I have paroxysmal AF, diagnosed in early 2020, on 5 mg bisoprolol and Edoxaban. I am highly symptomatic when I have an event, with fast heart rate, strong palpitations, heart feeling as though it will escape from my chest, but no dizziness etc. and this can last for up to 12 hours before it reverts by the end of which I feel pretty exhausted. For the first couple of years AF events were fairly infrequent and in between I feel fine. However I had a run at the end of last year and beginning of this year, around every two weeks for 3 months. I saw my consultant (EP) and we decided I could be a candidate for an ablation and was put on the list. The next day I went into AF for 18 hours. Since then I have had 3 months free and have felt very well. I have now been offered a slot for an ablation at the end of August but cannot decide whether to take it (bearing in mind possible risks, chance of success etc.) I know everyone is different but would welcome opinions. Thanks.
To ablate or not to ablate? - Atrial Fibrillati...
To ablate or not to ablate?
Hi Tamgirl
Speaking from my own experience, I had Paroxysmal AF for about 3 years before getting an ablation last September. Whilst I'm not totally cured, when I do go into AF, it is far less chaotic. Pre ablation, when I got AF, like you, my heart felt like it was going to jump out of my chest. Now when I get AF I hardly notice it, and a PIP 50mg Flecainide tablet gets me back into NSR within 2-3 hours. I am however still on daily Flecainide of 100mg, and 2.5 of bisoprolol.
I am on waiting list for a touch up ablation. I am 51 years old and feel I have a lot of living to do yet, so if a touch up ablation gives me a few years of no AF, then I count that as sucess. Like I say post first ablation, if I go into AF (which seems to be about every 6-8 weeks) , it is definitely not as bad, feels quite mild compared to pre ablation. Also the actual procedure for me felt very non intrusive, back up an walked out of the hospital a few hours later. In terms of recovery I took it very easy for about 3 weeks.
We are all different, and react in different ways. Personally I think the gamble is worth it, but only you can decide that for yourself.
Cheers Blake
How long did this touch up ablation take?
Hi Westknoxgirl. I've only had the one cryo ablation. I'm on a waiting list for the touch up RF, hopefully will have the procedure done sometime in the next 6 months. Cheers Blake
Look at my posts on this subject. Your story is very similar to mine. Briefly I had very symptomatic AF and Flutter. Put on meds as PIP,ok for a while. Then needed daily dose, again ok for a while. Put on ablation list,lengthy due to Lockdown just started. By the time first appointment for it came around,AF and Flutter were much better ( it seemed) so we deferred it but kept me on the list.About 8 months later I had 2 continous bout of 5 weeks and 6 weeks ,awful. So was fast tracked for ablation.
Done 5th June 2022. NSR since except for identifiable cause episode.
I too dithered and wondered if I was doing the right thing, yes I was absolutely 💯 right.
Your EP [ in the UK anyway] has to justify each procedure done now,in terms of success/ cost effectiveness so you can be sure he or she is confident that you will benefit.
Best wishes whatever you decide xxx
This is the $64k question that is difficult to answer. Here in the UK, if you are offered an ablation on the NHS you can be fairly assured that the EP is confident that you will benefit. Of course there will always be risks associated with any form of medical procedure and it’s right that you consider them but the medics consider an ablation as being a very low risk procedure. Around 10,000 are performed in the UK annually and apart from issues occurring during the so called blanking period, it’s very rare to hear anyone on this forum say that they regret having had their ablation. When you consider that forums tend to attract “bad news” that is well worth considering. Paroxysmal AF is best ablated early for the best results so I think you will have guessed by now that personally, I am pro ablation but listen to others.
I’ve added two links which you will find helpful. Good luck and if you proceed, please let us know how you get on……
Go for it but understand it may need repeating. This is not being negative. Many people do have great benefit from the first but the point is that once youv'e had one you know it is a non event and the next will be far easier (if necessary).
Prof Sodt's law is that if you decline you wil forever regret it when your AF progresses.
It’s such a dilemma, isn’t it? Most of us have dithered over it a bit - other than those whose symptoms or frequency are so bad that they’re just begging to be ablated asap!
What everyone has said about UK EPs not recommending it unless they feel it’s medically warranted and will improve things for you is totally true, which I find reassuring. I’d just add that for me there’s a couple of other things worth considering when making your personal choice:
1. Overall, AF episodes tend to get more frequent, even though there’s periods of time where it feels better. And ablations are statistically more successful before AF gets persistent. My EP said that getting the balance of doing it soon enough for someone who is reluctant to have it done (eg me!) is tricky, because it’s worth waiting til the patient is sure, but there is a risk of leaving it too late. (Does it help to ask yourself which would you feel worse about? If your AF was getting worse and you’re back on the waiting list, or going ahead if you’re currently feeling ok?)
2. The one thing that makes it worth delaying I think (and my EP says), is if there’s ‘lifestyle’ choices that haven’t yet been seriously tried. So if there’s something like obesity, or sleep apnoea, or over-exercising, or stress that’s affecting you badly, or sleep problems, or (as in my case) chronic pain and inflammation, etc, then it could be worth addressing those before ablation. Not just to give it the best chance of working, but also because a change in these kind of things might actually improve the AF. (But even then if my AF was getting worse, I’d go for the ablation rather than be too late, I think.)
Hope you can get some peace over your decision. Do let us know xx
I think when we have ablations we all dither and wonder if it's the best thing to do. Then we say we'll have it, thinking to ourselves that as the date for the procedure draws near we can always opt out. I've had 3 of them that way.
The first stopped my heart from banging in my chest when I walked up hills (I had no idea that other peoples hearts didn't do that). However I still had attacks of AF, roughly every 6 weeks.
My second ablation only appeared to make attacks worse.
My third was more of a success though I still had some AF attacks. I'm now in constant AF and find this is the best thing ever and with a heart rate of between 60-90 I feel fine.
I did discover along my AF journey that food containing artificial additives, especially sweeteners were a trigger. Wish I'd known this from the start, then I may not have needed any ablations.
Not much help to you am I!
Jean
Thanks Jean, everyone's comments and opinions are valuable! It's good to be able to discuss these things with others who have similar experiences and it all helps to concentrate the mind! I don't appear to have a particular trigger - although possibly stress. Having said that - I had a very stressful 3 months recently and no Afib!
I can understand how you are questioning your decision. I also am down for an ablation in next couple of months and am really wondering if I should go ahead. I got diagnosed in 2014 and on Sotalol and Apixiban. AF on average twice a week. Can go spells of 3 to four weeks with nothing. Awaiting total knee op and three failed Pre Ops being told they will not operate as too risky. Have decided to go for ablation rather than change meds but AF now quite settled recently and I am wondering if I’ve made the right decision. It’s stressful for you but I’ve certainly been reassured by reading the replies to your post so I hope you have too and you have your ablation and are glad you went ahead. Please let us know what you decide to do
a knee op is a lot scarier and more painful than an ablation! Good luck with both
Thank you. I’m must admit I’m not looking forward to either
honestly apart for the build up and needing to rest a while, ablation a doddle. Knee op? I keep kicking it along the track, putting it off as long as possible!
I’d go ahead with it. I didn’t think twice when I was offered ablation. I was scared at the thought of it but knew something had to be done.!!
I ended up needing 3. I’m a lot better than I was but still get the occasional episode but it’s far less troublesome than before. My mental health has benefited too since the ablations. Go for it, I’m sure it will improve things.👍
Best wishes.Ron.
Just my uninformed 3p worth and never had an ablation, but ...All drugs have side effects and interactions with others. The more we have to take and the longer you have to take them, the more likely we are to have unintended or unwanted consequences.
Operations have risks, but so does all life and medicines, so we are not comparing a risky solution with a risk free one, both have risks.
So in theory (not knowing the circumstances or people involved), I would go for the physical solution with no/less drugs than the pharmacological
I had a conversation with my very approachable GP before having my ablation as I was getting cold feet and had any (noticeable) episodes for a while.
She explained that my heart was no longer working efficiently, which was part of the reason my legs were swelling and I felt tired a lot of the time. She felt my pulse and said, 'Are you aware that you're actually in AF at the moment?' I wasn't aware of it at all.
She considered that the ablation was a good option and gave me the confidence to go ahead.
I had it done last July and my general health is now greatly improved. My legs don't swell anywhere near as much and I have more energy.
I do get short bursts of tachycardia from time to time but these are infrequent and seem to accompany viral infections.
Xx Moy
not dissimilar to my journey. I took the ablation - the earlier it is done (depending on the health of your heart) the better the outcome. Mine had gone quiet just before the ablation too but I knew those fierce episodes would recur. Three years on and I have had one mini episode each year since, 140 for an hour or two. Well worth it, and I would consider a touch up if I am offered it.
An ablation carries risks, may have to repeated more than once so more risks and even then you may still have to continue with drugs.
If in doubt don't go under the surgeon's knife was my late mother's advice. Because you are asking here rather than begging for it, I suspect you are not ready yet.
I turned down an ablation offered by 2 cardiologists and an EP but was also dead against pills and determined to come off them after 6 months. I have now been taking 200mgs Flecainide (100mgs wasnt enough) for over 10 years and not had any problems yet.
I would ask your EP if you can roll the ablation date forward 12 months and in the meantime ask for an anti-arrhythmic drug such as Flecainide. Suggest daily rather than PIP and be aware the entry level is usually 100mgs and you may like me have to go up to a medium dose at 200mgs to stop episodes.
Also max out on improving lifestyle choices as mentioned here many times. You have to hit AF from all sides to be sure as it is an individual and mongrel condition.
Not dissimilar to my story; paroxysmal, highly symptomatic during episodes, diagnosed June 2021, Edoxaban and Bisoprolol. AF is progressive and my episodes were becoming more frequent.
Had cryoablation last November. I’ve had two episodes since - about 5 months or so after and nothing since then. They were short episodes - 2/3 hours rather than 12 hours, and far less symptomatic and uncomfortable.
I’m very happy with that and will have a second if necessary.
Good luck!
Lyn x
I had 2 years of Persistent and I would say in Purgatory if not Hell.I thought I could self improve without ablation but no I got worse.It was the unpredictability of it all.One day I could do a 2 ml walk + a bowls match.Another day I couldn't do 400 yds.Lots of things affected .I chased the ablation.Now 5 months post ablation.I was given 50% chance of success.So far so good.And yes I would happily have another.
Reading your post and all the replies has been so helpful! I’m currently like you were, with episodes coming every 10 days or so, and highly symptomatic. Not yet been offered an ablation - haven’t even got to see a cardiologist yet - but I’m starting to think it will be my least worst option as the Flecainide PIP is now making me feel worse, not better, and I’ve ended up in A&E twice so far this year
I was exactly like you and when the Af attacks got too frequent had an ablation which stopped the Af for 6 months. Then when it appeared again I started on 50 mg Fleecainide which has allowed me to continue in sinus. If it gets bad again I won't hesitate to have another ablation x
I would definitely go for it. 3 months free of AF is nothing in the scheme of things. I've been 4 years free and it still came back with a bang.
Yes you may need a second touch up ablation but as Bob indicates once you have had one you won't be quite so concerned about a follow up.
I would say go for it while it is still Paroxysmal- you have a better chance of success. And no regrets for not trying before the episodes get longer or become persistant especially as you say you are symptomatic. Good luck with whatever you decide. X
Go for it! I was diagnosed with PAF and bradycardia late October 22 after a blackout playing football. Immediately put on rivaroxaban but no rhythm control meds due to bradycardia. Had a few weeks of tests and scans to check for any underlying causes but none found. Felt dreadful having multiple PAF episodes a day, everyday with breathlessness and/or dizzy spells right up to my ablation at the end of January and have been pretty much back to normal since. Resting hr is consistantly 60-70 (was 50-60 pre ablation and still earlyish days but would do it again tomorrow if I had to
I had a PVI cryoablation 5 and a half years ago, and have not had AFib since. I was fit and healthy with no comorbidities. Prior to that i had had 13 AFib attacks. Following my first AFib attack a consultant cardiologist warned me it would return . He was right . After the 13th I got a referral to him for an ablation. With hindsight I should have had the ablation after 2nd or 3rd attack and saved a lot of hassle and drug side effects!
I have not taken ANY drugs (except paracetomol) since May15 2018!
Best wishes what ever you decide to do.
I'm curious as to an update. Did you have it done? Your story sounds similar to mine. My episodes come on without warning and last from 10 minutes to 30 hours. I just met with the electrophysiologist to schedule an ablation. I am very worried that my outcome will be worse and not better.
I decided to defer ...... and then a matter of weeks later the episodes returned. (As wise people on here said they would!). Soooo, I asked if I could go back on the list, and I am having an ablation this coming Monday, 15 April. Have been suffering some unpleasant episodes so am pretty much in the mind set of "bring it on"! Watch this space. I will be back to report.
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