I started asking you all questions about 6 months ago before finding EP.
Went to Papworth Hospital in June and had cardioversion which worked straight away. However had overnight AF in early September.
EP said if I had another before Xmas should go for ablation as better to catch it early. Of course, I experienced another overnighter AF last weekend after some family upset.
Question is will I have to take the bloody bisoprolol again (along with Edoxaban) as I hated how it made me feel for the month before/ after the cardioversion or won't they insist on it for an ablation?
Thanks
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AKatieD
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I'm getting the feeling that the currently only available causal therapy for vagal AF is wolfminimaze.com/. Unfortunately having it in Houston is very expensive. Thus folks go to the only other place in Tokyo where it is available for approximately the same price as a catheter ablation and it's performed by a doctor who learned at Wolf. After having one failed ablation myself I'll go there in December and will report about it.
You will need to be on an anticoagulant - usually for 2-4 weeks prior and some time after ablation for sure so I believe that will not be optional if you go for ablation but for how long - that is a question you will need to ask of your EP. If you don’t get on with Edoxaban then ask for an alternative brand and see if that works better for you, I’ve had no problems with Apixaban which is the only heart drug I take.
Bisoprolol will be optional and that is a discussion between you and your doctors. Personally I refused to take after initial few weeks and feeling like death. After reading a recent post about their affect on AF that confirmed my view.
Oh I think MiniMeGreen has already posted the link. Definitely worth reading both the links before having any discussions with EP.
If you tell your EP how ill Bisoprolol made you feel, there are other beta blockers he can prescribe. I take Metoprolol as Bisoprolol worked well but really made my legs ache. Quite often they may ask you take take a drug called Amiodarone, this should only be taken for a short while.
Anticuagulation is not optional for ablation the only variable being how long for prior to and post procedure. Three months before was my protocol and I have never stopped due to my CHADSVASC score. Any other drugs you will need to discuss with your treatment team as we are all different.
It was only the bisoprolol that made me feel like a zombie, edoxaban was ok if a little annoying when you scratch yourself. Consultant said not surprised bisoprolol was bad when it made my heart rate so low and think he would suggest other things after that.
The vagal stuff is very interesting as I did not know there were different types of AF so I will study that now.
I did wonder when heart seemed more noticeable at night, when leaned back etc. Mentioned to consultant but he seemed to think was coincidence. And the episodes of AF after cardioversion happened over night.
Consultant is talking about wound in leg and they do pulsed field ablation at Papworth (among other things of course) so that was what I imagined they would do on me. MiniMeGreen do you mean that PF ablation would not be suitable if it is vagal and only the mini me thing would work, which i think is a much bigger operation?
Well, the pulsed field ablation is roughly said about the same as any catheter ablation, see here pubmed.ncbi.nlm.nih.gov/321..., it's just about different methods how to induce the scars which should block the unwanted electric signals. The name catheter ablation already tells that it is done on the inside of the heart. If you have vagal AF it will likely not be sufficient because the culprits sits mainly outside on the heart wall, hence the need for a MiniMaze which definitely is bigger surgery and has more possible side effects but also definitely more benefits like being able to stop the anticoagulation drugs while having a better protection against stroke than with them (likelyhood in %). I will be doing it myself next month and I got my cardiologist to write me a recommendation letter for my German insurance, thus hopefully they will heavily participate in the costs.
Many cardiologists are not willing to skip the catheter ablation, to my knowledge only Dr. Wolf in Houston has couple of patients who did skip it and are AF free. I have seen at least one talk with such patient look for his youtube videos wolfminimaze.com/.
Just wanted to let you know, I have vagal AF and take Bisoprolol ( I’m only on 1.25) and it actually helps my AF and my episodes have reduced significantly to one a year currently. I hated how it made me feel initially, but it did improve over time. I know being on a low dose helps. There are always exceptions to the rule and different people will always have different symptoms. The studies on the link did have people who had other conditions such as hypertension too. I just wouldn’t read too much into it.
You also may or may not but have ‘vagal’ afib, some medics don’t even accept it as a ‘thing’.
I just wouldn’t want you going off in another direction unnecessarily. It is best to discuss with your EP what is right for you.
I was also on 2.5 and after reducing to 1.25 (slowly, I hasten to add, as I know too, how awful it was as I also did try and come off it too quickly and failed 😞 ) my HR hasn’t really changed on 1.25 perhaps by 1 or 2 beats a minute, but it was very minimal and I do feel better, though I know a lot struggle too on 1.25. But do explain your concerns to your EP.
I’m sure there must be a lot of people who don’t even know what type of AF they have who have very successful ablations.
I do read studies, but there are usually caveats in many and it’s always worth ‘reading between the lines’ sometimes. I’m not saying there isn’t anything in it, but just apply some caution is my advice. You could mention the possibility of having a calcium channel blocker perhaps, especially as you had a bad time coming off the bisop before, but see what your EP advises. There are always other options.
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