Ablation or Not?

[Peakoverload]

I'm currently waiting for an ablation and have been for over 6 months. When I first developed AF I was quite badly affected by it. I would:

Get out of breath just walking a short distance

Keep falling asleep

Found climbing stairs and carrying 'heavy' things more difficult than they should

Occasionally feel like I was about to black out

Often would feel light headed

I had a Cardioversion nearly a year ago which worked initially but failed after 3 weeks. I felt much better immediately after the cardioversion and in normal sinus rhythm, but when the AF returned, I noticed that it was slightly different.

Whereas pre cardioversion, my heart rate would sometimes go as low as 40bpm, now it's always above 50 and so I don't feel like I'm going to black out or light headed. My heart rate rarely goes 'high' and even when it does it's only really when I'm being active and doesn't really go above 140bpm and that's just in short peaks.

Since my Cardioversion I've also been concentrating on losing weight, so far I've lost around 2 stone (13kg) and whilst I still have a lot of weight to lose, I feel much better. Now I can:

Walk for about 45 mins at a fairly brisk walking pace - although admittedly by the end I am sweating and puffing but I quickly recover again.

I rarely feel tired

I never feel light headed

I can climb stairs more normally, but lots of stairs still make me puff a bit

As I've 'improved' and as I believe I'm probably at least 6 months to a year away from getting an Ablation, by which time I hope to not only have lost more weight but also to have moved to another county, I'm starting to wonder if there is any point in having an ablation. Don't get me wrong, I'd still LOVE to be in normal sinus rhythm, I'd still LOVE to have all my energy back, but I'm starting to wonder if the cons are now starting to outweigh the pros of having the procedure.

I know that this is a very personal decision but I'd appreciate any thoughts on the matter as I keep swinging from one to the other.

[bean_counter27]

You should discuss your options and thoughts with you EP or cardiologist. Most will say there's no cure for AF. Treatments, including ablation are therefore largely about quality of life and slowing AF's progression (almost always a progressive condition).So, the obvious question you're faced with is will ablation improve your QOL relative to other options?

Losing weight may be a factor in your recent improvement and more gains might come from further weight loss.

6 to 12 months before ablation means there's no rush to make a decision and there's a possibilty your circumstances could change (better or worse) during that time. So keep your options open is my advice and make your final decision closer to your deadline. In the meantime determine the circumstances under which you would proceed with an ablation. That way you're ready to make a decision when the deadline arrives, based on the prevailing circumstances.

[jeanjeannie50]

The situation you're in now is one we all face when an ablation has been considered the way to go. No one can really advise you and you'll be undecided right up to the day you have it. Some people will say go for it as an ablation really helped them, others may say having several did nothing to help their heart rate. It sounds like you won't have to decide just yet. So don't let the thought worry you for now, but keep an open mind and watch this forum for what others say about having the procedure.

As you have said, if you lose more weight and have a more healthy diet well perhaps you won't need an ablation. Concentrate on doing that for now and make your decision later.

Jean

[JOY2THEWORLD49]

Hi

Good on you. You are taking charge of your weight.

If reducing weight has a big positive effect on your AF I personally would wait and see how you are.

Ablation sometimes reduces Heart Rate dramatically and therefore you would be at risk of requiring a pacemaker.

Scarring is not reversible!

Think on and continue to make positive steps in the right direction.

cheri JOY. 75. (NZ)

[JoDogBlue]

The other consideration is whether you're on any meds and you can live with how they make you feel. Like you I'd leant to cope with AF, then I had a cardioversion and was in NSR for nine months up to an ablation six weeks ago. I really questioned why I was going ahead as I felt fine going into the procedure. But I knew AF could come back at any time and my hope is to get off the drugs that make me feel lousy.

I now know the path to where I want to be has more twists than I'd imagined (I'm back in AF and waiting on a cardioversion) but I'll get there and don't regret having the ablation. Should I need another I'll know what to expect!

Good luck with your journey

[PCC62]

Hi Peakoverload

As others have said, it's a very individual decision and you can listen to other experiences but each of us responds and copes differently to the various options be it meds, ablation or cardio version. But making lifestyle changes is always beneficial so well done in getting that underway so effectively with the weight loss. Keep it up.

I had asymptomatic PAF so I was merrily living my life, busy with work, going to the gym, swimming, kayaking etc and unbeknownst to me I was in AF frequently and when it was discovered by heart rate was 220. So I was very lucky that it was caught before possibly having a stroke. After a month in hospital and failed CVs, meds finally brought it under control but still with episodes every couple of weeks lasting about 3 days, but again asymptomatic. So I went down the ablation route, partly to hopefully eliminate episodes but also consider the possibility of reducing or ending some meds which for me cause fatigue. I'm only six months post-ablation and my Apple Watch tells me I've been in NSR consistently. My second review with my EP and cardiologist is next week when we discuss the reduction in meds. I'm pleased I went down the ablation route - for me it was an easy procedure and genuinely lucky as I was back doing most things (not the gym or swimming !) after 10 days and feeling good, but most of all with the worry significantly reduced.

Good luck!

[wilsond]

Look up my previous posts on this very subject. Briefly,I had the same dilemma. You have AF capability forever once it starts,I'm afraid (to be blunt.)

I did as you have, lifestyle alterations etc. Thought the beast had been defeated and put off the ablation planned. Then out of the blue ,wham! Back with a vengeance.

Ablation June 2022,only 2 known episodes since.

HOWEVER even this is not to be thought of as a permanent 'cure' although some people don't go back into AF there is always the liklihood of it.

I hear the newer techniques( mini maze etc) look promising though.

My response to your question, not to cancel. Your medic obviously thinks you are likely to benefit and are a good candidate for success( in the UK NHS resources are carefully used . Ablation is an expensive proceedure )

Your lifestyle changes can only benefit your all round health, many of us paradoxically are in better health generally since having AF!

Best wishes

[MWIC]

My advice would be to stay on the path you’re on and see how you go and make your decision closer to the time your ablation is due - with me I waited @ 9 months for mine and as I moved closer to it my AFib just got worse so it was an easy decision- I know there’s a lot of talk about getting ablations done earlier than later but it’s only you who are able to make that decision - very best of luck

[Sixtychick]

I had to wait 18 months for my ablation. I kept thinking “should I cancel it”, but decided not to, as when you have parxosysmal AFib, the ablations are said to be more successful. I was very nervous, but went ahead with it in September last year. I’ve read that the success rate is anything around 75% to 85 %, so hopefully my Afib won’t show it’s ugly head again and the Doctor who did it, said it went very well and that they also ablated for the SVT, I had. The success rate for SVT is 95%, I believe. So hopefully, I won’t get either back, in which case, it will have been worth going through with it.

The people on here, were very helpful, but really, only you can decide, but if it keeps the awful AFib away and you can come off the medication, then it will be worth having it I say. Good luck.

[Peakoverload]

Thanks all for your replies. It really is appreciated and whilst it is a personal decision for each of us, it does help hearing others points of views. I'm still unsure what to do. I know I want to be in NSR and therefore want the Ablation. I also know that it may not work and that even if it does, it may not last and I know that I will feel worse before I feel better. I think that's the bit I struggle with. Having felt so rubbish with AF in the past, now that I'm feeling quite a bit better, the thought of going back to feeling like, even if only for a couple of months or so, is less than appealing. That said, if it did work I was able to be in NSR for a few years then that would be amazing. Its the fact that nobody can tell you if it will work, how long it will work for and how much better you will feel that makes it feel like a gamble.