After few initial episodes (20-30min each) I went on meds (biso & propafenone daily) and everything ok untill early December when I had a few short episodes again which I strangley stopped with vagal maneuver. Since then episode free. Stopped the biso 30 days ago since it made me dizzy. All ok. My BP is almost always around 117/70 so pretty good. As I'm nearing my ablation (in 15 days), naturally I'm having my doubts more and more in my head. Although I know this is probably the best way to deal with my afib since I'm 41 and I really don't want to be on propafenone for the rest of my life and in constant waiting of a next episode, I still have a turmoil in my head about the whole thing.
I rationalize to myself that since I didn't have an episode for more than two months and I made a lot of changes (lost 25kg, lowered cholesterol, healthy diet, no alchohol) I have doubts if ablation is worth the risk and if it's maybe too soon to have it after only 4 months after the diagnose.
Deep down I know it's fear from the procedure doing all this talking.
Also I'm starting apixaban (Eliquis) today for pre-op. And in my country they do the ablation with local anesthesia and sedation. Hopefully I will be high enough during the procedure to just not be bothered. But the waiting of the day is the enemy currently.
I don't know, just needed to vent. Maybe some words of comfort?
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NewOne2023
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Oh been there, done that. The morning of my first ablation I even developed cold like symptoms - sore throat, runny nose etc. I was staying in bed but Hubble dug me out, got me to the hospital where nose and throat swabs were done - all clear! Symptoms vanished. I’m really good at somatising anxiety!
Well done in all of the life style changes, they will serve you well and give you the best chance of sustaining NSR.
At the onset of my AF journey, my AF episodes could be up to a year apart, but they got more and more frequent, however, I left it too long (didn’t even know ablation existed until 2013 as was never offered at my local hospital). With hindsight - I would have gone for ablation much, much sooner at the 2-3 episode mark. I had 2 ablations, gave me about 3-4 years of being AF free but I was near my 60’s when I had ablation.
You have the best chance by going ahead with the ablation now, look forward to putting AF behind you - for good.
I think it would be odd if you were not full of anxiety . I had three between 2004 and 2008 when my AF finally ended but to be honest I was so symptomatic that I was almost on my knees pleading for them to do it. Frankly I would rather have an ablaation than root canal dental treatment!
Relax, take some deep breaths and look forward to the new you.
Yeah that's the thing. Since I didn't have a lot of symptoms and a lot of episodes in these 4 months, my mind is less eager to do the procedure. I would probably look forward much more to ablation if I was in constant afib or much more frequent episodes.In contrast, I have a friend who basically got diagnosed with afib one month before me and he's also doing ablation 10 days before me with the same EP. And he is even more stressed about it than me because he only had one episode of 6 hours in the begining and nothing after that. He also had an episode 3 years ago, and that's the reason they advised him to go forward with procedure.
One thought is that Propafenone should, strictly speaking, not be taken on its own, but should have a beta blocker or calcium channel blocker added for safety. So that’s two drugs for life. Well done on the lifestyle changes but you clearly have a tendency to AF which is much more easily treated the earlier it’s done. So go for it! (Resisted the temptation to say ‘Man up!’)(Nearly ☺️)
Tnx for the comment. I did take bisoprolol and propafenone daily but 30 days ago in consultation with my cardiologist I stopped it to see if the dizziness and low heart rate stops, amd it did. I don't feel dizzy anymore and my hr is now around 60-70 at rest. I had a good blood pressure even before taking bisoprolol. Cardio told me since it was 1,25mg dose that I should not get whitdrawl symptoms which in the end was true.
Today was my first day on Eliquis and I must say I did feel dizzy few times already. Not too much that I needed to sit down but enough ai can feel it. I don't know if it's due to apixaban first time use.
Propafenone alone was ok for me to begin with but then caused tachycardia episodes so diltiazem was added which slowed my heart too much so I can’t take it any more.
I rationalize to myself that since I didn't have an episode for more than two months and I made a lot of changes (lost 25kg, lowered cholesterol, healthy diet, no alcohol) I have doubts if ablation is worth the risk and if it's maybe too soon to have it after only 4 months after the diagnose.
First, congratulations on the weight loss! Second, I don't you're rationalizing anything, but rather are having second thoughts based on logic and evidence based medicine.
Losing more than 10% of your body weight in obsese individuals can have a significant impact on your afib. Multiple studies show both a dramatic reduction and even elimination of afib burden.
So, if your ep hasn't first suggested a trial off of daily propafenone, I think they are not doing their job and rushing to ablation where a watchful waiting approach may be indicated.
If it turns out that you need daily propafenone to keep you in rhythm, then by all means consider an ablation. But if a trial off of propafenone shows that your lifestyle change, including weight loss, have significantly reduced or eliminated your afib, then you have saved yourself an unnecessary ablation. And remember, ablations are not small procedures without risk and one ablation can often lead to another and scarring among other things can result.
Based on what you said -- and the experience of your friend -- sounds like your ep is one to rush to ablation regardless of circumstance. but remember the decision is yours, not theirs.
I understand your view. And deep down I'm still really torn in between. But there are some reasons that are pushing me to do the ablation now.
For instance, I have kinda stressful job filming weddings. Right now it's off season and I'm feeling alright editing at home. But in less than 3 months we start our season and it's going to be a full one which means a lot of situations where afib could kick in. Don't get me wrong, I love my job but it's stressful in some situations. So I'm not really keen to risk doing my job on meds and if they fail on me (like they did on 9th of November when I went into afib during filming of ceremony) I can't just stop my work since clients depend on my filming.
Another reason I would be more focused to try the ablation is the anxiety disorder issue that I developed from the diagnose. I battle with chest anxiety due to whole current afib reality. I'm not crippled by it but it does bother me. I tried 2 professional psychiatrist but nothing changed. I think some of it could subside after the ablation. Don't know.
And in the end I had 2 periods of episodes even though I was on meds at that time so basically not really protected from afib. In addition I have side effects from propafenone. And I take them 2 times a day. I just want to stop this, I feel these meds are not great for the body in the long run, but thats my laiman opinion of course.
My EP really didn't rushed me into it. He told me it's my decision in the end but his opinion is that I'm too young to be on the meds for the rest of my life and I already had 2 periods when meds didn't help. He told me that its really great that I managed to change so many things and that this is only going to help after the ablation in the long run. But he advised me that now is the best time to do it, while it's still early in the process and basically that in majority of cases it only gets worse with years.
We had this discussion in December and I had plenty of time to process everything.
But the fear factor is always here.
Anyway, thank you once more for the lenghty reply.
You make some good points. If you feel you've given yourself enough time post weight loss to access the situation, then ablation does make sense. If not, then you know my opinion
As to the procedure itself, I would not worry about the local/sedation versus General. Sedation means faster recovery time and potentially less complications. Personally, that would be my choice. Most seem to do just fine with sedation, but always a good idea to have an agreement beforehand, that if you express discomfort during the procedure, they will up the sedation.
I think you've done so well with your lifestyle changes! Two.months being AF free doesn't mean its gone though. I'm not being negative here. Jim makes a good point about seeing how you do off the meds as an interim. You've also mentioned sometimes the meds haven't seen AF off - is that right? That's also something to consider re ablation.
Yes, in early December I had a few episodes despite being on propafenone (3 x 150mg daily) and bisoprolol. These days as I mentioned, I take propafenone twice daily, no bisoprolol and yesterday started Eliquis for pre-op.
I'd say go for it. I've had it twice. First time under sedation which didn't work so well. It wasn't that I couldn't tolerate it - apparently I was still wriggling when unconscious and with my being small they couldn't give me any more sedative. 2nd time I had a general anaesthetic and it went much better.
My biggest regret with having an ablation is I didn't have one sooner saving myself months of constant highly symptomatic persistent AF (breathless/sweating/feeling ill) with no quality of life.
The cryoablation itself under sedation was no big deal and preferable to the nightmare root filling I had a few months earlier on a calcified tooth.
When I went into the cath lab in Coventry under the care of a competent experience team I used my slow breathing excercise and counting breaths to help keep me calm and to distract my mind, the whole thing was over faster than expected . I was constantly asked if I was ok and to signal if I wasn't and needed more sedation .
Good luck NewOne 🙂 I am now out of the 3 months blanking period and appreciate every day that I am in normal sinus rhythm .
The drugs (sedative) will be a blast, you will have a minor wound in the groin that will heal within a few days and maybe you will need to take it easy for a few weeks afterwards (that's the general advice).
Well done on the life changes - those were way way harder to achieve than any "struggle" the ablation will cause.
Well I meant the procedure risks. I know it's presented as a low risk and safe procesure but still, every procedure brings some risks. And to be honest, in my mind a procedure on my heart brings much more fear than a procedure on a knee or the back for example.
I would have said postpone the ablation for a year until you have fine-tuned your Lifestyle and medication options, as in my view you need to be gagging for it not in two minds.
However, my thoughts changed when you mentioned work stress. I guess you would be unwilling to pivot to a new angle there, so on balance my vote would be ablation...only just!
Well, I do film other kind of projects besides weddings like short ads, real estate videos and event videos and those are much less stressful than weddings. But weddings are the majority of our income since they are paid much more than mentioned type of videos. Of course it's not only the money, I do like to film weddings, but the editing and delivery part is much more enjoyable for me since the filming of that day can bring a lot stress since I need to keep in check a lot of stuff. From handling 3 cameras, drone and microphones to constantly being aware to notice the best moments. It gets exausting but it's worth the hustle. So I need to be at my best with my health, especially mentally. Since I already had a 'mishap' on our last wedding in Novemeber when I went into afib during the couple's exchange of the rings even though I was on bisoprolol and propafenone, it's a fair example that It could happen again this season and I really want to avoid that.
Luckily my episodes are 'only' irregular heartbeat and mixture of fear and anxiety with no other symptoms so I did manage to ride it out while filming (still can't believe I did that ) but I was exhausted afterwards and I still needed to film for another 6 hours, but I did it.
So I would like to think that ablation in addition to my lifestyle changes would help me much more than 'meds only' in that kind of situations. If I still get episodes I hope it will lessen my burden and at least I tried both paths and I will cross that bridge when it's time.
Sadly my afib journey has lead to no surgical or cardioversion intervention. Go for it NewOne and don't worry about the procedure. Let us know how you get on.
The procedure itself will allow the surgeon/specialist to see what is going on with your heart. That's a plus. No more guesses.
You have made up your mind.
Therefore what you need is positivity on the decision you have made.
Remember that these procedures create scarring and there is no going back.
Perhaps go over everything again, make a decision again and move forward.
Its like any decision, you make it maybe you retract and make your decision again maybe to double check yourself, whether it is the same or different .. move forward.
hi, at your age with another 20 years ahead of work I can understand your anxiety of being under threat of more AF episodes. Being on heart medication for half your life is obviously not perfect and most drugs have side effects. Ablation these days is far more precise and with higher percentage of effect, but it’s not a lifelong cure. You need to learn to manage your stress triggers. Too much adrenaline affects your heart and that causes all manner of problems.
Have you considered hypnosis or therapy? If you are of a nervous disposition then maybe trying that first could decide what you do next.
I’ve now had 4 ablations! My original cardiologist kept medicating me for my paroxysmal AF for years, until it eventually became persistent. When ( eventually) I managed to get referred to an EP he said I should have come to him when it 1st started. Success of ablation much greater when done early, before becomes entrenched. Hopefully latest ablation (3 weeks ago) has done the trick, but not convinced! Get it done while you can.
I'm sure my fear will culminate on the day of the procedure, but I keep telling myself that they will give me sedatives which will relax me and at that point I won't be worried anyway. But the anticipation is the problem.
Hi, have they not given you the option of GA? I was your age when I had my first in 2007ish, second 2012ish & Nov 2022 had my third. The latter was GA I’d ask for that again.
Ask your consultant about sedation or preop meds if GA or GP may prescribe a sedative for night before - ate the alarm clock loudly so you get to your appointment on time 😂
Fear of the unknown is scary, try to find something relaxing that you can do any time of day or night that becomes automatic if practiced enough. Listen to music the minute you feel tense - maybe if it’s a particular piece but you can’t play it that moment sing or hum it inside your head to distract from the anxiety.look up box breathing, or headspace has 10 free sessions of meditation etc I’m sure you really will be fine x
Well I'm not scared of being awake for the procedure. On the contrary, I would be more scared if it was GA since I can't fathom the concept of being put to sleep on purpose. So I'm ok with being awake but I will ask them to shoot me up with enough sedation that I relax or even dooze. My fear is from the whole procedure and if it goes well. But I don't think there is a person who wasn't scared of this.
From almost 130kg to 105kg currently. But I didn't loose that amount in only 4 months. I started to lose weight few months before my diagnose and after the initial afib days that just sped up due to complete change in diet, stopping alchohol and sugar. I'm kinda big guy all my life so around 95kg would be my ideal weight. So still few kg's to go.
Hi NewOne, apologies in advance for putting you in even more doubt, but i first experienced Afib in my mid-40's. After 4 years of living with it (my Afib occured roughly every fortnight, usually during exercise, and would last approx 24 hours) without medication as none of the meds prescribed to me ever worked (i.e. didn't stop the episodes and only made me feel worse, due to slowing my heart rate down to mid-40's and feeling lethargic). After first ablation my condition actually got worse, i was having Afib more regularly, and i was back on the meds again (Fleccanaide and Metropolol), however this time is was now passing out each time my heart kicked back into NSR. So doctor told me i needed to stop driving! ( i didn't listen as it would have meant me losing my job). In retrospect i would have been much better off not having the procedure. However given that things were now worse than before the doctor suggested a 2nd ablation a year later. Still no joy unfortunately but my heart was a little bit closer to being back to how it used to be, but still not as good as pre first ablation.
I have since had a 3rd ablation (just last year with a different EP), who did a better job i think but hasn't fixed my Afib, i still get it about once a week and now on Sotalol which i tolerate really well except it does suppress my heart rate a touch which means when i exercise my tolerance is not as good as it was without Sotalol. However i seem to be in more control than i have ever been since the first ablation back 7 years ago, and by that i mean i can usually predict when an episode is coming as you can almost set your clock by it, and therefore i can work around it.
I am still exercising, and for me at least, i honestly believe positive lifestyle changes have had a much better influence on my condition than any ablation (limiting alcohol, avoiding stress of any kind, keeping fit, eating healthy, and most importantly getting a good consistent nights sleep every night).
I know how you feel, you want your Afib cured and EP's will tell you they can, but trust me a lot of the time they can't, but like i said every one is different. Only you can decide what path to take.
I am scheduled also for my ablation next Tuesday. Like yourself I am fearful of the procedure and have been on medication for 2 years. I am very fit and a former athlete and was also in a stressful senior executive job. Since giving up work unfortunately my Afib condition progressed so I don’t think stress was the trigger.
I am now 60 but have kept myself in very good fitness health. Exercise does not seem to trigger Afib and it has generally occurred when I am resting or sleeping.
While an ablation is not a cure from the research I have done it offers the best chance of managing this condition without medication.
I will be going under GA and it will be an RF ablation. The EP has given me a 70% success rate and said that it is best to do the ablation while you are in good health.
Good luck with your decision and only you can decide what is best. You are young so you probably would have a higher success rate.
Thanks for the reply. Like you, my episodes occured always in bed either while I was resting, waking up or went to sleep. Only once I had an episode while standing in the middle of the day, but that was stress induced for sure since it happend during a stressful moment while working. I will be under sedation but awake and that's fine by me, I'm just gonna tell them to crank up the sedation because I want to be relaxed as much as possible and I don't want to feel any pain but from I read there shouldn't be any pain except strange sensation.
Everyone is different. For me the challenge will be the recovery. As I am a very active person and it seems the healing process can be a bit of a roller coaster. Medication I am on now seems to work and at best I can come off the meds or at worst I continue with the meds. Like yourself it is not an easy decision. I had booked and cancelled the procedure previously as fear took hold. Now I am mentally preparing myself to go ahead.
For me, it all seems quite fast. Just over 4 months from the diagnose to basically doing thw ablation seems really soon. But taking in consideration that I had episodes even while on meds, the incoming stressful work season which I need to follow through and deliver to the best ability and prevalent information that the ablation early in the process especially for a younger patients like myself are coming with better success, I also feel this is the right thing to do.
Hi there, i too was diagnosed with AF mid november last year. MY AF was diagnosed as persistent ( yours sounds like paroxsysmal), so mine was beating from 53-115 BPM. My first indications were occasional breathing issues; difficulty catching my breath sometimes., and when using BP equipment at home it came up with irregular heart rhythm. I too was prescribed Bisoprolol, 1.25 mg to reduce rate, however, increased to 2.5mg by cardiologist in December. We agreed best treatment was ablation ( cryoblation) which I had 3 weeks ago and also had to take apixiban for min 3 weeks prior to procedure.
I was also very apprehensive and struggled a bit with anxiety- however much you read that its a minor op - its still invasive and carries risks, however, these are very very small.
The procedure took 1 1/2 hours and i have been in sinus rhythm since and now exercising a few times a week - my heart does not go above 120 when cycling ( was upto 215 prior to op!) and averages 80 BPM at rest - without this constant 40BPM fluctuation just sat down!
So far, everything for me has gone well and recovering well, though, as I'm sure you have read, you dont leave hospital and everything is back to normal - it does take time to fully recover.
I wouldn't hesitate to have this done again if I am one of the unlucky ones where AF returns - with persistent AF success rates are around 50/60%, though for paroxysmal, this rate is higher, i believe around 70/80%.
Im sure you will look back and also think that ablation was a very good decision.
Look, no one wants to be on meds for the rest of their life for any condition, but please consider that at the age of 41 you need to make sure your quality of life is the best as possible. I say this because ablation is NOT a cure. You will get AF again sometime again, be it years or decades later. A chance for a possible second ablation or meds will be available to you again. Do yourself a favor and possibly get yourself some great AF free years before trouble brews again. Also make sure that you always take care of yourself. A healthy weight and regular exercise do wonders. Be aware that prolonged PPI use (for acid reflux), thyroid issues and sleep apnea can delay your progress and bring back AF, so make sure those are checked not only now, but in the future.
I had an ablation at age 51. It was 18 months after my AF diagnosis. Meds did not work very well for me, and as you know the side effects are usually low energy. I would do the ablation again in a minute, no regrets. I am in the US. Best of luck to you.
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