Today I went and seen my Electrophysiology specialist and have booked in for an ablation in 2 weeks time.
I am quite anxious about this whole procedure. He advised me it would be a 70% success rate and mentioned he does not like quoting over this rate. 70% is based on having no more AF episodes and medication free.
He mentioned if I leave it to long and continue with medication there is a risk that an abalation would not be successful especially as you age and could develop other medical conditions. If that occurs he probably would not recommend an abalation. He advised that I am in good health and from my echocardiogram my heart seems fine.
I am aiming to get back to some level of normality and trying to be positive about the abalation. My wife has seen me go down hill with the AF episodes. My anxiety levels are high and not sleeping thinking about this awful condition and now the abalation.
I am sure there are people out there that have gone through similar experiences.
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Murphy10
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So many of us have had ablations, nothing to be anxious about but be clear as to what is and is not possible and about recovery.
You as the patient have the easy part, you just lie there. It’s your doctor’s job to do the worrying. Was it decided to use sedation or GA? Pros and cons for both and often is influenced as to whether or not an anaesthetist is available, patient and doctor’s choice. You do need to keep very still if sedation is used and although you are asleep most of the time, you may have some sensation. The advantage is faster recovery as GA drugs can stay in your system for some weeks.
Recovery time varies but during this time you do need mind yourself and not overdo things and doctors’ often underestimate the time it takes to recover so read this leaflet - written by members of this forum who have been through the process so know what the doctor’s don’t tell you.
You need to consider as to whether or not 70% chance of being AF free and off all medication is good enough to go ahead. Factors that affect success:=
Skill of the EP and the equipment used - research both
Age and fitness of the patient - do all you can to ensure in best health
How long AF has persisted, the AF burden - how often and how long episodes last (assuming it is PAF - paroxysmal AF and not persistent - and how long you have been having AF for.
The location of the source of the rogue signals and how easily the EP is able to get to them.
Expect some episodes following ablation - it’s normal and don’t think it’s failed.
Expect your heart rate to be higher than normal - you have just had the inside of your heart burned (by heat or freezing) so there will be inflammation so your heart will let you know it is somewhat irritated - literally.
Know that worry to some degree is warranted but excess worry and stressing yourself is actually harming yourself so get some strategies in place for dealing with it. Breathing exercises, relaxation exercises, easy mediatation - plenty online to explore but I strongly recommend Yoga Nidra (literally means yoga for sleep) and is basically a progressive relaxation exercise. Many choices on YouTube, all free.
My first ablation made things a lot worse so I had a second 3 months later and that left me AF free with no meds for 3 years. YEAH! That was in 2013/2014 so big advancements in technology, skill and knowledge since then! That is not an unusual scenario for people over 60-65. When the AF returned episodes were MUCH less bothersome.
I have had a pacemaker now for the last 5 years and virtually NO AF at all - I had a rough time when I got COVID and AF stuck around a bit for a while but my AF burden is now 2=4% - I live easily and well with that as I take no heart meds, other than anticoagulants which I am glad to be on for life.
Ask any questions - thousands of us have had 1,2,3 or even a post recently 6 ablations.
Thank you very much for your response and information provided including the recovery information.
It was recommended to be put under GA.
Fitness wise I am reasonably fit and was an ex Navy Diver and instructor and keep fit now by doing bike riding. I have had a couple of health issues such as DVT twice with both clots travelling to my lung. Very lucky I got to them in time and have had no further issues!
I believe I have had paroxysmal AF for over 4 years and only realised that it was AF when I got an Apple Watch 2 years ago and it notified me of the condition. I used to compete in bike riding and often would feel very fatigued and felt my heart race and shortness of breath. I put it down to pushing myself too hard but it was likely AF now knowing what the symptoms were.
Up until recently I have been AF free for approximately 12 months and was on Solotol and apixiban. Unfortunately just recently I had 4 episodes of AF with each one lasting over 12 hours. All times my heart eventually went back into Sinus Rhythm.
What frightened me today was the EP was concerned of both the dose level of the new medication my cardiologist prescribed. He said to me that if I keep taking this medication (Flecainide - 200 mg per day) there is a good chance that it could result in permanent structural heart issues an a abalation may not be able to be done. He also said from my last ESG and the ESG done today he can already see a difference in my heart rhythm. Still in Sinus Rhythm . I have only been on the new medication for 1 week so it made me think whether he was pushing me into abalation. I have had no side affects of the new medication which he was surprised and no AF since taking. I did however reduce the dosage to 100mg a day which he advised he would never prescribe more than that.
Do you think it is worth getting a second opinion? This is one EP view and would hate to undergo an abalation and the condition gets worse. It seems abalation has become the first option to consider rather than medication. He said medication only has a 5-10% success rate and given my age and good health abalation was recommended.
He said to me that if I keep taking this medication (Flecainide - 200 mg per day) there is a good chance that it could result in permanent structural heart issues an a abalation may not be able to be done.
I am not against ablation. In fact, I've had two, however what the EP told you is very sketchy and may border on fear mongering.
If you do not have any structural heart issues to start with, I have not seen any evidence that Flecainide will damage your heart. So if this is a sole reason you're getting an ablation, I would definitely get a second opinion.
Thanks. He said just looking at my ESG while on Flec. for just over a week he noticed a difference in my heart Rhythm. He was very anti Flec. but did not offer an alternative. I think I will get a second opinion as I have had no AF while on Flec.
As my abalation is done under private insurance EPs do well out of patients like me.
Sorry, I think I missed the part about the EKG. Some EKG changes do necessitate either stopping, or lowering the dose of Flecainide. It is a very powerful drug that has to be monitored on the EP level.
Ask more details of WHAT concerned him on the EKG. Delve deeper - only way you can judge if the offer of ablation is based on money or a clear clinical judgement.
Thankfully, we in the UK do not need to worry about that aspect of healthcare and I fully understand why you think that way - I would also!
I had to stop taking Flecainide because I developed other more dangerous arrythmias known to be caused by Flecainide - luckily my EP had been looking out for them and regularly monitoring me. (Wide QRS)
My personal opinion is that I went for ablation because my personal experience was that drugs gave me complications to an underlying condition so I now have a red alert on my medical file to NEVER give me any of these heart drugs - so I agree with your EP. Much better to be drug free but each has a different opinion and seeking another, as you will see from the replies you already received, may confuse.
If you trust your EP the you need to go with them and decide for yourself whether or not ablation is your best route.
I would also strongly recommend that you read several books and blogs about exercising and AF - The Haywire and blogs from Dr John Day - cardiologist in Salt Lake City = particularly his blog on How to Cure AF. He also wrote a book of that name giving excellent information.
There is a lot we could do to help ourselves and speaking from experience - I know that many people, especially men, with a tendency toward anxiety use exercise as a self soother and because you can get a ‘high’ from exercise it is very difficult to stop as many then suffer withdrawal symptoms. Reducing exercise to a level your body can tolerat as we age is also IMHO really important. It’s no coincidence that SO many AF sufferers are bike racers, iron men athletes or marathon runners.
Sometimes less is more so detraining is also a learned skill. When we say Lifestyle adaptations - we mean EVERYTHING in your life may need adapting and that often means losing some of the things we used to do and now just cannot do in the same way and that’s really painful. For me it was competitive sailing and scuba diving.
Thanks for the reference re the books. I have toned down my bike riding and swimming. The EP I seen had no concerns with endurance exercise but I have researched and there seems to be a general view that it can cause AF issues.
I don’t want to frighten anyone who is taking Flec. Most of the research I have read seems to agree it is a safe medication having been around since the 1980s. There are some risks for certain conditions and like all medications they all have risks and benefits.
I will give him a phone call to understand this further and ask will he provide the ECG information to my cardiologist who prescribed Flec. Also if I need to stay on medication following an abalation he did not give me any answers apart from saying we will consider options if that occurs.
Interesting a 70% success rate with abalation is low when you compare to a heart bypass which has a 98% success rate.
AF obviously is more complex and science is still developing.
Hello, it is natural to feel anxious and concerned ahead of a procedure, I am sure all the Members will offer you their tips and advice based upon their own experiences. You may be interested in visiting the AF Association webpage to view some of our videos and download some of our resources, which contain a wealth of information:
I am sure there are people out there that have gone through similar experiences.
I would say exactly the same except I was given a figure of 60%.
I will be 8 weeks on Thursday this week and have felt really well since apart from one blanking period episode at day 6 which is not uncommon.
I found the whole experience quite positive but I had the same anxieties you have before and that’s quite normal too. They wouldn’t be offering it to you if they didn’t think you were a good candidate for success.
Thanks. There is a lot going through my head and I think the worst part is being anxious which turns into anxiety. You tend to think about the worst outcomes rather than the positives!
It sounds very positive for you and hopefully you have no further AF episodes and medication free.
I had an ablation in September and was terrified, but still went ahead with it. I think it’s human nature to be afraid of the unknown. I bet most people who’ve had an ablation, worried about it before hand, but we’ve all got through it and are ok, so I’m sure you will be also.If it gets rid of the AFib and you can come off medication, it’s worth going through with it. Good luck.
I took it easy for a couple of weeks afterwards and suffered from palpitations, for a several weeks. I’m still getting them now, but they’re not as often , so hopefully will stop eventually. I have been waiting for a follow-up appointment, which should have been in December. I now have one for February 16 th, which is almost 5 months since my ablation. All the strikes have obviously caused appointments to be delayed. Everyones recovery is different, but the fact sheets you get from this forum are better than the one I got from the hospital, so you should download it. All the best.
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