up after that. I really like my GP because he does a good job monitoring my general health and he doesn't hesitate to send me to a specialist (or the ER), but I feel more comfortable having an EP take care of my heart.
Sounds like my idiot gp. Of course ablation is done for paroxysmal atrial fibrillation. Your doc is just out of touch with current guidelines. Go find an EP. Read the AFib cure by Dr John Day and Dr Jared Bunch, educate yourself then educate your gp and get a referral to an EP.
I live in California. Ablation was considered a first line treatment. The line given was” a fib begets a fib.” So best to keep it from begetting !so far so good had it a year ago
As you've read here, ablation is very much a regular procedure for people battling AF..I would even say it's a rather typical stop on the AF train. Some have them quicker than others. I'm in the U.S., and in my case I underwent a cardioversion and then drug therapy for about a year (pretty much the conservative route), until AF won out and the drugs no longer worked, so then I was referred to an EP for ablation. I continue to have occasional bouts of AF, so am now awaiting my second ablation later this year.Good luck!
GPs don't know everything. They know what they've been taught, and what they've picked up along the way, but I've not met one knowledgable about AF, and I rarely see the same one twice at my practice. Ask for a referral to an EP (not just a cardiologist!).
Hi
I cannot have any ablation as the ECHO showed me as having an enlarged LV.
Also weight, age and how long you have had it is considered in NZ>
A friend had it done and they found he had 2 areas misfiring. He had had episodes for many years.
He is cured. Now in his late 50s.
cheri JOY. 74. (NZ)
Hi
I would go through the tests ECG, ECHO, stress test etc first.
By getting referred to a Heart Specialist rather than a Endocrinologist.
I lost my trust in the Endocrinologist on Stroke Ward whem
1. She prescribed Metroprolol after diagnosis with AF when I said NO to it. I told her it would make me breathless and tired. IT DID BOTH and NO FOLLOWUP.
2. When on day 4 post stroke I was discovered with thyroid cancer she argued that
I had to wait for op 6 months! But ultimately over ridden by surgeon and anaesthetest. It was done a.s.a.p at 4 months. 2 of the 12 right lymphs showed cancer and removed.
3. RAI is automatically given post cancer removed. She tried to make me have it but I said NO and surgeon backed me. Removal make me LOW RISK and it hadn't spread.
4. I was 70 years and had Heart Condition and it was a hard task to be in TSH suppression. So I refused to take an over and toxic dosage to keep me there.
2 years after USA top surgeon of Thyroid Cancer Centre now says a LOW RISK
patient should not automatically need RAI and Suppression of TSH.
There you are .. 3 years later and 3 yearly scans it shows me free of cancer from cancer cells left or new growth. Surgeon, him and me level my TSH at 2.0 and not under 0.5.
My heart specialist DHB Auckland advised he does ablations as well and he says no ablation for my heart.
Research and speak to a Cardiac specialist who carries out the procedure not the endocrinologist.
cheers JOY. 74 (NZ)
Hi Joy. So pleased you are now free of cancer.
My point is that your GP clearly knows of the existence of Catheter Ablation, so they are not unaware of the procedure as some are suggesting here.
And that procedure is specifically to treat cardiac arrythmias, foremost of which is AF.
The idea that your GP is aware of a procedure to treat AF yet tells a patient that it ISN'T to treat AF just doesn't sit right with me and I still suspect a communication issue rather than ignorance. He/she surely needs to clarify their assertion. I'd start by asking them what they think Ablation IS for if not AF?
....Haemorrhoids? 😂🤣
Hi all
Thanks again for all your practical advice and support. It's much appreciated.
I have now received an appointment with the cardiology team in a city nearby. The hospital has a catheter lab and 2 electrophysiologists that I know of. The appointment is in September.
However, with all the advice about getting a private consultation with an NHS consultant, I am still thinking it might be useful to do it so that I can be sure to see an EP, as well as getting an earlier appointment. But having the NHS appointment already just seems to complicate matters.
Also, does anyone know whether an NHS consultant can access test results on my NHS record if I consult them privately?
I saw a Private consultant, (who was also NHS) at a different hospital which comes under a different healthcare trust, to where my records were held, in the next town and he never saw or read any of my history as they can’t. I have since now attended this hospital as an NHS patient and have seen a different EP ( as he’s off on long term sick) and they’ve created a new, different NHS hospital number for me, as it seems they just cannot and do not access records from the other hospital.
So, If you see an NHS consultant under a different healthcare trust, then they won’t be able to access your NHS records from the other hospital. If it’s the same healthcare trust, you should be ok. Both my hospitals are 10 miles apart as the crow flies.
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