Had visit with an EP who combines RF/Pulse method in one procedure.

[OzJames]

I had a good chat with EP from the same practice as my Cardiologist about Ablations. He doesn’t feel there’s any hurry unless it seems my AF comes back more often. After being 5 years average apart over the last 30 years I've now had 3 episodes in 16 months.

As I’ve had one episode of A/Flutter he would RF ablate that area and then use Pulse field for AF. Each one goes into a different vein. He says less risk. The flutter side about 45 minutes the AF side about 2 and 1/2 hours. He says less risk of major issue and rates risks at 1-2% doing this way. I asked and he has done about 1,000 RF or Cryo ablations and about 70 pulse field since April. I also asked success rates and he said about 75% at 12 month mark and after you pass that you should get a few years.

Am I mistaken or have I read some people get 5-10 years and more after ablations?

[BobD Volunteer]

I haven't had AF sicne 2008 but it took threee ablations. I then developed other arrhyuthmias later and had one for atrial tachycardia in 2019. PM fitted 2022.

[OzJames in reply to BobD]

Thanks Bob that’s a good long period without AF, I’ll wait see how long my next episode is and then decide when to have one

[secondtry]

Disappointed to read they are still quoting 75% success rate on 1st ablation; they said the same to me 10 yrs ago and I decided the suggested at least 2 ablations was not sufficiently certain to undergo the procedure.

Can't remember your history, guess you may have already tried medication to reduce those infrequent episodes to zero. In your position and with my to date good experience with Flecainide, I would favour drug therapy over the ablation route.

[OzJames in reply to secondtry]

I’m leaning your way for the moment. I’m AF free about 3 months since last cardioversion, the previous Af was 10 months before that. He was amused when I told him my dose of metoprolol was down to 6.5mg twice day last time I went into AF currently I’m on about 10.5mg. The equation Bisoprolol you divide by 10. He called it a homeopathic dose!. I’m not keen on drugs. I’ve tried Flecainide and it seems to calm things though when I do go into AF my rate without drugs is not high. The idea of low dose metoprolol according to Cardiologist is to tamp down that adrenaline spike which can send me into AF

[MikeThePike in reply to secondtry]

'Disappointed to read they are still quoting 75% success rate on 1st ablation'. I agree totally. It seems that they are nearing the limits of AF success with ablation technology and that new approaches are needed. I think part of the problem is that cardiology seems so focused on ablation as the only treatment for AF that no one seems to be looking into alternative strategies. What are the root causes of AF? Ablation was a breakthrough in its time but I feel that we haven't really moved on since then.

[OzJames in reply to MikeThePike]

I agree, whilst I know AF is progressive, what I am trying to do is kick the bucket down the road by looking at nutrition, supplements like magnesium CoQ10 and vitd3 and keeping fit. I’ve read James Nestor’s book Breath and that’s enabled me to relax more. Hopefully before Af becomes persistent/permanent a new method of correcting the errant pathways has been discovered