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...
Update on many PACs and EP visit - Atrial Fibrillati...
Update on many PACs and EP visit
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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
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.
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…
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.
his advice is consistent with the more recent extensive European advice and is what my excellent EP would say .
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.
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…
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.
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
Be wary. Just as surgeons exist to operate, EP's exist to ablate. Listen to your hopefully (?) unbiased regular cardiologist.
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.
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…
More invasive than a catheter ablation? 🤔
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..
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.
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..
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.
`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.
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 !