Permanent Afib and Longevity

[marinoperna]

Been diagnosed ever since my prostate surgery (and Moderna shots?) 3 years ago with permanent Arterial Fibrillation. Blood pressure is normal for a 73 year old male with heart beats of between 60 and 90 generally throughout the day unless some major exertion. Other than Eliquis i take no medication for the A-Fib.. I'm curious for opinions as to whether or not to consider ablations. I use the plural as all i ever read about is how many times folks have gone thru this with needing further ablations. Secondly, How detrimental is lifelong Eliquis (other than to the pocket book!). Any better long term options?

I like life and living but fear that staying the course of not doing anything that this AFib will eventually worsen, possibly to the point where ablations will no longer be an option (confirmed by 3 electrophysiologist). However i don't hear much about the symptoms worsening over time in reading these posts. So, I'd like to hear from our group, What are your thoughts about longevity staying with this disease?

Thank You in Advance

Marino

[BobD Volunteer]

Any and all treatment is only for quality of life(QOL), in other words symptom control. If your rate is well controlled and you are anticoagulated for stroke prevention there is no difference in outcome. Though I am a great fan of ablation for atrial fibrillation, in your shoes I would look long and hard at the motives of any doctor pushing you towards ablation.

[baba]

I’ve not read of asymptomatic permanent Afib becoming symptomatic. I know anything is possible.

If you went for ablation you would still need to be anticoagulated, as it would not remove the stroke risk, so I don’t think there is any benefit in going for ablation.

Best wishes

[Rainfern]

I had persistent Afib and opted for an ablation which I was offered because it was quite symptomatic. I could feel the arrhythmia bumping around especially at night, I became breathless on stairs and inclines and it was having an impact on my daily life. My sister has persistent AF and doesn’t have symptoms and doesn’t want an ablation. I’m only on an anticoagulant now with HR 60 - 70. My sister has medication to keep HR down. Neither way is a better way.

I know people say there’s no cure but so long as I’m in NSR I shall think of it as cured because I’m feeling so much better. As to longevity I think eating well, meditation and doing something meaningful with our time is probably better than worrying.

Very good luck with your decision. Remember EPs are up on all the latest developments and procedures. Ask the right questions and it is true that Afib begets Afib so the more you can keep it under control the better.

[mjames1]

In your case, ablation only makes sense if your quality of life is compromised by being in permanent afib, or if your heart is being compromised.

The first component is subjective and something only you can decide. The second is measurable with periodic testing such as ekg's, echo's and possibly exercise stress testing. These tests are important because how we feel isn't always an accurate assessment of how the heart is doing.

As to longevity, since your rate is controlled -- and assuming that your testing shows no structural issues -- your lifespan should be the same with or without an ablation and the same as if you never had afib.

I'm also from the US where ablation is now often considered first line treatment and readily available. That may be where your ep is coming from. However, asymptomatic afib with a normal heart rhythm is not typical, so I'd give pause about the ablation route.

Jim

[marinoperna in reply to mjames1]

So far it sounds as though living the best life one can without surgery is likely the better way to go. If only the percentages of successful ops were higher or at least not so many needing 3 and 4 procedures, it would be a higher consideration for me

Thank you for taking the time to reply with your inciteful comments

[Jonathan_C]

An ablation is not a major procedure. If you have been offered one, go for it.

[DevonHubby1]

Have you had a cardioversion? It will indicate if there's any chance of success with ablation.

[secondtry]

A year ago post the C-jab my brother at 71yo was diagnosed with asymptomatic permanent AF and his specialist medic just gave him an anticoag. His QOL seems fine eg walking up hills and running a business.

[marinoperna in reply to secondtry]

I'm doing fairly well generally. My problem is that i seem to tire easily especially early - mid afternoon. That is the part that worries me. Don't want it to worsen. So many different opinions and my reson for asking here.

Thank you for your reply

[mjames1 in reply to marinoperna]

Mid afternoon fatigue is very common even in the non-a fib population. Hopefully at some point you have had an echo to make sure that your heart is structurally sound. If not, always a good idea for those of us with afib, even if "asymptomatic" because we're not always aware what damage afib may or may not do to our heart.

Jim

[Janey1955]

I am only on apixaban and that’s it, owing to a slow heart rate and a reaction to flecanade. My heart is structurally sound and i can lead a normal life. 68 and still working full time. Little bit of breathlessness up inclines. My ep thought best to leave well alone and not have an ablation

Jane

[marinoperna in reply to Janey1955]

That appears to be the consensus here

Thank you for taking the time to comment

[quanglewangle]

My AF journey started around 12 years ago with Paroxysmal AF at times when I likened it to be operating in fourth gear. Over time it became Persistent AF and eventually Permanent AF. Because of syncope faints I got a Pacemaker seven years ago and cruise along in third gear permanently - rarely run but walk a lot, a bit slow on upward slopes sometimes but importantly no longer aware of irregular heart rhythm, though HR ECG trace looks like a drunken spider. So now 80 and steaming along blissfully taking Bisoprolol and Edoxaban.... never been offered cardioversion or ablations and happy to do without - looking forward to another 20 years.....

[marinoperna in reply to quanglewangle]

i know there is never a guarantee but those 20 years you mention are exactly what i'd like for myself

Thank you for taking the time to comment

[ozziebob]

If it was me I would be investigating Dr Wolf's mini-maze procedure. He's in Houston.

wolfminimaze.com

Good luck.

[heartbreak]

this whole heart rhythm thing sucks ! I have PVS as soon as I awaken everyday - it’s not AFib but it ain’t much better . None of the medication helps me . The ablation is like a lobotomy of the heart because they know so little about it it , they just kill it . There is more knowledge here on this site than at most cardiologists offices . If the vagus nerve is where these impulses originate then why don’t they fix my vagus nerve and stop experimenting on my heart?

As I said , the whole thing sucks!

[marinoperna in reply to heartbreak]

Whole heartedly agree. I hate guessing especially when it deals with something i only have one of and that cold kill me

Thank you for taking the time to comment