I am struggling with making a decision to follow thru with my scheduled Heart Ablation procedure, or just continue my current medications that I have been on for almost 3 years. I am currently taking Diltiazem, Eliquis, and Flecainide, and have not had an espisode since I started the Flecainide twice a day a month after I started the other two meds. The nurse navigator said I will continue these medications for at least 3 months after the procedure. I have been researching the pros and cons of the ablation, and I know the results are an individual experience, as is the recovery process. I am truly terrified about having ablation. Can you guys please share your thoughts and experiences?
Thank you so much!
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Vinoandpasta
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Too complex an individual decision to provide constructive advice on.
All sorts of factors go into the decision pot but when this common question arises, I always fall back on the reply that if the questioner is asking then they are not ready for an ablation ie quality of life is still sufficiently good or their own overall individual assessment, including subjective thinking, is there is too much potential downside with an ablation.
So in short, I think you are of a mind to postpone your ablation but I have to admit I am biased as I postponed 10 years ago and have been fine on just Fleacinide.....others here will no doubt reply they have been fine after an ablation. Over to you 🤔.
Secondtry, thank you so much for your reply. You are so correct in your advice. I have talked to many who have had the ablation, and others that have been just fine on meds. I really agree with your assessment of my question! Obviously, feel I am not really ready for it just yet, but then worry about how it will effect me in the long run if I don't have it done sooner than later (in my case, Ablation considered a "proactive procedure"). My Cardio Dr didn't even recommend it, I was the one to inquire about it and he referred me to another specialist.
I would just add an argument for ablation often runs 'you don't want to be on strong pills with possible side effects for life' but all choices are a gamble and I admit I am gambling - namely that I can avoid side effects for long enough and I won't be too old (currently 70) to undergo an ablation, which I hope will have a higher success rate when the time comes.
Your decision & not an easy one.I was in a different position when I decided to have the ablation.I had been persistent for 15 months following 4 years of paroxysmal.I have only ever been on Diliatezem & edoxaban since 2017.After a failed CV & trying to improve didn't seem to help I took the decision to ask for ablation.Actually getting to the ablation took 9 months & although told only 50% chance of success it has worked since Feb.
The QOL I had was very bad so not a very difficult decision for me.But I do feel so grateful I didn't have to take more meds as I take enough for other reasons.
I worried about the procedure particularly as only having sedation but I would rather have an ablation than dental treatment.
It’s scary stuff isn’t it?! My ablation is scheduled for end of this month and I can feel a part of me wanting to make for the exit despite all assurances! The problem is, I feel the same way before a flight or long journey. It would feel much safer to stay at home which is actually illogical. If I’d listened to that voice I’d never have gone anywhere!
I know this will probably sound daft, but I’m finding it helpful to talk to my heart. With hands over the heart area I give soothing thoughts - telling it everything is going to be ok, that we’ll be strong, that the outcome of ablation will be good etc. So at least I’m approaching it with a positive and relaxed mindset. I would not have been offered an ablation if they didn’t think it could be helpful in the longer term, even though I’ve become pretty adapted to the ups and downs of now persistent AF.
This is me, your journey may be entirely different to mine and you’re the only one who can decide. Wishing you good luck, and if you do decide to cancel try to give the cardio team plenty time to reschedule for someone else!
You are sooo right! I totally feel your anxiety. I am actually a Flight Attendant and it is my job to travel. Since I got diagnosed with AFib 3 years ago, it has really been a struggle for me. Fortunately, I have been on some really good meds that have helped and have not had any major episodes that I know of because of the meds. Right now they consider me still in paroxysmal afib, but I have anxiety daily still worrying about it.
I wish I had your same mindset of approaching it. But it was actually my idea for the option of an ablation. My Cardio Dr didn't recommend it...it was mostly my idea as a solution to not be on meds the rest of my life. It was also my idea to try Flecainide.
Following a public talk given by an EP on all the latest advances on AF treatment I started to push for ablation - paying for private consultation with EP and generally making a nuisance of myself. I knew the longer I left it the less likelihood of a positive result. I had open heart surgery for hole in heart age 15, so blowed if I’m going to be intimidated by a catheter! (Haha) However, I’ve no idea what I’d do in your situation, with paroxysmal AF and the flecainide working so well!
Do you have symptoms when you go into afib? I have paroxysmal afib and I avoid flying because I have to go to the bathroom constantly during afib. Do you have any tips for flying with afib? I desperately want to go somewhere again!!
Oh my, I feel like I wrote your comment! I am to have a 2nd more complicated ablation in October. My first was for an SVT (rapid heart). I now apparently have both AFib and A flutter which has been constant since Jan. 2023.
The longer I wait for the surgery, the more I question having it done. That little voice in me says maybe I should just find the right medication (even though I’m extremely sensitive to them). I’m now questioning what the long terms effects of several ablations will be?
I’m 64 and in good health otherwise, except for anxiety (which is probably part of my problem lol). I’m taking Metoprolol and Eliquis (blood thinner). Oh and I have Raynauds (which is affected by the beta blocker).
I am just like you! I am VERY sensitive to meds also! And worry about the long term effects of having an ablation, and staying on certain meds. Also, anxiety is my enemy too! I just turned 60 in June, live alone, and it appears that is a major part of my anxiety also.
generally speaking you will know when you definitely want to go for an ablation that’s when the meds become ineffective or too much of a daily trial - I was on Flec for 12 years when it stopped working , then Multaq , didn’t work that well - daily episodes - ablation - big improvement
I really appreciate your response! The Ablation Dr asked when I had my last episode, and I couldn't respond because I hadn't had one since being on Flec (it could have been masked by the med). I finally got a KardiaMobile and it has only detected that I was in AFib once in the last 2 months. I'm thinking I will wait it out till ablation is absolutely necessary...
Thank you! You are sooo right! I think the "pupil is not ready!" My gut is saying some scary stuff. Just the thought of someone messing with my heart on a voluntary/pro -active basis just doesn't feel right. My Cardio Dr didn't recommend it, but I asked about it and he referred me to an Ablation specialist for consult. I was just trying to be aware of it going from paroxysmal to persistent AF...
The only thing I would add, is from my point of view there is nothing to be terrified of in terms of an ablation. I had a cryo ablation one year ago (September 2022). I'm in New Zealand, where the Cryo procedure is done under local anaesthesia, so I was conscious, I chatted with the theatre staff during the procedure. In the US, it may be different, you may have GA, so not be conscious.
Just remember there are no guarantees with the procedure, often it's not 100% effective, as you will read on this forum, many people undergo a second or more "touch up" ablation. So don't be disappointed if you do decide to go down the ablation track, the AF may return. My AF has returned, but is much milder, and less chaotic and less frequent. PIP Flecainide puts me back into NSR within about 40 minutes. I'm due (at this stage November) to have a second RF ablation as a sneaky signal must be breaking through.
Thank you so much for your response! I truly appreciate it. And hello New Zealand! In the US states we are put under anesthesia for Ablations, and have to spend 6-8hrs in the hospital before released due to the anesthesia. It is considered an out patient procedure, but held in the hospital for a little longer due to the anesthesia.
I decided against one as the flecainide dose I am on prevents episodes so I don’t take anything else and though the side effects of added fatigue and messed up digestion are a bit of a pain, I do not have confidence in the hospital docs who might do the op and at 79 really don’t feel up to it.
I hardly slept much at all as we had the flu and covid jabs yesterday, one in each arm both still swollen and the right one is particularly painful when I move it much! I wasn’t going to have the flu one as the result was so painful last time but was persuaded by the nice retired doc who had returned to do them like last time. Wonder if you or any others have had this problem? When we actually had covid we only knew from the test results as felt no different with no temperature etc and when I’ve had flu in the past just a few days in bed sorted it. Wonder how long the pain will last this time?
I was hesitant, too. For the past two years, I was in and out of a-fib multiple times a week. Since it was pretty symptomless, it didn’t really bother me much. I was on Xaralto & Dilitiazem240. Two different EPs recommended ablation. I decided to go ahead with it based on the significantly higher chances for success before it progressed to permanent a-fib. I was under GA for the procedure & it went smoothly, with no real issues afterword. That was 2 months ago & I have not had a single a-fib incident since. Keeping fingers crossed. Based on my experience so far, I’d do it again. Hope this helps. Best wishes.
No significant recovery issues. I had some fluid retention the first week, but it resolved on its own. I took it very easy the first month & have gradually resumed more strenuous activities like walking & gardening. Feeling great & hoping it lasts!
My Cardiologist told me that there are continuous improvements in the effectiveness and safety of ablations. As I am out of afib his thoughts were it was best to postpone getting an ablation as long as possible. He also said with no alcohol and keeping my BMI low I may never have afib. I have had 1 breakthrough in 5 years and PIP took care of it in 2 hrs. I was having the occasional beer at the time so no more.
Did he saying anything about the efficacy of an ablation early on vs waiting? My EP said this is true. The trick is not getting on too early but not getting one too late! Arg.
As you have stated, you have not been advised to have an ablation, you were just concerned about the future. So, in the interests of widening your knowledge base further, can I suggest you watch the following 1 hour video by Dr Wolf (at DeBakey Methodist Hospital Houston) and the mini maze procedure. I am not at the ablation phase myself either, but am not attracted to the catheter ablation procedure at all, but the mini maze seems to make much more sense to me. If available, I would opt for the mini maze if such a surgical intervention was needed. Just saying.
I am now 74 and had to make the choice (as you do) about 5 years ago. While on flecanide for paraxismal ( excuse the spelling) AF , I had a heart attack resulting in the fitting of 3 stents which meant apparently I could not stay on flecanide. My cardiologist suggested I see how I feel after a few weeks then we would review the options going forward.
To my surprise my AF symptoms were far less troubling and were quite tolerable and nothing like the debilitating symptoms I was experiencing prior to my heart attack. My cardiologist said we had a 2 year window at most if choosing to do an ablation.
I was concerned that records show that many people who have an ablation finish up having to have another within 2 years as they are not always a permanent fix. Given that I was coping fine after the heart attack and hardly noticed the AF I decided to stay in "permanent AF" which my cardiologist advised was the "safest" choice . My theory on the symptoms is that the restrictions in my arteries before the heart attack meant the blood pressure at the restricted sites was causing an irregular flow with a sort of "stop start" making the AF so debilitating.
I am now happy to live with my permanent AF and my regular meds are - Metroprolol controlled release 95mg, Clopidogrel 75mg, Losartin 25mg, Ezetimide 10mg.
I very seldom notice my permanent AF and my health has been very stable for some time.
I hope this helps and best wishes in making your decision. Kind Regards - Derek Robinson / Christchurch.
I’ve been in NSR for about a year and a half after my second ablation. When my electro cardiologist suggested the additional procedure I asked her what would you do if you were me. Get the ablation was her response. I took it and everyday I’m glad I did. She went to medical school and trained for years. I did not. That’s why I took her advice.
I was in agreement with you about 5 months ago but have been waiting so long for an ablation surgery date that now I’m uncertain.
I’m suppose to go in for my 2nd ablation this month. I’ve read that after about 3 ablation procedures the docs won’t do more. What then? I guess meds? I’m 64 yrs old. I’m on Metoprolol and Eliquis.
I’m trying to determine if I should wait and stagger ablations (my first lasted 6 years but from what I’ve read they usually last 2-3) or just get it done and hope for a medical miracle in the future…
I’m having mine on Wednesday and I am worried about it, but after a lot of thought, decided it was best to have one now rather than wait till the AF gets more frequent. Just hope everything goes ok, but will be glad when it’s over,!!
My heart was ostensibly health and I have no other comorbities. My “left pulmonary vein RF ablation” was a piece of cake -and “acutely successful” according to the doctor. I had it done in 22nd June this year
I had full sedation, so knew nothing about it. The consultant and staff were amazing and I've had no AF and I’ve been off ALL meds since. But there are different sorts of AF problems/heart conditions/ablations, so I suppose it would depend on your personal circumstances.
If it’s the procedure you’re concerned about, then I posted a video on this site where an American cardiologist introduces you to the Cath Lab and what the instruments and screens are for, and how they carry out the ablation procedure. A Cath Lab can be a bit daunting, so it’s well worth watching.
Hi I understand how you feel I was in your shoes some years ago. I decided not to have an ablation having done a huge amount of research and listened to the pros & cons of the procedure from EP and cardiologist. I felt better and less anxious once my decision was made. I am now in permanent AF and controlled with medication and manage to still have a good QOL apart from getting short of breath on walking but I can live with that I am 72years old .I personally have not regretted my decision but each to their own and we are all different and have different expectations. Good Luck to you.
After much deliberation & my meds no longer able to stabilise my AF I decided to have Cryo Ablation. I was also very worried. It was a successful procedure with a a continuation of Meds post Op for several months whilst the heart recovered. It was the best thing that I ever had done to bring back my quality of life. I have since had a cardioversion to reset my AF which was successful and if needed I will have another ablation. Technology & techniques have advanced significantly over the past decade so I no longer worry about the procedure itself, I'm more concerned about the impact of AF on my life.
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