Update on many PACs and EP visit - Atrial Fibrillati...

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Update on many PACs and EP visit

Iamfuzzyduck profile image
29 Replies

So my first diagnosed run of afib was in November, I am otherwise a fit, healthy 56 year old. I got the results of my holter monitor today, 140 runs of my heart trying to go into afib in a two week period- he said the PACs, tachycardia and everything were like mini afibs but my heart sorts it out (it was worse after I sent the monitor back for review). He doesn't think caffeine will affect it much at this point, just have one mug a day and if i want a glass of wine, a small glass with lot and lots of water! He has given me bispoprolol or whatever it is called... to try but I don't need beta blockers full time. Also doesn't recommend a rate med, he is pushing full on for an ablation, there is no doubt in his mind, do it now, sort it out and he believes with my sort of afib it will be very effective. I can do it in three weeks if I want. He doesn't recommend pulse field for a year as it is too new and not as effective and he says it is a procedure designed for more cardiologists to be able to do it. So I don't know if he is saying an ablation because he is itching to do the procedure or if it's because he really thinks I need it. He seems to know what he is talking about but I am going for a second opinion on January 31. I couldn't be bothered to tell him that I am also stressed because my son had a massive seizure while driving and my daughter had to steer the car over a 10 foot wall into a ditch and has a minor spinal fracture (New Years Eve day)... So that's that, thoughts on having the ablation?? He is basically scheduling me anyway, he's really pushing it...

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Iamfuzzyduck profile image
Iamfuzzyduck
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29 Replies
mjames1 profile image
mjames1

Definitely sounds like a US EP :) They see atrial fibrillation everywhere, in every EKG and maybe they have a point. I think there's a lot we still don't know.

Did you ask the EP how many ablations they've done last year? The answer should be over 100. And total ablations should be over 1000. Studies suggest best results from high volume centers.

Jim

Sixtychick profile image
Sixtychick in reply tomjames1

That’s interesting to know. I had an ablation in September and my EP said he’d done over 2,000 of them. He’s obviously very experienced, so I’m hoping it has been successful and my A-Fib won’t return.

Iamfuzzyduck profile image
Iamfuzzyduck in reply tomjames1

He did most of his work in Spain and Canada, and is South American and when I asked him how many he’d done he said lots, he’s been doing it for years(even though he looks about forty or less) and that is what he does-didn’t give me a number though. I brought hubby along to gauge the doctor-he thought he seemed really competent. There are so many EPs in Houston is difficult to know who to go with-he was simply the first available…

Buffafly profile image
Buffafly in reply toIamfuzzyduck

I always a bit wary of electricians etc who are available at short notice 😂

Poochmom profile image
Poochmom in reply toIamfuzzyduck

If you are in Houston look up Dr Fahed at Houston’s Methodist. He is a stellar EP and done many many ablations.

Iamfuzzyduck profile image
Iamfuzzyduck in reply toPoochmom

Thank you, I will check on his availability…

Rainfern profile image
Rainfern

First, what an awful start to the New Year with your son and daughters’ accident. You must all be in shock. I hope they make speedy recoveries.

Having an ablation can feel like a big decision and one only you can make. It sounds like you won’t have a long wait so you could always defer a month or two until family things have settled down a bit. I do think it helps recovery from any medical procedure to be as relaxed and calm as possible. I’m so glad I went ahead with an ablation myself.

Iamfuzzyduck profile image
Iamfuzzyduck in reply toRainfern

Thank you! I know I have to do it so I suppose sooner rather than later.. our household is very high intensity so no time will be good!!

Rainfern profile image
Rainfern in reply toIamfuzzyduck

As long as they all give you a proper break! 😅

OldJane profile image
OldJane

his advice is consistent with the more recent extensive European advice and is what my excellent EP would say .

Achant1 profile image
Achant1

In my opinion I would get the ablation as soon as possible, because AF can progress in to a bigger problem overnight, the earlier the better in my eyes. One of my friend’s had an ablation 7 years ago and not a touch of trouble since, ablation really isn’t a big deal in my eyes, it’s exciting if anything as it offers hope, good luck in whatever you decide.

Iamfuzzyduck profile image
Iamfuzzyduck in reply toAchant1

Well the EP did say he thought it would be nearly 100 percent successful because of the stage it is at so I guess I need to bite the bullet…

Achant1 profile image
Achant1 in reply toIamfuzzyduck

You’ll be fine, I’ve had three ablations, one for pvcs and two for af, you’ll be looked after, I’ve had two under general and one under conscious, just think if it all goes well, no more drugs and no more af 🤩 good luck.

Buzby62 profile image
Buzby62

Just my thoughts.

It makes sense to me, sounds like you’re having triggers but the pathways to sustain AF for any length of time might not have formed yet and an ablation before they do would make sense. There’s no guarantees but my EP told me “you tick all the boxes” and I have faith here in the UK at least that they would not push for an ablation unless you are a suitable candidate for success.

Bisoprolol = Beta Blocker = Rate control medication

Pulsed Field will be in more places in the future in my opinion, I wasn’t offered it either as only 4 hospitals in the UK had it and not in my area.

Hope your family are all doing OK after that.

Good luck whatever your decision.

Iamfuzzyduck profile image
Iamfuzzyduck in reply toBuzby62

Thank you! I do think I need to nip the electrical mess up in the bud before it sets in !

KMRobbo profile image
KMRobbo

I have not had AFib since my PVI CRYO Ablation almost 6 years ago.If I could run rerun my a AFib journey I would have organised the ablation after my second AFib attack rather than my 12th and avoided 18 months of hospital visits, drugs side effects, drugs shortages drugs changes and other hassle!

Best wishes

Iamfuzzyduck profile image
Iamfuzzyduck in reply toKMRobbo

wow, that sounds scary! I’m glad it was a success!

frazeej profile image
frazeej

Be wary. Just as surgeons exist to operate, EP's exist to ablate. Listen to your hopefully (?) unbiased regular cardiologist.

ozziebob profile image
ozziebob

As you live in Houston, why don't you investigate the mini-maze procedure, invented and performed by Dr Wolf. I haven't undergone any surgical procedures yet, but after my research, a mini-maze is the one I would choose, if it was available to me.

See wolfminimaze.com

Good luck.

Iamfuzzyduck profile image
Iamfuzzyduck in reply toozziebob

I do have an appointment with Dr Wolf but it is a much longer and more invasive procedure and I don’t think I need that at this stage of afib…

ozziebob profile image
ozziebob in reply toIamfuzzyduck

More invasive than a catheter ablation? 🤔

Iamfuzzyduck profile image
Iamfuzzyduck in reply toozziebob

I believe there is more risk? I am uncertain but the procedure is longer, recovery time longer and there are two incisions. It looked more scary to me, but i can definitely go and see what he can do for me. It was just what i was reading but i could be completely wrong..

Cangelo629 profile image
Cangelo629 in reply toozziebob

Yes Mini Maze is a more invasive procedure over a catheter ablation and of course your exposed to more complications with the Mini Maze.

ozziebob profile image
ozziebob

I see working on the outside of the heart, as in the mini -maze, as "less invasive" than a catheter ablation which burns the inside of the heart. Ouch! But I can see this is a personal evaluation.

In addition though, with catheter ablations, a lot of patients go through multiple procedures, often without long term success. I'm trying not to be negative, but need to communicate as best I can my feelings/thoughts on the different approaches. Of course I also am open to correction in these matters.

There are plenty of Wolf videos on his website or on the Houston Methodist YouTube channel explaining the mini-maze procedures and Dr Wolf's thinking re the causes of AF.

Good luck.

Iamfuzzyduck profile image
Iamfuzzyduck in reply toozziebob

interesting-I do have an appointment in February for Dr.Wolf already but I am new to afib and apparently need something done soon while it is less established. The EP said ablation is 80% effective but in my case he just needs to isolate one section and he thinks the success will be nearer 100 % in my specific situation but what do I know? Well Wolf was willing to see me so perhaps I should hold off on any procedure until I have seen him? Thanks for your input..

ozziebob profile image
ozziebob in reply toIamfuzzyduck

Yes, I cannot suggest a preference for you, as you just need to do a little research and choose wisely for your unique situation.

But second opinions are always worth considering, and as February is not far away, it would seem prudent to consult with Dr Wolf before your decision.

The axiom "act in haste and repent at leisure" is one you might want to avoid.

bassets profile image
bassets

`sorry about your family problems - I hope they are both ok now? It's great you have two avenues to go down to sort out your Af. I was very glad to have my ablation and it has helped a great deal. Let us know what you decide to do.

Iamfuzzyduck profile image
Iamfuzzyduck in reply tobassets

My kids are doing much better, thank you. Good to know about your ablation , I am glad it worked for you.. I may be offered an ablation before I see Wolf, I hope I make the right choice!

bassets profile image
bassets

It didn't exactly work as Af broke through when I tried to come off the meds, but it was nothing like as bad as before. Now I am back on low doses of meds I have been in sinus rhythm for more than a year now and feel so much better. Do what seems best for you and good luck !

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