I wonder whether someone can help me decide whether to have an ablation or wait
Iam 65 and due to have a Pulsed Field Ablation and have justhad my pre procedure nurse interview.
I have paroxysmal AFib -usually twice a year -lasting about 8-9 hours which I control with a one off mega dose 300mg of Flecainide and one metoprolol.
The nurse said that my episodes are very infrequent and that they have noticed that an ablation for 'some ' patients with PAfib can make it worse .The result being that they have to go for a second Ablation.
This has scared me and now I am seriously wondering whether to go ahead now or wait.
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manabouttown
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Nobody knows. It all depends on you but Pulse field is very new and supposedly better than either RF or cryo so I would not worry. That said you are like most people at this stage questioning whether to go ahead and most do go ahead and not regret it.
I agree with Bob, although the PFA is a new procedure, I would imagine that great care will taken to make sure that you get the best possible results. Well established procedures often need a second or even a third attempt but it’s rare to hear anyone say that they regret having it done. I expect the nurse has to be careful not to make over ambitious claims so try to remain positive, most of us started to get the jitters just before the BIG day, all the best and please let us no how you get on……..
The way you are feeling now, 'wondering if an ablation is a good idea' is how we all feel once we're told we're booked for one. We umm and Ahh about it constantly and to comfort ourselves we think, we can always cancel it, but what most of us actually do is have the procedure. Right up to the minute we're at the hospital for an ablation that thought is still going through our heads. Afterwards I've always thought that the procedure was no big deal, though it can sap your energy for a week or two and that's why it's always recommended that you take it easy over that period.
I've had 3 RF ablations but am now in constant AF. It's very mild though and I can live a fairly normal life now. My first one took away the banging of my heart when I climbed up hills, I had no idea that other peoples hearts didn't do that. It did nothing for preventing my AF attacks though. To be honest my second one did nothing for my AF either and it was my third that did. My heart rate now flits between 60 and 90bpm and the only time its gone high again was when I had covid and pneumonia together last September/October.
hi. I’m in same situation but need to lose weight before faced with decision whether to proceed with procedure or not. Paf diagnosed feb 22, very much stress related episodes two or three times a year. There are a lot of experienced people on here with excellent advice and support but only you can decide. I look forward to your update and wish you well take care 🦊x
I'd listen to your consultant rather than a nurse. Not being sniffy or nasty but the decision is best made by he/she at the business end !Honestly, on my opinion,go for it. I dithered needlessly for years( aided by Covid lockdown)
Look up my story and reports if you like. I felt just like you!
Leading up to my RF PVI a combination of lifestyle tweaks plus med's had my AFIB pretty much under control so I started to rationalise this as a reason for not going ahead, scared of the dark!! Glad I did, complete success and no bloody beta blockers.Very happy with the results.
No guarantees, but running with the odds seemed a sensible approach.
I dithered for a few years but didn't even know an ablation was an option until I joined this forum - my cardiologist was basically " it is controlled by meds" but never mentioned that there was another option. I had never heard of an Electrophysiologist .Went ahead with it last year - bumpy recovery but have been off all meds now since last October. It's the best ( medical) decision I have ever made. It is just getting off the fence so to speak which is the tough part. I am eternally grateful to this forum .
My goodness ! Twice a year - I would not bother at all. Before I had an ablation I was Afib 8 or 9 days a month for differing periods between an hour up to 12 hours. The Ablation was successful for 4 years and then had 2nd one after that. Had AFIB for 40 years. Still have the odd attack but slower pulse rate and shorter time frame. I am 79 now and can live ok with the odd attack. My mother who is 103 has had the various stages of AFIB for decades and still has a healthy heart for a lady of her age. I have a brilliant cardiac surgeon who is electrophysiologist.
The thing with an ablation, it scars the heart and there is no going back.
I read that the catheter ablation is the best one to start with.
Read all about ablation types etc research them yourself.
I've been given my verdict - no cardioversion, ablastion or anti arhythmnic drugs.
Reason - the ECHO showed an enlarged back chamber so the structure of my heart is enlarged but I was left without a follow up after stroke with AF. H/R 186 average on Metoprolol (it also shows pauses).
Bisoprolol showed 156 H/R Day avge and more energy.
Turning to a private H/Specialist the CCB Diltiazem was introduced.
I wonder whether you could be controlled with PIP pill in the pocket.
Are you on an anti-co.agulant? There's talk about it as PIP.
On my first appointment with the EP he told me that it’s usually not a single procedure that is required. Not for PVI ablations anyway.!!!
He was rite. I ended up needing 3 but I am alot better than I was mentally and physically. I too was scared at the thought of having more than one or possibly making things worse.?
It’s up to you at the end of the day but you’re in the hands of highly skilled educated professionals who know what they’re doing. Have a good think about it before making a decision. your symptoms maybe a rare occurrence now but over time things could change unfortunately and it’s better to get treatment sooner rather than later. I wish you all the very best in whatever you choose to do manabout.👍
I would discuss it with your consultant who will look at your condition and prognosis for the future. Ask questions, for example I wanted to know if my heart had been damaged and asked about the success rate too.
My decision was based on how I felt whe. I had an episode (like nine circles of hell playing out in my chest)
I do think your consultant will put your mind at ease and give you the facts.
Hello, I think I’m with Smileyian on this one as your AF burden seems very low . If you can control this with the PIP then I would most likely continue this , rather than have a procedure that does have risks , although I know the new PF ablations are supposed to have less risks . Prior to both of my ablations I was in persistent AF for many months and I could barely function , hence I wS raring to go for the ablations !
I just had my second ablation a month ago. When i was at your level years ago, basically having a couple episodes a year, I didn't even know what AF was or that it was what i was experiencing. So, consider yourself ahead of the game! Possibly people can stay at that level for many years to come? That i don't know. It seems more common for it to slowly get worse and more prevalent, which was what mine did. By the next year i was having episodes that lasted steady for three days, and within a year or so I was in AF steadily fir a month. By that point I had finally learned what i had and have been on the AF conveyor belt ever since. My goal is to get off the meds, as I'm on a pretty high dose. And i will add that when I'm in relatively persistent AF, I will do just about anything to get out of it! But when you're feeling normal long enough its easy to forget how debilitating AF can be. If you aren't ready yet then go ahead and wait.. statistically the sooner the ablation the more likely it is successful? At least from all the stuff i read. But if you only have a brief episode once or twice a year, i can see your hesitation. There's still so much mystery and individual differences in this condition and-or how it returns..nobody can give you absolutes. I did not have the option of Pulsed Field, just the Radio Frequency zaps. PF tech sounds like an improvement, especially in removing some of the more dangerous potential complications esp with esophagus troubles (which are very rare, but exist). Still, i couldn't wait to have an ablation. I was disappointed to need a second one, of course! But I also knew it was likely. Recovery from the second 9ne has been much easier. Fingers crossed that in two months i can get off the meds for good...Best of luck to you!
In my case, I waited until my a-fib episodes became a real distraction in my life as they became more frequent, before I had an ablation. Yours aren't at that level yet, but something to remember is that they almost always will progress, as that's the nature of the beast. Maybe take that into consideration in making your decision. Best of luck to you.
I had 3 ablations and have been one year free. My 1 st ablation made me worse. 2 nd put me into all sorts of rythems and third worked wonderfully. Anything with Afib is not a quick fix. It’s seems to take time .Well for me it did. Good luck
All surgery choices are risk vs benefit decisions.Benefit needs to outweigh the risk.
Your AF burden is currently very small indeed, and manageable without regular long term medication.
If I was in your position of having only 2 episodes a year, I would not have surgery.
On the little you have told us about your situation, the risks seem to far outweigh the potential benefits.
In my case, for instance, I have AF every 2 or 3 days, and take meds all the time that affect me but do little for my AFib, so it has a *very* significant negative impact on my life, and I am choosing surgery because benefit heavily outweighs the risk.
Not trying to put you off surgery - if you and your medical team think it is the best choice, then you are the experts.I just think that there is something of a conveyor belt of drugs then ablation that AFib patients ( and others) get put on by our health providers, that does not necessarily treat us as individuals.
Medical professionals can be awfully rigid and blinkered sometimes.😏
Given the vast spread of AF sufferers' experiences in terms of severity, frequency, duration and the impact of their symptoms, I just think it is advisable to press pause and make sure that the road you are on is the right road for your precise circumstances right now, and not just a one-size-fits-all approach.
Better to pause and have that conversation before you have a procedure so that you can be confident in your choice.
I think your advice is very sound and I will consult my electro cardiologist. On my last visita month ago , he was non commital about having an ablation -he said'it's a treatment availableto youoryou can continue with your medication'-ie hedidnot say I think you should have one.
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