Hi guys. Just wanted to give you an update on my first visit to EP.
In short, after she carefully looked at my complete documentation (afib diagnose 2 months ago) she advised me to proceed with ablation.
Her main arguments are following
-I'm relatively young (40) and ablation has the best outcome in younger patients who just got diagnosed with afib especially since I'm in paroxsysmal afib
-the fact that my medications (bisprolol and propafenone) aren't working 100% of time for me is a good indicator to give a chance to ablation
-the fact that I changed a lot of my lifestyle points like loosing weight, stopped completly with alchohol, eating healthy and bringing my cholesterol in normal value is only gonna do extra positive effect on my ablation outcome
-she told me I could wait and see if I reduce my afib almost to zero with lifestyle changes if thats what I want but she thinks I should do the ablation and continue with lifestyle changes nevertheless.
Her opinion is that everything above is working in my favor to have a successful ablation and it would be a shame to wait if I have a chance to do it relatively quickly.
In my country, the waiting list is not that bad. She told me the nurse would call me in next 1-2 months to offer me a date (max 3 months from today) and if I accept the date they would put me on apixaban one month before and 8 weeks after the procedure.
I'm still processing this, although deep down I knew it would be like this, that I would be offered an ablation.
Any thoughts guys?
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NewOne2023
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It was offered to me also at my first EP visit. It will be decided by me after my holter monitor results are revealed. I will also seek further opinions but they do seem to think it is much easier to fix early on …
You say that you are 40, so really young. Why do you think that you will be so much older when you are 45? We had a lady here, with 79 yo, considering an ablation... If you know that the ablation makes irreparable damage to the heart (the walls of the atria are thin, there is not much flesh to be burned), with the success rates being under the question mark (given to the patients in a very wide range from different clinics), then why to hurry?
In your place, I would put things on hold, for a year or two, and would persist on lifestyle changes. If you achieve the result in this, natural way, then, again, why to go for an ablation. Many will tell you that the AF will get worse and worse with the time, and it is correct when the duration of the bouts is in question (from paroxysmal, over persistent, to permanent). AF is AF, never mind are you at the beginning or are you with 20 years of experience with it. But, there is something positive that may happen "naturally". It is my case, and others have also written about it - after some time, the heart gets used to new way of functioning and the symptoms subside. I had some unpleasant symptoms in the beginning. Now, after over 15 years with AF, I have no symptoms at all.
It is always good to hear some words contra the mainstream, lol. Of course, the decision must be yours, it is your body after all...
I get your point. I went in for the meeting kinda thinking they will give my lifestyle changes a chance before going for the procedure but as she said, I already had reccurence of episodes even on regular meds so there is no point in waiting because AF is only going to scar my heart tissue even more over time. And as a result it's going to be harder to resolve it later down the line.
I didn't decided anything nor did I felt I was rushed into ablation. Everything is still on me, just wanted to hear few thoughts.
But all things considering, I feel more towards doing the procedure rather than waiting.
Will see in next 2 months how I feel, I can always postpone it when I get the call.
I am in a similar position to you in that I have had 6 episodes of AF that I know about, but increasing in frequency. I have made lifestyle changes but have been referred to an EP for an ablation and will take it if offered. On the basis that it is only going to get worse.
If your ECHO shows your heart structurally sound I see the reasoning.
You haven't said which type. Reading the one using a 'balloon' cyto..... I think.
I can't have a cardioversion, ablation or anti-arrhymnic meds.
So I study the researches from my position.
I have a friend struggled with AF on 5 different meds. For years. Finally he was put on the list, after 3 attempts of time at Auckland changed through COVID TIME, it is 2 years now. Surgeon found 2 rogue electrical spikes causing AF - double the trouble. Scarring two areas so far has been successful. He had the above ablation.
Well, she told me that either radio or cryo. But that will be decided by the doctor who will do the procedure. And as far as I know, he is moat respected in Croatia regarding ablations.
2020 I had a double ablation (Cryo and heat) which sorted my AF, Flutters and ectopic beats. Never looked back. I was 41, now it’s like it never happened. I didn’t have a choice but I am still sooooo glad I did it.
I am with Nesko favouring a postponement of an ablation, provided your episodes don't get unmanageable.
From the information you have provided, I would give myself 2 or 3 years doubling down on lifestyle changes (you almost certainly have more to address) and discussing alternative drug therapy eg Flecainide with your trusted EP or cardiologist.
My personal take on ablations for me at 60yo (now 70yo) was that they sounded unattractive both the procedure itself, the 70% success rate & no guarantee of being able to come off the pills. Don't forget with a postponement there is a small chance procedures will improve over the interim period.
The bottom line is the decision comes from a full & frank discussion with your medics and your own gut feel; no one can say whether you are right or wrong as what would have happened taking a different course of action will never be known.
My son had an ablation at age 36 (extreme athlete , one of the group that is often affected). He is now 53, but after recovery the EP said he could carry on as usual - he was already a non-drinker and non- smoker and not overweight due to sport. He did for a number of years, but now prefers to go on hiking or cycling trips with his family. They hike regularly in our local Drakensberg Mountains and have flown to Europe and have done the Santiago both ways, starting in France and starting in Portugal. He has had so far had no further AFib. episodes, is determined he will not (remains to be seen as my sisters and I have the familial type that affects us later in life) and takes no medication at all. You are a similar age , so go for it !
I'm 67, had my 2nd at 66 (first unsuccessful due to my moving about even when unconscious). No regrets. Keep the lifestyle changes afterwards too - outcomes apparently much better long term. This is what my EP told me.
Consider your options - pros and cons - and make an informed decision. You have age on your side and if your Paroxysmal AF (PAF) is under control then there's no urgency to make a quick decision. The other reason for taking your time is to see what impact lifestyle changes makes on your AF. However AF tends to progress over time so waiting too long might make it harder for ablation to be effective. Your doctor is best positioned to advise how long is too long in your case.
The other consideration is the type of ablation you should consider including pulsed-field ablation, which is relatively new. It is reported to have a high success rate combined with a low risk of complications and a low risk of recurrence. If available to you, then you should discuss the type of ablation (pros and cons) with your doctor as well. Good luck with whatever decision you go with.
I would be inclined to go by the advice of your EP, as they’re the experts. It might be different if lifestyle changes alone had stopped the AFib, but it sounds like you’re still on medications.
I was diagnosed quite late on, when episodes were lasting for days. Over the year it became persistent and although I had an ablation one year ago, it lasted less than two days. I was told that there was too much fibrosis in my atria, and that they would need to have caught it ten years earlier. I think there is a strong family connection in my case - although I could do with losing a few more pounds, I’m not obese, good cholesterol etc.
I am doing ok with permanent AFib and on rate control only, but it’s really not ideal.
I had my ablation at least five years ago when I was 70 and have had no symptoms whatsoever since then. Definitely the right thing to do if you are feeling AFib effects on a regular basis as this could damage your hear over the long run.
Well I'm still in the early stage since my first episode was just over two months ago. Since first diagnose I was put on medications, bisprolol and propafenone. They told me to take propafenone when I have episodes but since my short episodes were happening daily, I went on regular intake of propafenone. It took time to see which dose was right and now I'm on 3×150mg or every 8 hours one tablet. It was 15 days since my last episode (which by the way I strangley stopped with vagus maneuver and no additional tablets). So basically although I had 2-3 episodes in the last month and a half, they are obviously still here despite my medications. And in addition I made a lot of lifestyle changes for better. But I'm still torn about the right path. Either I wait or postpone my ablation (because they are gonna give me a date kinda soon, max 3 months) to see if my lifestyle changes in addition to medications make a noticable difference or to go with the ablation and continue with lifestyle changes afterwards to make ablation possibly more succsessful because of it.
Not sure yet. At this point I'm slightly more towards listening to specialist. But the good thing is, it's still ultimately my decision.
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4 month post ablation ep visit yesterday 
Recent visit to EP
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Today’s EP visit (and our George)
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