Hi all, I have been on waiting list for a catheter ablation for over a year. They called me today and offered an ablation next week at a private hospital instead. Has taken me a bit by surprise to be honest. My AF is paroxysmal and generally very tolerable. I'm 48 so not sure if I should go ahead with it now. Some EPs believe that if burden isn't too bad it may be worth waiting until later ( when I inevitably will need it when older) if coping well with meds and lifestyle is unhindered. Confused.com as I'm quite young and AF isn't preventing me from doing anything. Any thoughts welcome please!
Proposed ablation next week. 48 Yr ol... - Atrial Fibrillati...
Proposed ablation next week. 48 Yr old. PAF
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JLONDON
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BobDVolunteer
On the other hand it is generally accepted by many people that early intervention stands the best chance of success.
One protential issue is that anticoagulation is generally required for at least a month prior to this procedure to ensure that there are no clots which might be ejected and cause a stroke. Have you been anticoagulated or has this been discussed.?
Thanks BobD. Some more background, I had a 3 day episode of Aflutter in 2021 and was hospitalised and ablated for that. Unfortunately flutter went away but was replaced by AF. Since then, I have been treated with sotalol and apixaban. At one point I thought I was AF free but when advised to reduce sotalol to minimum dose, AF came back
A rushed decision is usually a bad one. You're young, "coping well with the meds, and your "lifestyle is unhindered. When you make the ablation decision, take your time and make sure it's the right one. You will have other ablation opportunities if that is what you want.
Jim
You are taking drugs you would not need if you had a successful ablation. You didn’t say what type of ablation is offered but if cryoablation that is quicker and often used very successfully as an early treatment.
There are so many ways you can look at this but let me tell you that when anyone gets the appointment for their ablation, panic sets in and we torture ourselves wondering whether it's the right thing to do. That feeling is perfectly normal. Some people will say have it while you're young.
Others like me will ask whether you have cut out artificial additives from your food. Artificial sweeteners and additives were a sure trigger for my attacks of AF. I've had 3 ablations which still left me with AF, though it's a lot milder (or is it the fact I cut out all additives).
Jean
I agree it's a tough one to consider.
I was your age when I was diagnosed but didn't have my 1st ablation until about 16 years later. It took some nerve on my part to agree to this so you can imagine how mortified I was to be told at a pre op meeting with EP ( they did that in those days....) that due to the time lapse I would most certainly need 2 or 3 😱
Fast forward, I'm now 79 (just) and have had 4 ablations and 25 dc cardioversions. My episodes were almost all persistent and needed intervention to terminate.
I think I would be inclined to go for it!
Best wishes
J
PS.....i still have AF 🤔
Wow I didn’t realise you could have that many ablations and cardio versions !
Well I'm the proof......I haven't finished yet ! I was about to go up to theatre for another dccv a few weeks ago but flipped back into sinus as the anaesthetist was talking to me .
I had the same dilemma recently, the questions I had for the EP were
What’s your opinion on frequency of episodes and burden? Answer: A lot
Likely to progress to persistent or permanent? Answer: Yes
Treatment options, medication or ablation? Answer: ablation as anti arrhythmia medication was not suitable for me and already evidence of substrate change (remodelling) from the AF seen in my ECGs.
It’s a shock when you get the call and all I kept thinking is what if it makes me worse as I was coping well most of the time as you are. I had the ablation 4 days ago so it’s too early to evaluate yet but I have been much better than I was expecting so far, so a really positive experience. Only you can make the decision but I do feel the better you are going in to these things, the better you are coming out and early intervention is said to be more successful.
Hope my thoughts are helpful, good luck whatever you decide.
PS, They would have cancelled if I hadn’t been on regular anticoagulant for more than 21 days, they asked more than a few times.
I was also recently offered an NHS ablation at short notice, except that in my case I didn't know I was on a waiting list and the EP I saw privately who had referred me, with my wife there to take notes, had advised against having an ablation and said he would refer me for an NHS cardioversion.
He forgot to refer me for cardioversion and instead referred me for an ablation. See: "Is an ablation for Persistent AF right for me?" below.
I had my first cardioversion eight years ago, which left me feeling fine and in NSR until last year when I needed a second CV, done after a referral from my GP, that has again kept me in NSR since.
I think that if I had an opinion from an EP I trusted that an ablation was the way to go, I'd go with their advice.
It does seem that there is a lot of attention to waiting time stats for procedures at the moment, perhaps at the price of patients getting the advice they need. That sort of advice was readily available to me eight years ago.
If I was in your shoes, I would have a full and frank discussion with my trusted cardiologist (or EP if preferred) then afterwards make the final decision yourself at home.
At that point if I am still asking myself 'should I or shouldn't I' then I would postpone the ablation.
as I understand it … the longer persistent af continues the harder it is to fix. I have persistent af and had not realised for a long time - put palpitations down to anxiety / menopause / over weight
. Only diagnosed when I was admitted to A&E with severe nose bleed. Cardioversion doesn’t seem to work for me - only gives me 4-5 days in rhythm. 1st ablation in June 2023 made a big difference - 80 % there ! Booked in for 2nd next year to see if I can get any further improvement
My 2 pennies - go for it !
Hi Mrs D. Can I ask were you awake or asleep for your ablation? Did you feel any different when you came round from anaesthetic? I am scared as I have been told it would be a good idea to have an ablation even though I have only had two episodes of af though both 180 heart rate
I would maybe wait if you are protected by blood thinners medication to reduce risk of stroke if not take the abalation, if it comes back have another that's only what I would do personally
I was late in being diagnosed - just last year at 67 - but had suspected AFib for years. (Runs in the family.) Never caught on monitors, and being reasonably asymptomatic didn’t help.
Yet it sort of took off last year, with quite high heart rates, and of course I started to notice how much better I felt in NSR. Anyway, by the autumn I got a never-ending episode. I had gone on the ablation waiting list, and got an earlier appointment. Just this time last year!
It lasted less than two days. At the three month appointment I was told that there was too much fibrosis to make further procedures, even cardioversions, viable. So I am now on rate control.
I am doing ok, but the galling thing was to hear ‘if we had caught it ten years ago’…
It’s still a difficult decision, though remember it is only offered on the NHS if they feel it will work and is a good course of action for you. You will need to think how you would feel if it proves to be less treatable in the future.
Hello, I and 46 and offered an ablation at a private hospital a bit earlier than expected (Nuffield Trust at St Barts) the hospital experience itself was amazing and very different from the NHS (literally like staying in a nice hotel!). I am 5 weeks down now and still recovering but I decided to do it because of all the advice that it can get worse. I also have had PAF for 10 years which got worse this year. It’s a hard decision. Good luck x
Hi. I hope you are doing well still does it really take weeks to recover? Did the ablation hurt? I too have that decision to make but don’t want to make this worse. Don’t know why I think it will
I'm the same age as you and had 3 last year. The last one, touch wood, seems to have worked. The first two didn't. Took 5 months after the third to go into NSR but I have had AF for 20 years, at least 10 in constant AF and it was very definitely affecting my life and really a bit of a long shot. The last few years I've been much worse in terms of symptoms and impact. The AF had remodelled the heart. I was in mild heart failure. Having an MRI tomorrow to check in on that. Hoping things have improved.I think I'm pretty lucky that the EP was prepared to have a go, not just once but three times after such a long history and I'm extremely grateful. It was a difficult year but well worth it.
I wouldn't have done it though if it wasn't feeling pretty necessary. It's an important treatment for AF but it involves scarring of the heart and a fairly long recovery. It can also cause other complications, for some. It shouldn't be taken lightly, in my view. I'd read up about it, talk it through with family/ friends and your EP and cardiologist but would also remember that it's not their heart on the line.
Hope that offers something. Good luck with your decision making. 🌸
I was offered the same at short notice 5th June 2022( platinum jubilee weekend) so I dithered about thinking they'll be short-staffed etc etc etc. Went for it,care and facilities top notch .
I too whittered to myself about my pAF along the lines of oh its not too bad ,I can cope with the meds,let's wait and see if I really need an ablation/ think of those risks they mentioned and so on.
So I had put off the first appointment offered to wait and see. 4 months later I had 2 extended (24/7 episodes for 5 and 6 weeks respectively ) out of the blue. Promptly took myself off the ' paused' place on the list!
Fine since,no flutter at all, fib out in a few appearances but seems to have been well gone now. I feel great.
Just thought I'd share my story as I get where you are coming from!
Best wishes, and think of all the great films on over Xmas you will have the ideal excuse to watch! Xx
early best. If you were under team I’m with you would be urged to do it. You have many years for the AF to worsen. However, any intervention is daunting! Talk to the EP? Is it the same one?
Hi
PAfib progresses. I had it for 12 years and the episodes became more frequent and closer together. After dithering I decided to make the leap to have an ablation before my Afib became persistant. I wish I had done it sooner.
They don't always work for everyone but so far has worked for me. Only you can decide but you are young and Pafib will never go away. So if an ablation is an option it is worth trying. What I enjoy most is being off all meds.
Take care and good luck with whatever you decide.
Are you still doing ok. Was it the best decision you made? How long was your recovery?
Ive just turned 53. My AF diagnosed in September 22 although had symptoms for years. Started getting weekly then daily. Meds helped somewhat with symptoms but not frequency. Was scheduled for ablation in October but they forgot to put me on anticoagulant a month before. Just had it done Thursday past and after all the worry I have to say it was worry over nothing. Done by Dr Douglas Elder at Edinburgh Royal Infirmary. With cyro balloon . Couldn't believe it was over so quick . Feeling totally normal. Although still taking it easy . So far so good.🤞
How are you feeling now? I too have to make that decision. Did it hurt at all?
Feeling loads better. Had a few episodes of different arthymias to start then settled down to 1 since Xmas. Little discomfort during procedure when freezing but went quickly..
We’re you awake?
Yes but well sedated. Felt low like no time at all.I've honestly had worse experiences at the dentist. Don't worry. Id easily do it again now I know about it. And I'm a total worrier. Still stressed about everything.
I have been told I will be under a general so happy with that. Glad I’m not the only stresser here
I think that's why I got AF. Worrying about everything. Inherited from my late mum.
And that’s another story 😀
Hi
Yes I am doing fine thanks! I just looked at your posts and it says you had an ablation 18 years ago so you probably know what to expect ( but it will be more modern with newer techniques). It was the best health decision I ever made.
Good luck with whatever you decide.
Take care.
I did but it was pretty horrific hence why I think I am anxious. I was awake for that one. This one is under a general
I would want to speak with my EP first and know their opinion.
When my ablation letter arrived I was shocked, but I knew what my EP thought - that I was an excellent candidate and he believed I had an 80% chance of not needing a second ablation. He was clear that an ablation was the best course of action for my heart.
Equally, if there isn’t time for that, you will be offered another date, so maybe a call to the co ordinator who schedules ablations and ask when the next date would be. I did this as I had a holiday booked for first date.
Good luck!
I had a cryoablation procedure to resolve my PAF in2016. I was 50. It resolved my PAF and I have had no events of AFib since. I was normal weight, and active. I asked the EP whether I should wait, he said no as it it’s more difficult to get an effective result later.
Last year I went in to Atrial Flutter, with HR fixed above 150. It stopped me doing any exercise as that was just too exhausting. I had a successful cardioversion and then an ablation of right atrium a couple of months after.
I still get what feels like a lot of ectopic beats, and have had this investigated a number of times, always told those are not clinically important. So ablations haven’t resolved everything, but have gone a long long way for me to live without arrhythmia and be free(ish) from the stress of it.
3 months ago I had a TIA (mini stroke). So now on anti platelet drugs having been off the anti coagulants for some time. After investigation, they cannot find any specific reason for the TIA event, and do not believe it is related to anything my heart is doing.
I am glad I am free of AFib and AFlutter, and after the mini stroke warning, somewhat grateful that things weren’t worse. I am 57, last year my stroke risk was negligible, but 30% of TIA/stroke are in working age people. For me, I am glad I reduced my stroke risk by having the ablations, things could have been worse.
The procedure for me took 2 hrs, under sedation. And I had no complications.
I asked about postponing until later life and was told it wasn’t an option (can’t remember why I’m afraid). Hope you come to a decision you’re comfortable with
Hi, and all the best. I am a bit older than you at 68, but my Afib causes me virtually no symptoms, but its persistent as I have had it for some 3 years.
I was put on the waiting list for ablation and had mine just a year after diagnosis.
It appears that the medical evidence points to having an ablation sooner rather than later if you have Afib ( within the first 3 years). Afib is progressive, but I think you need to try and get back in NSR as soon as you can.
That said it may not work ( mine lasted a week !! )...However I am pleased I had it, and I am now listed for a cardioversion!....Chat with your cardiologist
HI JLONDON, Afib is increasing in every country, so there are always new procedures and improvements coming down the line, ie., pulsed field ablation which allows less collateral damage to surrounding tissues etc. And types of mini maze procedures, such as MummyLuv, saulger, and others on here have had, which are less invasive w/ shorter recovery times, are options you will likely want to check out before going for a standard ablation, which has its own risks. (You could ask them for more information.)
Many on this site have had multiple ablations, but I am another paroxysmal afib person who finds that taking daily metoprolol and PIP flecainide isn't stopping me from living life normally (work full time, travel, perform as a professional musician, etc.). Also, the number of successful ablations a doctor has done has been shown to be a very significant predictor of success, but I've been offered ablation by at least 2 young drs. who hadn't done as many ablations, so I happily said NO. Ablations that are safer/less risky, and more likely to be successful without needing 2 or 3 more, will become more & more available in future, as the incidence of atrial fib is rising all over the world; many of us are waiting for those improvements so you will have other opportunities, I think, in future, if life is going pretty well right now. Much to research and think about... All good health and NSR to you! Diane
I’ve waited nearly a year and have mine Friday - for me it just has to be done as my AF whilst paroxysmal, occurs pretty much every 2-3 days and QOL down the pan - nervous about it if I’m honest but the thought of resolving or improving it means has to be done
Hope it went well
Hi - Yes it went well and feeling way better than I’d expected at this point - mine started several years ago and only had a few odd episodes of it - scary as had no clue what it was and had a hell of a time getting it diagnosed as never happened when having “tests” but at a point it all changed and ended up in AFib every 2-3 days and highly symptomatic - life effectively turned to sh*t so for me had to be done and finally it has so taking it easy and seriously positive about this working and getting life back. I know the experience is different for everyone (AFib as well as the ablation) but nowhere near as bad as I’d expected- I’m in zero pain including the groin wound- have a few odd feelings in chest and throat when first lying down but it goes off and then fine and only day 2 after having it. I had the call about it 2 weeks before and the nerves started but whilst not the most pleasant experience it honestly wasn’t anywhere near as bad as expected- if you have any questions feel free to ask me and I’ll do my best to give you as much info as I can - very best of luck when you have it and let me know how you get on
How is your recovery going?
Hi - going well so far - had a 2 week blip 6 days after having - thought to be due to inflammation from the procedure but been 5 weeks now since it settled and no sign of AFib or any high or low HR runs
my story slightly different to yours JLONDON.? Diagnosed at 45 with paf, my symptoms were actually more mentally distressing than physically.!! But I went ahead with 3 ablations in total anyway because I was told better to intervene early because better success usually.?
Fast forward 10 years and I’m still getting episodes but nearly always in the early hours and the symptoms are not as bad as they were at all.👍 I’m still working full time and enjoying life. I recently saw a cardiologist who is swapping my meds about to see if things improve with the possibility of an another ablation in the future.!! I don’t regret having the ablations early because who knows how bad things would have been if I’d have left it until later.?? Have a good think about it mate before you decide, and I wish you well with whatever you choose to do.👍
all the best.
Ron.👍
I totally agree with Jim and Jean.
maybe you are best discussing with your doctor. Of the two people I know who waited until later their AFib became permanent and sadly the ablations haven’t worked.
My AFib suddenly got worse in the summer after a chest infection. I had the ablation in September and haven’t looked back.
Almost three months out no probs at all
Thank you
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