Cut loose from hospital support

[Suze43]

I posted a few days ago about turning down the offer of a second ablation as I've been in NSR for 12 months.

My arrhythmia nurse has just phoned and pointed out that, as I am 71, my time may be running out for the option of further ablations! Am I correct in thinking that there are plenty of people on here who have had ablations in their 70s?

We also had a conversation about a reference to 'dilated aortic root' in one of the letters I received from the hospital. He asked if I had high blood pressure when it is clear in my record that my blood pressure has always been on the low side (which is why I was desperate to get off bisoprolol). He said if I didn't have high blood pressure there was no need to worry about the dilated aortic root. Any thoughts on this?

The conclusion of the call was that I would now be discharged and and for any future issues I would need to be referred again by my GP. Fortunately my GP is very supportive as are the people on this forum and I am so grateful for everything I have learned here.

[Jalia]

I had ablation no 4 in my 77th year.

[Suze43 in reply to Jalia]

That's reassuring, thank you.

[Rosie1066]

I was going for one when I was 74 but they then decided to go for Pacemaker instead. No more AF since I had it fitted in June last year.

[Suze43 in reply to Rosie1066]

Glad that's worked for you.

[Sharonsue in reply to Rosie1066]

I am suppose to get a Pacemaker next month. What is the recuperation after getting it? Did it work correctly from the start?

[2learn in reply to Sharonsue]

Hi, I got a PM. I was told not to lift ,push or pull anything above my head for a few weeks, but apart from that it was ok. I was checked out by hospital PM department within a month and still get annual checks and they are available at short notice.

[Finvola]

A friend had an ablation at 76 and a follow-up at 78. He's like a new man.

It's good that your GP is supportive - it means a lot. Long may you remain in NSR.

[Suze43 in reply to Finvola]

That’s great.

I had never had a face to face appointment with this particular arrhythmia nurse so he had no concept of my general state of health (which I think is pretty good for my age).

I would not hesitate to have another ablation should it become necessary.

It would be interesting g to hear from anyone who has maintained NSR for several years after their first ablation.

[vent in reply to Suze43]

My AF was first diagnosed in Apr 21. I was hospitalised with it in Apr 21 and Jun 21. I had. Crying-ablation in Sept 21. I was put on Bisoprolol and apixaban. No Issues after ablation except low HR and dizziness. NHR resting was always ~ 60 , with Bisoprolol it was ~50 but fell to 44-45 each night. After NSR for 1 yr I stopped Bisoprolol with agreement of GP. Was discharged by my Heart Consultant. Now after 2yrs & 4 months no further AF😀

[Suze43 in reply to vent]

Good to hear if your success and I’m sure, like me, you are also happy to be free of the bisoprolol.

[mjames1]

Two ablations in my 70s. See another doctor. You're getting bad advice if age the only reason.

Jim

[Suze43 in reply to mjames1]

Yes I'm afraid I've been unfortunate with the arrhythmia nurse I was allocated. This forum is far more knowledgeable.

[mav7 in reply to Suze43]

. This forum is far more knowledgeable.

Be cautious Suze, be cautious. Experiences are shared here for good info, but trust your medical professionals (may want a 2d opinion) which are familiar with your medical history.

if I didn't have high blood pressure there was no need to worry about the dilated aortic root. Any thoughts on this?

Have you had a recent echocardiogram ? Seems doctor thinks your aortic root does not need to be addressed at this time. You may want to google for more info on an aortic root and ask doctor for further explanation.

Best to You !

[Suze43 in reply to mav7]

I started my PAF journey over 10 years ago & had 2 excellent arrythmia nurses that I trusted implicitly. However, after my ablation in 2022, the whole department had a reshuffle and I was allocated a new nurse who did not inspire confidence. I have never had a face to face appointment with him nor with an EP apart from the day of the ablation.

My last echo was immediately after my ablation. I did google aortic root and was somewhat alarmed so will be discussing this with my GP and hope he will be able to request an echo.

[OzJames]

if it is available to you maybe a 2nd opinion. I had a conversation with my cardiology office and they were happy for me to get a second opinion and referred me to an EP. I went and had an overview of my history with him and about ablations and he said I would be a good candidate for ablation however I am currently in NSR as well and will wait and see and feel much better having spoken to the EP.

[Suze43 in reply to OzJames]

I cannot access the arrythmia team again without a referral from my GP but I would pay for a consultation if necessary. The ablation has produced the outcome I was hoping for in terms of NSR so I just need some clarification about the aortic root dilation.

[hanne6263]

I'm 80 and had my first ablation last November after almost a year in constant AF. My age wasn't an issue at all. I'm now in NSR, long may it continue!

[Suze43 in reply to hanne6263]

Great to hear this 🙂

[Steve112]

This is why face to face consultations remain absolutely essential..She has no idea whatsoever of your overall condition and ability…Good that you have a supportive GP something increasingly rare in these strange days.

[Suze43 in reply to Steve112]

I was shocked to only be offered phone appointments. I had to ask my GP to organise a full ECG & he’s also done blood checks for potassium, magnesium etc. I know I’m lucky. I would feel very vulnerable without his back up.

[Fullofheart]

I would be reluctant to be discharged. It's great that you are in NSR but I'd still want to be monitored.Could you ask if there is an option to be reviewed in 12 months?

[Suze43 in reply to Fullofheart]

I didn’t have a choice. I will need my GP to refer me again if I need further support.

[Ppiman]

My brother-in-law has dilatation of the aorta, but with no AF, although he has had a replacement mitral valve many years ago as well as what might once have been a small stroke, also some while back. He remans under a cardiologist and has an echo-cardiogram, I think every year or two to check if the dilatation has increased (which isn't the case so far, I gather).

From reading, I think the link with other cardiovascular issues, such as blood pressure, remains hard to show. It seems that other changes, such as kidney function, might offer a better measure of whether the dilatation is a worry or not.

The arrhythmia clinic cannot, I suppose, likely offer much more help than your GP is able to, hence signing you off. As a born worrier myself, I would likely find myself wanting an echocardiogram at some point in the future to keep an eye on things but I suspect you can rest easy.

Steve

[Suze43 in reply to Ppiman]

The results from my annual blood tests at the end of last year showed the kidney function was fine so that’s reassuring. My GP is very thorough and I’m hoping he will arrange regular echocardiogram’s.

[Ppiman in reply to Suze43]

Mine hasn't arranged one and I was told by my cardiologist that they would be worthwhile as I have a bundle block (LBBB). I keep meaning to ask him about it but, like many of us I guess, especially with my worrying temperament, ignorance is bliss!

Steve

[kkatz]

1st at 73.

[Suze43 in reply to kkatz]

Hope it was successful and you’re in NSR

[kkatz in reply to Suze43]

Actually it was age74 .Feb 2023 .Still in NSR.And I would happily have another if needed.I had similar experiences with one Arrythmia nurse .At start of switch to persistent I was told possibly too old & too many comorbidities to be able to help but organised 24 HR monitor.Afib95% of time .Same nurse told me after failed cv that I would have to get ECG & new referral from

Gp.

Rang back spoke to different more senior nurse who said this was wrong and discussed ablation with me.

But I presume you have asked why they offered ablation?

Anyway long may you stay in NSR.

[Suze43 in reply to kkatz]

I had quite a few ‘ blips’ during the first 6 months after the ablation - short, minor episodes of PAF that resolved quickly, quite a bit of tachycardia & lots of ectopics. Even though I felt things were settling my arrhythmia nurse insisted I either went back on bisoprolol or the waiting list for a second ablation. I didn’t feel I needed either at that point but agreed to the waiting list so I could see if AF would break through or if everything would settle. Fortunately, I have been in NSR for 12 months now so declined the offer of a second ablation. Like you, I would have another IF it was needed.

Hope you stay in NSR too.

[Tapanac]

I’m 80 this year and I am still being given the chance of an ablation if my recent insertion of a pacemaker doesn’t help and it’s the more complicated left sided 6 hour GA one apparently

I had my first ablation when I was about 75

Maybe a different EP is called for?

Stay well

Pat

[Suze43 in reply to Tapanac]

I had no interaction at all with an EP until the day of the ablation. He obviously did a good job as I’m now in NSR. However, I have no confidence with the arrhythmia nurse who has been so poor with the (lack of) follow up.

You stay well too.

[GordonS]

I had my first ablation at 60, 2nd at 68 and am now aged 73 on the waiting list for number 3. I am in persistent AF controlled by Amiodarone and Bisoprolol.

[Suze43 in reply to GordonS]

Hope it’s 3rd time lucky for you.

[momist]

As you've been advised, age is no barrier. If you don't have any recurrence of the AF, all is well and you are well free of that hospital's incompetence. If it comes back, a referral from your GP to a different heart centre would be indicated. You are entitled to go "out of area" if you choose to.

[Suze43]

Thanks, I’m hoping the NSR will continue. I have no issue with the EP and his team who carried out my ablation. The arrhythmia nurse (& an inefficient secretary) were the problem.

[2learn]

Hi, from my own experience I get a yearly check up with consultant and my GP refers me if there are any other issues. Aged 74