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Delaying 1st ablation: foolhardy or fine?

acordeon profile image
22 Replies

I am a 52 y/o male with PAF in the US. Have a cryo ablation scheduled for later this month, but am considering pushing it back to Nov. Looking for advice on whether you all think I'm being foolish.

I have been in stable NSR for the last month and a half. Prior to that, in May and again in July, I had 3 episodes of AF that didn't resolve after 24 hrs, and all 3 resulted in successful cardioversions. I had 2 episodes in July, 2 weeks apart, but have been in NSR since then.

Since July I have made a few med/lifestyle adjustments that may be contributing to staying in NSR. I reduced thyroid dosage that was a little high, stopped eating at night before bed (which I did before both of the July episodes), stopped taking ibuprofen, etc. So far so good.

Ablation was recommended for 2 reasons. One, my AF does seem to be ramping up. Prior to this year, my last episode was 8 years ago. Two, I can't take the usual rate-control meds because I also have intermittent 2nd-degree A/V block, and the meds would tend to make that worse.

I'm all for the ablation, but not sure if there's a huge rush to get it done. We are moving to a new house, and that's going slower than planned. Doesn't look like we'll be moved before my current procedure date. And if recovery isn't fast and easy, I'm concerned moving will get pushed back even further. Would be easier for both me and my family if we were moved prior to the ablation.

I can get it rescheduled for a month and a half later (early Nov). Waiting times aren't as long here as they seem to be in the UK.

I know none of y'all are doctors, and can't give me expert medical advice. But based on your experiences, does anyone think waiting an extra 90 days to get ablated is a big deal? Am I being an idiot if I do that? I understand I'm taking a risk that I may have AF episode(s) during that 90 days, which would stink, but I'm balancing that risk against the risk of a more difficult recovery that complicates our move.

Would love to hear your thoughts. Thanks!

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acordeon profile image
acordeon
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22 Replies
jeanjeannie50 profile image
jeanjeannie50

Whenever we're booked for an ablation our minds go into overdrive with questions like, "Do I really need this". It's the natural way for most people to respond, so you are not alone in the way that you're feeling unsure now. What do you think will happen once you postpone your ablation? Do you know about 'Sods law', because the chances are you could start getting more attacks of AF. I can tell you, hand on heart , that every time I had a date to see my EP I would feel wonderful right up to that day, then once the appointment was over, back would come my AF. Sometimes even the day right after. I have a feeling our minds have a lot to answer for with regards to our AF attacks. Ok that's one way of looking at it .

Another view is, why rock the boat when you're keeping so well right now. After all you've changed your diet and medication and all's looking good. So yes, postpone your ablation until November and then you won't have to worry about taking care and not exerting yourself too much for a few weeks after your ablation, especially with moving house drawing close.

There you go two opinions and the only person who can make the final decision is you.

I can tell you that if you opt for the November ablation, those doubts will still be there and you will still think, should I have this procedure done or not? As I've said, it's natural to feel that way.

I've had AF for 18 years and in that time have had 3 RF ablations and numerous cardioversions. I still have AF, but it's at a more comfortable rate now between 60-90bpm and I can lead a fairly normal life.

Jean

Desanthony profile image
Desanthony in reply tojeanjeannie50

Absolutely Jean.

Buffafly profile image
Buffafly

Hi, I just moved house in persistent AF. It was horrible but I managed. If you have shortish episodes you will have to reduce your activity for a day or few, but if you have an ablation you should reduce your activity for at least two weeks and if your recovery doesn’t go smoothly it could be longer. As you know people in the UK often have to wait 6 months or more but I don’t think it makes a difference to the outcome. Best wishes ❤️‍🩹

LordGabriel profile image
LordGabriel

I was in NSR when I had my ablation done. In the most awkward time, right in the middle of lockdown during covid. All reasons for not doing it…. but I did it.

I hate flying and when I have a flight booked … right before I think of a million reasons not to go. Everytime I settle on ‘I won’t go’ I feel relieved but logic takes over and I always overturn the decision and go.

I think you know where I’m going with this…,

Good luck

Jajarunner profile image
Jajarunner

Re recovery, it took me forever to get over my ablations. I was told I'd be back to normal within a few weeks. Instead it was four months before I could walk a brisk four miles. Months more before I could be more active. In the first three months I couldn't do much at all and couldn't walk more than a few hundred yards. So moving house if you feel like that would be a horror. However most people seem to recover a lot quicker. Hope it all goes well x

bassets profile image
bassets in reply toJajarunner

I was exactly like you after mine. Just unlucky I suppose.

acordeon profile image
acordeon in reply toJajarunner

There seem to be a lot of folks on the forum who had difficult recoveries. OTOH, I've spoken to 4 acquaintances locally who had ablations and all had pretty easy recoveries. I do wonder if people who experience complications are more likely to find their way to a forum like this.

Desanthony profile image
Desanthony in reply toacordeon

Absolutely. People are more likely to come to and stay on this forum after a rough time than if they had an easy recovery. They may just post twice or three times to say how well it went and then disappear back to their own carefree lives. Everyone is different so you don't know until you have had it done. Many years ago my wife had a procedure done which she had waited and questioned for a few years but really really needed it and right up until the time they wheeled her into theatre was about to get up and run away - did she really need it - would it be better to have it or not she could go on as she was - really? (actually no) - especially when she saw the woman in front of her come out and mistook the iodine stains all over the sheets for blood! Having said that although her procedure was longer and more difficult and had a few complications immediately afterwards and put their schedule back by 2 hours - brilliant care form the NHS she was fine by early next morning and was discharged at 9am - the woman who had the procedure before her was still poorly and had to stay another night - hey, maybe that was blood on those sheets and not iodine? :)

secondtry profile image
secondtry

You are caught between a rock and a hard place! I would favour postponing until after your move and making more lifestyle changes as post ablation a quite period is best.....however moving is stressful and so episodes are likely to occur, which may make a move near on impossible?? So either way extra careful planning is required.

Ducky2003 profile image
Ducky2003

If you're just putting off for a couple of months to get your house move out of the way, I don't see how that would make a lot of difference as I would factor in more like 3 or 4 weeks for ablation recovery before you start humping stuff about.

OldJane profile image
OldJane

That sounds a sensible plan to me. I wouldn’t think 90 days is either here or there.

momist profile image
momist

Good luck when you make your decision. When I refused an early opportunity for ablation with a new to the team EP, the head man I was on the list for took me off the list entirely, which I didn't find out for six months. I then I had to wait from the back of the queue again. YMMV of course, the person at the top of the team sets their own policies, pretty much.

waveylines profile image
waveylines

Oh that is a tricky one to answer. Pros and cons both ways. Have you tried to have a chat with the EP and see what he/she thinks? Moving house is one of the biggest life stressors. Afib and stress don't mix well. I wouldn't want to do this soon afterwards. Maybe you should discuss what measures that could be taken if you delay it and if the stress of moving does trigger your Afib off? Then decide. It's not an easy nut to crack tbh...

The other way to look at it is what stress could you remove from yourself during the house move. Do you have family/friends who could shoulder the burden between them? So your stress is minimised as much as poss.?

There will be no perfect answer but your decision will probably lie in what you can manage best with advice from your doctor.

EW518 profile image
EW518

First of all, I am not a physician and certainly would not advise you either way. That said, I was diagnosed in 2020 at the start of Covid with Paroxysmal AFIB, brought on most likely from stress according to my EP. We tried several different medications that basically aggravated the situation and finally discovered Sotalol. I have been offered a Cryoablation but the EP feels I have done an above average job of lifestyle changes and has said it is basically my choice to proceed if I feel that it would be best. During the learning curve I began to follow Dr Percy Morales, EP located in Houston and Dr John Day, EP located in Utah to develop a lifestyle strategy. I completely changed my diet, totally pushed aside alcohol and began a regiment of early morning 2-4 mile walks and learned to "take a break" when I am tired. The changes have made a huge difference. I occasionally get some ectopics and the Sotalol seems to sometimes slow my heart rate a bit much but other than that my EP says the changes are significant to making the condition improve. My Sotalol dosage is the very minimum of 40mg twice daily. When I was diagnosed, the EP said that for the most part is Afib is controlled either by age or triggers and while we can do nothing about the age factor, we can certainly work on the triggers. I am a wine collector and completely eliminating a glass of fine wine with a meal was, in the beginning, challenging but the joy of the wine is now watching our friends enjoy it with us during a meal. I can, without question, highly recommend both Dr Morales and Dr Day as the most authoritative resource based upon my experience following their methods of either controlling or reducing Afib episodes and the ability to eventually not rely on medications. Afib, in the past has been thought to be a condition unseen in younger generations but it seems to be that it is now being discovered in patients as young as 20. As my personal EP has said to me, there are many people walking around who are not aware they have Afib until they experience a stroke and those situations are unfortunate. If you haven't already, take a look at Dr Morales and Dr Day's printed materials. It is all very informative.

Banquo profile image
Banquo

I've just had my second ablation, and my first one was definitely harder on me. Recovery time longer than they said and just overall difficulty. Really, if you have doubts and want to push it back then that is pretty much your answer? My second ablation was roughly 8-9 mos after my first, and i was feeling really good the month and a half leading up to my second one! Really as good as i had felt. I still went through with the second, and indeed a couole of rogue signals were found and a reconnect. So . obviously glad i had the second and am now recovering..with hopes that im good for a while. All this to say..DO keep up with the lifestyle changes, but DONT do the procedure until your mind is fully ready and willing. I'm not talking nervous or anxious ..that is normal. I'm 53 yo male in the US, with no other underlying heart conditions and good health otherwise with an active lifestyle. Good luck to you and happy heart rhythm!

mav7 profile image
mav7

have intermittent 2nd-degree A/V block

 acordeon

Best to discuss with your doctor who knows your complete history. Does seem a delay would not hurt if no crucial symptoms.

Are you seeing an EP or cardiologist ? Have you discussed the success rates of an ablation with a 2nd degree A/V block, any effect ? Has a pacemaker for the a/v block been discussed ?

To a person not familiar with little knowledge, it seems treating the a/v block would be a priority that affects the afib ?

Best to You !

acordeon profile image
acordeon in reply tomav7

Yeah, this has all been discussed in detail with my EP. He thinks ablation first makes sense because a) I may never need a pacemaker if the block doesn't get worse, b) ablation doesn't tend to make block worse, and c) pacemaker can make AFworse, so if I do ever need that, being ablated reduces likelihood of problems

execz1 profile image
execz1

My guess if you asked your doctor or a neutral cardiologist, their advice would be to delay your procedure until after your house move. I am 82 and had a AFIB since 2012 . My second episode was five years after the first and then few episodes in the next two years . I was on meds for three years after the fourth episodes before the episodes became more frequent then they recommended Abliation and I am waiting for the new electrical pulse procedure which the safest of all and avoids burning the heart muscle for it does not produce heat or freezing . This is now possible . By the way I also live in the USA.

acordeon profile image
acordeon

Thanks to all the replies. I know there's no one right answer here, because I can't know the future. But it helped to hear all your thoughts. I did decide to push it back, so we'll see how it goes. Really appreciate this forum!

HiI suppose there is no real correct answer to this but my partner had an ablation in 2021 and the recovery was very easy. He had no complications at all. He was in NSR when he had it because of having a cardioversion previously but he still felt massively improved after the ablation. If in the UK my partner said he would definitely say do not delay. I think we come on forums when we have problems so those without them are harder to find but my partners Cardiologist says that a complicated recovery is rare.

Robinson1 profile image
Robinson1

59-year-old female here in the US. I had my first ablation six years ago and getting ready for my second one in October. For a touchup. I think you did the right thing. 90 days is no big deal since you’re not having lots of episodes. But don’t post pone it again lol. Congrats on your new house.🤗

sdweller profile image
sdweller

It's your choice of course, but my guess is you're hesitating because you just don't WANT to do it. But remember... the sooner you can stop recurring episodes the better the chances of staying in NSR. Of course nobody WANTS to have these procedures done, but they are VERY safe, and everyone is different, but for the vast majority, it's only a matter of time before it progresses. So all you're probably doing is "kicking the can down the road"... and by procrastinating you just might end up progressing into a place that is worse than where you are now...no fun.

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