Ablate and Pace

[quiltergran]

I have had Atrial Fibrillation for nearly 30 years and have been offered an Ablate and Pace procedure. Can anyone tell me their experience and did it improve their symptoms.

[Rainfern]

I’m relatively new to AF but have been visiting this forum for over a year. In that time I’ve heard all good news about pace and ablate. Although no experience myself of the procedure, thanks to the good people here who have shared their experiences I no longer feel afraid of any longer term consequences of AF and treatments that may lie ahead for me.

[LadyLawson in reply to Rainfern]

That’s how I feel too 😊

[BobD Volunteer]

The pace provides a pacemaker to take over control of the left ventricle (main pumping chamber) whilst the ablate removes the heart's natural pacemaker, the AV node, meaning that the rogue signals in the left atrium can't affect your heart rate. In other words you should not then be affected by the AF in terms of energy etc but you may still be aware of the feelings in your left atrium.

Most people soon recover and report great improvement in their quality of life.

Hopefully one will pop by soon and re-assure you.

[CDreamer]

I had the Pace bit in preparation for the Ablate bit but the Pacemaker worked so well I did not proceed with the Ablate bit. Still going really well after 5 years with this PM and just had consult with the PM Physiologist who told me that my PM is now working nearly 100% of the time, I have no sensations from it and it was the best thing I ever did.

Be aware that not everyone has that experience and those who go on to have the Ablation of the AV node can still feel palpitations when in AF, as I can, but the symptoms are greatly relieved.

Don’t expect immediate improvement - it takes time to recover from the procedure and for your heart to recover so think more like 3-6 months to notice significant improvement.

The procedure of implant is very straightforward and done under local anaesthesia. I went onto the ward at about mid-day and was home eating dinner by 7.00pm

Hope that helps.

[DawnTX]

hi there. I had a pace and ablate a year ago on the 13th of this month. I wish I could’ve had it sooner for me. It’s been amazing. I am not telling you there are no rough spots and if they don’t tell you, it can take up to a year to heal inside. That being said, please know I was in heart failure also and had been unable to walk for almost a year because of my circulation, as well as the chest pain that brought tears to my eyes and shortness of breath. I really couldn’t do anything just so you know. They do the pacemaker first, but do not hook it up for me. It was a two week wait then they did the ablation of the AV node. They also hook up your pacemaker at that time. The AV note when blocked prevents the natural pacemaker from messing us up and once it is done, the pacemaker is the only thing doing what we need and that’s a good thing my heart failure has decreased since getting the pacemaker because my heart got to rest and start to heal. I have had tachycardia since my first a fib event a few years ago. If you don’t know about it, tachycardia is beating much too fast, a heart rate, and the best way I can describe it is it wears your heart out.

Previously, I had two ablations in the first year and a half following diagnosis. The first one lasted six months. I felt fine after it, but it just wasn’t enough. I ended up with a fib that needed to be blocked. The first was a cryo the second was RF and that lasted about a year and again I felt pretty good most of the time. I was going through an extremely stressful situation where I was living which I have no doubt contributed to my a fib coming back with a vengeance. it started when I was getting ready to leave Florida for Texas. That was in October. I finally got an appointment with a very well-known EP at DeBakey in Houston. he is the pioneer of the procedure he used on me and without getting into it I will tell you it failed horribly and he turned out to not be the doctor. I thought he was or the man. That is when I physically started to seriously fail. On top of it, I was living in a hotel for six months. I had the procedure in April and was abandoned by the Doctor Who never called me back when I was having trouble. It’s a long story I don’t wanna talk about it my procrastination could’ve cost me my life. Thanks to my male carrier lady. I found the most amazing Doctor. First the cardiologist who had me on the table for cardioversion within four days. It was amazing as if I had not even been sick. Unfortunately, it only lasted 3 1/2 weeks. Cardioversions are known to not last long. Some people are lucky. I will say, those 3 1/2 weeks were wonderful and I was grateful for them. Christmas week I was scheduled for another one and then to be put on Tikosyn and kept in ICU for five days because it is that potent and could have bad side effects. I didn’t care. I couldn’t stand the way I was. Anyway long story short cardioversion failed. They tried three times to get me into sinus rhythm they were having trouble getting me into any kind of rhythm it was pretty bad. I did not know how bad at the time thankfully. Because of the failure everything else was canceled. The medication was to go hand-in-hand with my heart in rhythm. in recovery my doctor told me we’ve got this you’re not going anywhere I’ve got you. Can’t explain how much I love this doctor and how he makes you feel so I truly put my life in his hands again.

am told I am unique, because not only do I have a pacemaker, but they did not have one to work for me and my amazing doctor thought outside the box got in there and devised everything just for me.

from the sounds of you it should be really normal and easy as far as things can go being easy lol mine was more complicated and longer but here I am no remorse whatsoever from day one

The hardest thing I found was not moving my arms around lol I always say I am Italian. I talk with my hands. It’s uncomfortable, but not really painful. If you’ve had one ablation then you know how it feels. I did get a horrible headache this time around. I forget what the reason is but it’s very common. I had it for about four or five days just so you know if you get it don’t be afraid of it. It might be miserable but it’s not uncommon. I also had an ache in my chest. I had forgotten that I had that after the other obligations also. Again not uncommon they will give you something for the pain and it’s uncomfortable but with a fib you probably already felt something worse If you have questions, ask your doctor or nurse and try to stay out of your head. Your heart rate should immediately be good. I was able to walk from the wheelchair to my car. You know they make you stay in the wheelchair for safety. But I was able to walk. I had arrived needing a wheelchair. I won’t tell you I felt perfect but darn I felt really good. You are going to feel discomfort just like any surgery. We forget that we have to heal inside and it’s very tender and many layers. Think about your finger when it’s cut and how it takes time to heal. Again if you think with common sense, it’s not scary. One final thing is no cardio no watch no oximeter. I drove myself crazy not realizing how extreme and how often your heart rate changes even just rolling over in bed in the beginning was exertion stress can really affect you, so if you You are gonna be stressed and make things worse. They all go hand-in-hand. My doctor told me to put everything away. Don’t look at my numbers he will take care of that.

speaking of which, I have an app for that it monitors me 24 seven And they can even take a transmission. My pacemaker is from Medtronic and I have a tech that can check it when I am there and even make changes but the most important is behind the scenes. It really takes a village and I can’t take those people. once I realize how much is done. My doctor works with all of these people and AP is not only a doctor and a surgeon. He is an engineer of sorts and has to know all the technical and software that goes along with the equipment uses and the equipment we get put inside of us.

I’m telling you all this to make you not worry, it amazes me how many people there are taking care of me just plain old me I feel like a princess these people really care about us. I learned all of this during a situation in July when my battery seemed to have lost several years of life. We don’t know what we don’t know, I just saw what was on my app. My EP brought me in immediately with his nurse, my tech from Medtronic and a special engineer on the phone who works behind the scenes and can see everything about my pacemaker and heart. He can also do things FYI.

Know this is more than you wanted to know, but I want you to see how amazing and wonderful pace and ablate can be. it gave me my life back.

[Megams in reply to DawnTX]

~Wow - hope you don't mind me jumping in here but found your post helpful. Had 2 lead Medtronic implant 16 days ago - next step AV junction ablation March.

Gives me some hope ~ thanks again~

[Nannysue1]

Hi. I had the pace and ablate procedure, September/ December 2022. Best thing I ever did since my first bout of AF 10yrs ago.I'm a real baby and dreaded the whole thing. Luckily for me , somebody else on here going through exactly the same as me at the same time.

She had the pacemaker a week before me and talked me through that and I had the ablation a week before her and hope that I was helpful back.

My outcome was a complete success and I'm no longer aware of the AF. It definitely gave me my life back., not in a dramatic way but in that, I can do everything that I could pre AF.

I have a Medtronic pacemaker and the app on my phone which allows it to be monitored remotely. It's all very clever stuff.

I wish you well and if there's anything that you would like to ask please do.

[Golfer60UK]

Good morning, I had pace and ablate two years ago and have been back to normal activities since, golf too. I am feeling quite well without any adverse issues.

Bob's reply is spot on

Best wishes

Dave

[Hylda2]

Go for it! It will give you your life back.

[Hardjuice]

all reply’s are uplifting after Pace and ablate

Now look at mine

After AV node ablation I was out of breath walking to neighbours

Then out the blue I got co vid

Then got checked for chest infection

Clear no infection the doc said

water tables are no good to me as I have lymphedema not edema so stop the tablets

The few days later went to AE with breathing issues doc said I had a chest infection gave me anti biotics

I couldnt lay in bed really struggling

Went to consultant

Discovered my heart was struggling and left lung half full of water and my legs and stomach were massive

I’d put on over 3 stone

Left ventricle impairment

I was given 160 mg of fromoside to take daily

I started to drop weight a kilo a day

My body shrank inc muscle loss

My legs were the last to go down

The plan was to come off drugs following av node ablation

now I take 9

Have I improved yes massively

Was it co vid

Was it av node ablation the jury is still out

I’m still in recovery mode

Back in bed at night water off lung lost over 3 stone

So from pacemaker implant it’s been 10 month

Was I unlucky I think so

At 69 I’m back doing a bit

Able to get in my van again my massive legs wouldn’t bend enough to get in before due to water retention

Dropped to 40 mg of fromoside now

I watch my weight and adjust to suit

The pacemaker seems to be good

I’m 100% paced so I guess it’s working

Been a hard road past few months

My disappointment is I’m on more drugs not less

But I guess I need them

There are more positives from pace and ablate than mine hence the reason I took the plunge

If drugs controlled my AF maybe I wouldn’t have done it

I’m hoping my heart will bounce back

Once my consultant pin points the cause I’ll let the group know

Now I need to build my strength

Take care

[Tricia239]

Hi, I had a pace and ablate last October, the actual process was no problem and I was barely sedated and totally conscious of what was going on all the time - quite amazing. Apart from feeling some fumbling around the groin area (long time since I've felt that, ha ha!), I didn't feel anything, I expected to feel at least something when they actually did the 'snip' and although I heard them talking and agreeing they had got the right spot, I didn't feel a thing. I went home the same night. I made myself take it easy for a couple of days but quite honestly I felt fine and thankfully still do - except, I am very short of breath and at the moment no one seems to know why; I've started taking furosemide which has helped a bit but breathlessness is still a problem. I'm having an echocardiogram in a couple of days, so hopefully that will help find the reason and not reveal something awful (always a worry no matter what tests you have). I was aware that sometimes it can take a while to adjust the pacemaker to the right setting. What I would say is that it is lovely to be off the toxic drugs but even better is the fact that I no longer live in fear of going into AF; so very much worth it. The Consultants also told me that from their point of view it is one of the easiest procedures to perform. Feel free to ask any more questions, you could always PM if you would like to.

Good luck and best wishes, Tricia

[reinaway]

I had 2 lead PM inserted 18 months ago and then my AV node ablated 6 weeks after the insertion. I suffered with very symptomatic PAF for 12 years before that and had been offered P&A for some time before I plucked up courage to go for it. It has been a fantastic success and I now have no discomfort and can actually plan ahead without fearing I might have to cancel as I use to. I know everyone is different but in my case I'm so glad I went ahead. Best wishes to you.

[bushy2016]

I had pace and ablate in 2017 after 3 ablations that didnt work, everything has been ok until the last 18months where I am now feeling and been out of breath with af, Ive been told I will need another type of pacemaker and now on Known as the “four pillars” of heart failure therapy, these medications are beta blockers, angiotensin receptor-neprilysin inhibitors (ARNIs), mineralcorticoid receptor antagonists (MRAs) and sodium-glucose co-transporter 2 Inhibitors (SGLT2i).

[Ashburton51]

I had my pace and ablate procedure in 2022 and it was like a miracle cure. The pacemaker was fitted three months before the AV node ablation to ensure that it was embedded and healed before having the ablation and connecting the leads to my heart. It does take some time to recover and it doesn't 'cure' AF. However I really feel that I have got my life back and can do everyday things without thinking about how tired I will feel afterwards.

I had two failed ablations and changed my consultant. The one who did my pace and ablate procedure was brilliant. No one else had suggested the procedure to me so I was very nervous but my nerves were unfounded.

Good luck with the procedure, you will be able to enjoy life again.

[JeanetteH]

I had this procedure in October 23.The procedure was very quick much quicker than a normal ablation.It was painless.I just had to lie still after to ensure the entry wound did not bleed .I cannot feel any AF incidents if I have them.I have had glass of wine,or a couple of beers again no symptoms.My pacemaker was set at 80 reduced to 70 in December and will be reduced to 60 in June but the pacing team say they would do this at my next cardio apt in March( but this has been cancelled).I have started to do some gentle exercise walking on a treadmill however I have had a chest infection for weeks so stopped.I had a day where I had a lot of unusual beats and rang the pacing team who said it was ectopics and they wouldnt normally do anything about them but the pacemaker was still pacing.I would recommend it.It has changed my life.I am no longer onbeta blockers and can plan things without worrying I might go into AF.I had had 3 radio frequency ablations which failed I might add one a year ago.

[JeanetteH]

Oh I forgot to say I already had the pacemaker fitted as beta blockers made my pulse too slow

[Jholl]

I had a pace and ablate in June last year after having had persistent AF for ten years and two ablations, one of which lasted 4 months and the other only 6 weeks. They said there was only a 25% chance of success with a third ablation as I’d been in persistent AF for so long, so offered me a pace and ablate. It’s the best thing I’ve ever done. I felt better straightaway and even more so as time progressed. The breathlessness has gone, the feeling faint/nauseous has gone and I have loads more energy. I also feel mentally sharper now I’m not on the betablockers. I hadn’t realised how much of my feeling rubbish had been down to the AF. You get used to not feeling so good when you’ve been like that a long time and tend to tell yourself it’s just age (I’m 68) or that it’s not so bad. Once I had the pace and ablate I realised that wasn’t true. So glad I went for it!