I have been very fortunate and had my Afib ablation in Leicester in May. I had excellent treatment with very minimal side effects from the procedure and am back doing exercise and best of all, no episodes of Afib - so all very positive even though it is very early days. My follow up appointment is in October and this is where I would welcome other members' experience. As the follow up is a phone call, there will be no evidence from ECG, Echocardiogram, BP readings etc to show how successful or otherwise the procedure has been; does this mean that even if I have no episodes of Afib -then, with no medical test results to the contrary- I remain with a diagnosis of Afib and Heart failure ( heart failure diagnosis was due to LV EF of 35 - 40% attributed to the effects of Afib) and need to declare this for Travel Insurance, possibly DVLA and other bodies.
Alternatively, is October - five months after the procedure- far too early to reach any conclusions and most centres wait much longer to review?
I obviously can't self diagnose so how did other members get on after ablation - was your diagnosis reviewed and how, is an Afib diagnosis permanent (and no episodes are simply 'in remission') and are you paying significant Travel Insurance costs for the Afib you don't currently suffer from?
I'm obviously new to this so any views and experiences from members extremely welcome, a little bit of clarity would be greatly appreciated!
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Since any and all treatment for AF is only ever for symptom control (quality of life) you may well be correct in what you think. Be thankful that for now you have no AF!
Regarding the heart failure you should probably have , at some point, another echocardiogram and blood test for BNP to check EF etc. Plenty of time yet as we say in our fact sheet on recovery many people are still improving at nine months or a year.
Numerous papers and I would disagree with your statement that "AF is only ever for symptoms control (quality of life). " In fact, uncontrolled afib -- and possibly even controlled -- over the years, can result in heart failure with a lowered ejection fraction. On the other hand, a success ablation has the potential to improve the ejection fraction and lessen or even change the diagnosis from heart failure to normal heart function.
Your frequent statement "Since any and all treatment for AF is only ever for symptom control (quality of life) " often fails to mention the words "controlled afib" or the potential of heart failure in the same post.
Not only misleading but may cause many not to seek more appropriate treatment.
Recently you seemed ok with someone remaining in afib for up to a week at a high heart rate as as long as it wasn't above 180 bpm, while others suggested the A&E. Do you consider that "controlled"?
Many thanks for your contributions, I must admit that my thoughts are the same as yours. Towards the end of the ablation procedure I was told that my EF had already improved to approx 50% so there is a possibility, if I am very lucky, that the Heart Failure diagnosis may no longer be appropriate- in which case why am I on Dapagliflozin for the foreseeable future. In the same way, I thought that the aim of Afib ablation was, if possible, to stop Afib and the medication and potential complications associated with it. This is why I think it might be helpful (and not just for Travel Insurance purposes) to formally review how effective the ablation has been and possibly review the diagnosis.
Your posts have been really valuable and very much appreciated, many thanks for your thoughts and your time.
Thanks for the kind words. I've read more than a few times of similar cases where EF has returned to normal and a previous Heart Failure diagnosis reversed -- and sometimes to the shocked surprise of even a cardiologist The damage afib can potentially do is understated, as well as the positive changes that can happen if the proper interventions, like yours, are taken.
Yes, the aim of Afib ablation, best case, is to stop afib in is tracks and get off the medications entirely-- but it can still be deemed at least a partial success if it significantly cuts down your afib burden while keeping the episodes in control. I'm hoping for the best case with my ablations, but would be happy with just a few episodes a year, which would let me go off daily medications and just use them PIP (as needed) as for example, my Flecainide.
Can't speak to UK restrictions for afib diagnosis, because I'm from the US, where we don't have any such restrictions. However, a successful ablation can potentially improve your ejection fraction and change your diagnosis from heart failure back to normal. Hopefully, that will be the case with you when you eventually get a follow up echo.
I think you might have to ask a travel insurer whether they consider AF is for life. I seem to remember being asked on a form for something whether I had had a ‘successful’ ablation for AF. The truth is, unless you wear a monitor 24/7 365 days of the year you will never know. When I had a monitor I was supposed to press a button if I felt anything strange, didn’t press once but the monitor showed frequent AF!
I’m in the process of trying to renew my travel insurance, after having a hybrid mini maze. At present I’m not being very successful as travel insurance companies haven’t a clue what I’m talking about. I may wait until Aug when I have a 7 day holter and a follow up consultation with My surgeon, on the bright side it will be cheaper to travel then outside the school holidays. With regard to your heart failure it can improve massively, I was diagnosed with mild heart failure prior to my surgery my most recent blood test states no evidence of heart failure, that’s in less than 7 weeks.
I was under the EP team at Glenfield- I can’t overstate just how good they were. I had sedation rather than a general but the amount of sedation can be increased instantly as required by request or by the team.
I take all your points and you raise an interesting dilemma regarding the bureaucracy of travel insurance regarding AF diagnosis. I have never found Lone AF to be a problem in that after treatment, not waiting for a procedure, have had no hospital admissions or fewer than 2-3 and when you are on anticoagulants I have ever paid more than £10-20 loading/trip because it is controlled. Age + other conditions have had a much more of an impact. What has happened but I believe to have to do with another condition I have, is that I have been refused annual travel insurance policies, which I used to have as we travelled extensively, a few years ago now though.
As to DVLA, is it self declaration last time I researched with no restrictions if AF is controlled UNLESS you have a history fainting or have been told by a doctor you must not drive, which could be the case with additional conditions and indeed happened to my husband whilst waiting for a pacemaker. Now 89 and having survived cancers, AF and heart failure still driving and no restrictions other than the usual 3 year reapplication medical review because of age whereas I need medical physicals + eye tests! Try getting that with a GP in the time frames allowed these days!
Heart Failure, as far as my understanding goes, an EF fraction alone is not enough for a diagnosis, it is an indication but you can also be in heart failure and have a reasonable EF fraction and vice versa. My husband’s EF fraction was 30-35% but I have never seen a written diagnosis of heart failure on any of his medical records and his doctors’, wisely never uttered the words that he had heart failure to him but he is screened regularly - echocardiogram and blood tests. Now AF is controlled his EF fraction improved to 50% last reading.
I think there are nuances with form filling which hard and fast rules make difficult to interpret as everyone is individual and reacts really differently and therefore would suggest that maybe you are overthinking regarding travel insurance and DVLA? Both are attempting to assess risk using rather blunt tools. As we move relentlessly toward an automated world unfortunately nuances do get lost and so self interpretation is sometimes required. I do think the diagnosis of AF is much less important in itself, than the fact it has been controlled. Same with any disease, I believe cancer and autoimmune diseases are treated similarly regarding bureaucracy, believe me I know! I think as far as travel insurance is concerned, if you are cancer free for more than 5 years you do not need to declare - maybe the same could be said AF if you are not taking any drugs? And think of all of the people who have no idea they have AF.
As to why you are still on Dapagliflozin - that is a question for your doctors, not a drug I would want to continue without good reason.
Oh by the way - I have been in AF with HR of over 160 for 4-5 days because I can’t take rate control drugs at all. Maybe I’m naive but I didn’t worry about it, as I came out of it -eventually.
What a wonderful, detailed, informative and positive response. I really appreciate the time you have taken and all the information you have included and I’m so pleased to hear that both of you are doing well, being so helpful and sharing your experiences. Many thanks!
I read your comments re AFib and travel insurance with interest, CDreamer. For me, travelling to the US (where my daughters are, so a necessity) it has nearly doubled my insurance. I have no other comorbities such as hypertension, and consider myself a Lone PAF - though I recently read somewhere that age removes that designation as over 66 is considered a risk factor (I'm 67) I haven't been to hospital in the last year and have no outstanding investigations. I know that it was purely the AF that caused a huge hike of £190 because I did another quote out of interest, with the same company and left off the AF. Of course, US is the most expensive destination because of the ludicrous cost of treatment there. Annoyingly, I have Medicare as a US citizen so I'm covered for hospitalisation, so now I'm wondering whether just to not take out insurance but that would leave me uncovered for outpatient care, and travel disruption, loss of luggage etc. I imagine insurance is much more reasonable to destinations in Europe.
The company I use had 3 different levels of cover so you could opt for travel and cancellation only if you are confident you are medically covered? We did that when travelling backwards and forwards to and from Spain.
I learned though for medical cover you do need to talk to someone rather than just do it online. AFA have good sources for travel insurance as well but I use TravelInsurance4Medical which is a World First organisation.
Age is predominantly THE major factor we found - as soon as you hit 65 and hit 80 and it becomes another story - then it really does become ridiculous. My husband is 90 in a few months and used to work in the US - he has had to close all business interests in the US now as it has just become impossible with regulations, tax and travel insurance costs. And they say that ageism is against the law - not for actuaries evidently!
That's really helpful, I'm with Staysure so I will probably use them as the first port of call but then get other quotes - which is very time consuming- but my premium will be up anyway as my 70th birthday present!Thanks again for your reply
I had my own ablation at Leicester in 2019 and agree with all you say about the unit and its medical team.
Given that the consultation will be by phone, which I think is understandable but unsatisfactory, what about getting some kind of home ECG done yourself to send along beforehand? Of course, if your heart is behaving impeccably - and let's hope it is - this would be unlikely to show anything nor be needed, but if, like me, you are still having palpitations and the like, it might be useful?
You could ask your GP's surgery to carry this out beforehand or use a home device which is more likely to catch any issues. An excellent well-priced model that can run for up to 24-hours is the Wellue AI ECG. often available direct at a good discount. There's also a very inexpensive handheld version, but that will run for a maximum of five minutes, although it still provides an AI analysis over the period. I bought both in the end, not knowing which was best. There's also the excellent Kardia device and Apple Watch, but these are limited to 30 second analyses although the Kardia will run for longer. I would then carry out a home ECG for a reasonable period - an hour or more - to try to catch any palpitation feelings or other heart aspects you might be experiencing. You can then email a PDF copy of the ECG to the specialist's secretary at Leicester Glenfield. I would say that with this the chances of a more productive discussion will be increased.
With regard to heart failure, it's an unfortunate phrase since, in this context, I believe it refers to the reduced ejection fraction rather than to some kind of pathology such as CHF. I gather, too, that it is the tachycardia created by AF that weakens the heart and valves, rather than the arrhythmia itself, and that these will likely improve over time as the heart remains not so much in normal rhythm but without tachycardia.
I haven't seen any evidence myself that controlling arrhythmia does more than improve symptoms and QOL, as Bob says. What will improve the heart is to keep persistent tachycardia at bay whether by ablation or medical means.
I am so happy to hear that you are doing so well after your ablation procedure! It gives me hope.
It is my understanding from my electrocardioligist that ablation is not a cure for Afib even if we do go back into normal sinus rhythm. Afib can still return.
I am 73 years old. I had my ablation procedure on June 9th. After three glorious days in sinus rhythm I went back into Afib.
I also had a video/ phone follow up the following week and was told to double up (am & pm) on amiodarone.
I am scheduled for a cardioversion on July 10th if my heart doesn't go back into sinus rhythm. I am praying that I will go back into sinus rhythm before this, as I'm under the impression that I am in what is known as the blanking period where scar tissue can build up enough to stop Afib.
Glenfield hospital cardiac department are an excellent team and I get my checkup via phone call too, but this is to ask you all the questions and discuss your problems. This in my case is always followed up by appointments made for me to have the necessary tests to conclude my actual heart situation etc.
phone consultation is easy for you and avoids the congested waiting areas etc, but it doesn’t mean you won’t be checked further once you’ve had your discussion.
Get your notes ready and ask everything you want. They are very thorough and do not rush you.
That’s very helpful, and many thanks for taking the time to reply. My treatment has been fabulous but I was uncertain about the follow up procedure, it’s good to know that you’ve been impressed with them and have experience of what to expect.
I have a pre- procedure assessment appointment on July 20th, at Glenfield. Been waiting over 1 year for an ablation. What do they do at this appointment. ? They told me it could take up to 3 hours. I’m assuming they do scans, ECG’s etc. but they must do more than that if it takes that long. I’m a bit nervous about having the ablation. Can you please tell me what it was like and help put my mind at ease. You have quite long way to go. We live about 20 mins drive away from the Glenfield.
I have never had an ablation, but my reason for having my second opinion at Glenfield was because I researched the doctors qualifications in the U.K. for ablations and the consultant at Glenfield had top marks for his expertise in this procedure.
At that time I was told locally by my own hospital consultant that he wanted to do it. That was 15 years ago and the procedure then did not have such a high success rate. So I went to Glenfield to see the best man for the job. He was very thorough and I’m still doing well under their care but without an ablation. I have a pacemaker and am monitored at home plus consultant checks by phone. If you are concerned just ring them and ask your questions.
It’s worth the mileage to be under their care, the tests will take time because you have to go to various clinics in the hospital and wait. Be confident they are going to look after you well.
You replied to Dinamite who has not had an Afib ablation at Glenfield. As I said in my post, I was lucky enough to have mine there in May. If it would help, I could give you some idea of what to expect, some suggestions and perhaps some reassurance. Let me know if I can help, I don’t want to butt in uninvited to your post!
Hi,First thing is that I found the treatment at Glenfield fabulous and the care and consideration of all the staff quite outstanding. I feel lucky and privileged to have undergone the procedure and hope that you have a similarly excellent experience.
The second thing to mention is, as is very clear from this site, that everyone is different and reacts in different ways to medication, procedures and recovery - so this is just how I found it.
The pre op is straightforward and mine was nowhere near 3 hours. They did basic tests such as blood, BP and ECG and then I had a very detailed discussion with one of the Cardiac Rhythm nurses ((They give you a phone number if you have any concerns over your treatment which is very useful; when my BP was getting too high, the GP surgery offered me a Sister's appointment in two weeks time, the Cardiac Rhythm Team had got it sorted with medication changed by the end of the day) The discussion is very detailed and very important and allows you to raise any concerns about the procedure and recovery. I would strongly recommend that you take your partner/ friend with you; two people remember far better than one and may ask the questions you forgot.
The procedure itself was straightforward and very impressive, the room seemed to have more screens and equipment than a NASA control room. The staff were fabulous, considerate and reassuring and one of the doctors talked me through the process before going down to the ablation room. You have some sedation as things start but if you need any more either ask for it or they will give it anyway. I found the whole experience profoundly positive, whether or not there is any discomfort depends on the individual but you are in excellent hands and hopefully your medical situation/ quality of life should be enhanced afterwards which is something to look forward to.
As a summary, have any questions you have ready in advance, try not to overthink everything, try to remember that they are doing everything they can to help you and they are excellent at it and that for any worry involved, there could be a significant return in the future.
Good luck, if you feel able, I would love to hear how you get on!
Thank you so much for replying. It sounds as though yours went well and maybe I shouldn’t worry about this so much. My pre- assessment is at 1pm, just when I have my lunch.!! Awkward time, as I’ll have to leave at 12.30, so will have to have an early lunch that day. We’ve cancelled our holiday for this appointment, as I thought I might be put to the bottom of the list if I cancelled it, ( we have a caravan, so haven’t lost any money) so was annoyed to hear the senior Drs are going on strike that day, but it sounds like you don’t get to see one anyway, so the appointment won’t be cancelled hopefully, because of it. Don’t know how long it will be after the pre-assessment that you get the ablation. Hope you stay out of AF. Thanks again, your info has been very reassuring.
Well I was due to go for my pre-assessment on 20th July. Guess what — it’s been cancelled due to the Consultants strike. I am very annoyed, as we’d cancelled a holiday for that. At least they have given me another one on August 2nd.
I feel so sorry for the Consultants. They only earn from £88,000 to £119.000 a year. !!!!! Junior Drs earn basic saleries of £29,000 to £34,000 and seem to do a lot of the work in hospitals and you hardly see the Consultants when in hospital, so have more reason to strike, but I don’t agree with strikes by NHS staff, as it’s bound to affect patients, which is wrong.Looks like these strikes will continue, as the government are now giving them the recommended pay rise by the review body of 6% and it is not enough for the Drs and the Government have said they will not be offering more money, so stalemate.
Goodness knows when I’ll get the actual ablation.!! Just want to get it over with. I’ve been waiting over a year now.
Hi,Sorry to hear that your appointment was cancelled, at least you have a new one.
This is obviously a health forum but I do disagree with your comments on consultants; you say their pay can be around £120, 000. For the years they train, for the hours they have worked, for the debt they have incurred to train, for their experience and for their immense responsibility they are an absolute bargain and if we do not pay and respect them we will lose them.
By comparison, people running Severn Trent, Thames and Southern Water all earned well over a million pounds each last year - for what? No wonder they are so effluent.
We need to support our NHS, especially our consultants and good luck to them in trying to improve their conditions and our lives.
Rant over, good luck with your procedure, hope your consultant doesn't read this forum!
yes I’m very happy with Glenfield. It’s much easier to have your consultant phone ou than, in my case, have to make a 70mile round trip to ask questions.
I had my first AF episode in Leicester in January. I have been prescribed Edoxaban and Sotalol and have had two episodes since, one in March and the last in May. I haven't seen a Cardiologist since January but have an appointment in October. No episodes for 6 weeks but I have just walked 120 miles in the French Alps climbing and descending a total of 40,000 feet with no ill effects so maybe it is only transitory. We will see.
One thing that is clear from this site is that the severity of Afib varies enormously and for some people the consequences really are life changing. I've been lucky that mine has imposed relatively few restrictions on me and I can still exercise regularly, do long walks of several hours but I no longer run. When I've had a bad episode of Afib it really is extremely unpleasant, to put it mildly. One thing I am acutely aware of post ablation is the 'management of risk factors' ie, maintaining sensible weight, diet and continuing exercise. The ablation and the EP team can do their bit but it is essential that I do my bit too to maximize chances of success.Many thanks for taking the time to reply and good luck with your treatment and recovery.
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The damage afib can potentially do is understated, as well as the positive changes that can happen if the proper interventions, like yours, are taken. 
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