I know I have asked this question before but I am still confused and I didn't get to speak to Dr.Natale for my pre-op, just his NP and she didn't have my ekgs with afib from ER. But, should I have an ablation considering I have only had one registered afib event of 44 hours (and I have probably had a couple of events during the past 10 years)- or should I have a linq monitor with Dr. Wolf to see what is going on with my arrhythmias (ironically I was given the go ahead for a linq monitor literally 10 minutes before my scheduled call with Dr.N's EP in Austin which threw me off a little). Basically I don't want to take risks I don't need to take, I am a caregiver of two with some serious issues and I can't afford to have anything go wrong, I just don't know what to do...
Afib free since November, should I ha... - Atrial Fibrillati...
Afib free since November, should I have an ablation or monitor with linq?
Hi - I am really sorry you are confused but as this is the third time you have asked this question which we cannot answer for you so I think you can imagine what I am going to say - only you can decide.
It seems to me however that you have already decided about going ahead with the ablation by saying Basically I don't want to take risks I don't need to take, I am a caregiver of two with some serious issues and I can't afford to have anything go wrong, I just don't know what to do...
Life comes with risks, some we can control and others not so we need to balance risk with benefits. Seems to me you are focussing on the risks - What might you GAIN from at least having the Linq monitor?
PS - I empathise about being a caregiver but surely you have some sort of back up plan for temporary and more permanent care? I think if you were confident in that care plan you would be more able to focus on your own health and well-being, which is intrinsic to your ability to give care.
The reason I have asked again is because time has progressed and I still have not had another episode and I am panicking about an ablation when no one seems to be looking at my records closely-the ekgs and rhe ER visit . I do have temporary back up for caregiving but the permanent one is a huge headache and massively worrying and sad. We can’t even get away easily for a couple of nights, so I am panicking. Thank you for your time.
I know little about Dr Natale I'm afraid but have heard wonderful reports of how Dr Wolf has completely cured people who have heart rhythm malfunctions.
Now if I said to you don't have an ablation and you had stroke, who would you blame? So I'm afraid I can't give a view as to whether you should have a procedure to prevent AF.
I've had 3 RF ablations but still have constant AF but it's at a lower rate now 60-90bpm. I can live a fairly normal life, need to build up my energy levels now that spring is here.
I wish that before having any of my ablations I had changed my diet drastically and cut out all foods/drinks containing artificial additives. I now eat less red meat and have more fish, and chicken I can't help but wonder if this would have decreased or cured my AF. I know for a fact that artificial sweeteners were a sure trigger.
You could try the ablation with Dr Natale and then there would still be Dr Wolfe afterwards.
Jean
Thanks! I am worried I may make things worse by trying to fix something that isn’t broken! We shall see!
that’s a tough question and it’s a decision you can only make. I’m still trying to decide about ablation. I first got AF about 31 years ago and only short episodes and would self convert through exercise. I had them on average once every 5 years up until 2022, and was on no medication. I’ve had 3 since then all 3 cardioverted. After all those years my heart is still in pretty good shape. I think I’ll seriously consider an ablation if I can’t get over a 12 month period of Sinus. I guess I was lucky to get 29 years with only a handful of AF episodes without intervention of surgery or drugs. I now take a very low dose of metoprolol and will stay on low dose of Flecainide for a few months to settle heart following last CV start of February
Thank you! I think I am in a bit of a panic really! I’ll try to figure it out!
it is as others say, entirely your decision. I think Jean makes a good point that you could have an ablation with Dr Natale and would still be able to see dr Wolf if things didn’t change.
Even though you haven’t had an episode for a while, remember that Afib doesn’t tend to go away on its own, so will currently be lurking around a corner somewhere unfortunately, waiting to pounce at an in opportune moment 😳
Yes, I think you are right, i keep imagining myself in the middle of nowhere when it strikes next!
hi there
I know we’re not meant to give advice but it sounds like you’ve only had 3 in the last 10 years ? Is this correct? You also said you’re not sure if you’re fixing something that’s not broken… to me , in my opinion ( and I’m not medical) I think that’s what you’re doing.
I had understood that you should only have an ablation if it will seriously improve your quality of life. There are risks associated with ablation so if the Afib isn’t seriously affecting your QOL I would sit tight and see how it progresses.
My Afib started 16 months ago and I’ve had 3 really bad attacks ( last one cardioverted July 23) and a lot of minor Afib activity. I haven’t had any Afib now since November ( like you) which I’m really happy with for the moment. I know it might change in the future but at present it’s not now seriously affecting my QOL they seem to have my meds just right and for now I will sit tight. I’ve made some changes to my diet, exercise with caution ( I used to do loads ), drink in moderation now and I try to stay well hydrated. I’m remaining positive, trying to get on with my life and I’ve put AFib on the back burner for now. How long it will stay at bay I don’t know but for me there is no way I would consider an ablation, for me, right now. But we all have to make our own decisions. Agonising over a decision is the worst thing you can do, make a decision and get on with your life. Good luck with it I wish you well xx
Thank you, wise words. I think mine is triggered by electrolyte imbalances, not sure how to cure that..
Hi,
Some AF info from Dr. John Mandrola, a cardiac EP, that's posted on his website blog is a few years old, but hope it might help:
drjohnm.org/2014/02/13-thin...
drjohnm.org/2016/04/af-abla...
Dr. Mandrola also has AF info on YouTube. Take good care. 🙏
Well, that is good information, thank you! I am flip flopping between waiting and having it done, my kids are very anxious about me having it done....
I can't advise you but I can give the best estimation of what I'd do in similar circs - based on my own AF experience (17 years, almost 200 episodes and no ablation) and wide reading: I would continue without an ablation because the success rate isn't particularly high. If the incidence of episodes increased drastically then I'd reconsider. I'd also probably take one dispersible 75mg aspirin daily (which I did until I was 65 when I was started on Edoxaban) and omega 3 + magnesium citrate). But, we're all different, and the choice has to be yours. Perhaps there's something in your diagnosis, some other risk that doesn't apply to my situation, that specifically points to an ablation in your case?
I think I would be a simple case, no other risk factors. Hmm, maybe I should just carry on with aspirin!
It's sad that you aren't able to find some clarity between the choices you face. The anxiety you are causing yourself obviously isn't helping.
I have replied to your previous Posts, stating my choice would be to follow the route suggested by Dr Wolf (an initial linq monitor).
As an addenda, I will add that Dr Wolf still has a remarkable "cure" rate for his minimaze despite the fact that he usually has to accommodate the most desperate of AF patients (ie. with multiple failed ablations).
So it is particularly worth noting that Dr Wolf, in one of his live AF videos, when replying to a viewer question, stated he obviously prefers patients who have had no previous ablations (ie. no previous scarring inside the heart). And you are currently in that "no ablation" cohort.
Thank you, yes I remember your responses. The reason Dr.Wolf took so long to confirm the linq was because he referred my records to his EP, Dr.Fahed so they could decide the best course of action in my case, which is adding to my confusion as they are suggesting the linq. My first EP was adamant I should have an ablation, the second one I haven't really had a good talk to but is suggesting the ablation. I shall decide tomorrow I think...
Disclaimer: this reaction is not to be taken as medical advice, as I’m not a trained medical professional. It is my personal opinion, based upon my own experience and research.
If I would have been in sinus rhythm since november, I would never consider an ablation. I have been in afib practically every day during the last month (the episodes tend to come in clusters; before that, I was 2 months in sinus rhythm) and still I would count on my medication (Apocard 200mg. + Tambocor 200 mg. when there is a breakthrough – max. 600 mg. Flecainide/day) to stop an episode. Which always happens between 2 and 6 hours after taking the extra dose. During an attack my HR in rest is between 70 and 100, and I feel dizzy and tired. Unless my episodes would become a lot more debilitating, I would stick with medication.
Why am I not considering an ablation? First of all, I have suffered a massive heart attack 6 years ago, and thanks to vigourous cardiac exercise I managed to limit the remodeling of my heart to the absolute minimum. My cardiologist says I still have a ‘very healthy heart’. That is the first and most important reason I would not consider an ablation: damaging parts of my heart by heat or extreme cold is contrary to everything I haven been trying to establish. It always reminds me of the lobotomies of the 40-ies.
Second reason: the succes rate is less than stellar: many people need 4 or more ablations to get a reasonable result, and more often than not they are still on medication after the procedure(s). Others end up with an arrhythmia that is more bothersome than the one they had in the first place.
Third reason: there are quite some risks involved, including a damaged oesophagus, a perforated heart, internal bleeding, new arrhythmias, infection of the entry wound, and sudden death (1/500 mortality rate).
Fourth reason: the procedure involves a very high dose of harmful radiation, that I would rather not add to the dose my poor body received during the insertion of my 3 stents. Radiation doses are cumulative, hence the dose-meters carried by X-ray personnel.
Fifth reason: one of my best friends is a retired cardiologist, who has Afib himself. He too would never consider ablation, for exactly the same reasons that I listed above. I trust his 40 years of experience in the matter, although it might not be perfectly up-to-date, it still is hands-on experience.
So, unless I would eventually end up in permenant Afib with a rate wildly out of control making my life miserable, I would always try medication first – all possibilities, and there are many- before deciding to have my dear heart, that saved my life once, having damaged irreparibly by such an invasive procedure.
Again, this is just my personal opinion and that of my friend cardiologist, and so by no means to be taken as medical advice. Everyone is different, has different tolerances and priorities and therefor can olny decide for themselves after having been informed in the most complete way possible. That is the sole purpose of my contribution here.
Good luck and all the best!
Thank you, you raise some really good points. I am still undecided! I will decide tomorrow when I am not quite so stressed or tired!
Hi Fuzzy Duck,
Well I managed to go with no AF until Monday. So was exactly 4 months and it popped up, took Flecainide and 45 minutes later gone. Shortest event yet.
So, however, I am still scheduled for the Mini-maze in August, and I am 90% sure I am keeping it.
I thought well if I go 9 months with no AF I am cured right? I knew the answer was no (just wishful thinking)
I have seen too many people post on this forum and the AHA forum of Paroxysmal turning into Persistent overnight. I am still young and otherwise healthy so my thought process was to get it done while I could recover better.
I am not looking forward to taking daily meds before and after for Dr. Wolf, nor possibly the increase in HR a lot report, nor the recovery.
But I would like to avoid Persistent AF, long-term Flec, or Amiodarone, Anti coagulants or other meds. That's where I am.
Good fortune on your decision.
Thank you, I will be thinking of you in August! I suppose if I put the linq monitor in i shall know exactly what is going on with my heart, i have been having some ectopic runs recently, triggered by antibiotics...
I’d say you could leave it because your AFIB burden is low. But so was my burden but in a short time it actually got to a point where it was knocking on the door a lot, actually too much.!! It’s a weird condition is AFIB And is extremely unpredictable.? I would personally do whatever they are suggesting. But only you can decide.?
I wish you all the best in whatever you decide.👍
Thank you! i do feel that it could suddenly come back. My episodes are triggered by vomiting, but not everytime, something I may not be able to avoid ....
The question is, how worried are you about the thought of further episodes? If you hope to avoid them (ablation is not a guarantee) then have the ablation. If in doubt, don’t, at least until you have had the linq recordings. It’s not exactly an emergency situation considering you have had so few episodes and they have been triggered by a rare event. You might just try to get better migraine meds!
Yes, very worried about another episode as the last one was long lasting with a high heart rate and didn’t self convert!
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