Since first experiencing Afib 4 years ago, I have been advised off and on to consider ablation. Many people seem to think that ablation cured or reduced their Afib, while others have reported disappointing ineffectiveness and complications. It is difficult to pin down statistical assessments because every patient, every doctor and hospital, and each procedure offers a different set of parameters.
I will be 80 in two weeks. Over the past year, I have experienced Afib episodes of 8-12 hours duration, occurring between 10-16 days apart. Unlike episodes I had several years ago, the current symptoms are mild and not too traumatic to wait out. During Afib, I generally stay in a safe range with BP and HR. (I think the daily 50 mg of Metoprolol helps.)
When not in Afib, I am lucky in that I feel very good, with a very healthy BP and HR. I can walk briskly for a sustained period, climb stairs, lift weights and do squats. My immune system is strong.
The question for me is: why submit to potential problems stemming from an ablation when, except for the brief periods of slight discomfort, I am healthy and strong?
The Afib does not seem to be damaging my heart, and I take daily Eliquis to lessen the chance of stroke. It feel that, after each recovery to NSR, I am "as good as new!"
I will be meeting with another EP in a few months for further evaluation and discussion. It is clear which direction I am leaning, but I am interested in the opinions, experiences and perspectives of others.
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fibnum
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I would say a lot depends,re afib and an ablation, on the type of afib you experience plus your obvious good quality of life .My own afib. never warranted an ablation or I did not think so as i did not really feel troubled by it. others are sick and quite ill for even days on end.Recently my afib changed a bit for the worse so the cardio upped my Bisoprolol and bingo all is back to reasonably good again. i am 86 and have a few dodgy heart probs that so far do not stop most ordinary activites.I would say be guided by your general well being and how good your life is right now. Why rock the steady boat?
Any any and all treatment for AF is primarily for quality of life (QOL) so if your QOL is good then hold. And this from a great fan of ablation. At the very least you will have to go through several months of recovery post procedure which may feel worse before you feel benefit.
I've had three ablations and still have AF which is now constant, but it's at a lower rate 60-90bpm and I feel reasonably well for most of the time.
Before my last ablation 8 years ago my AF attacks were dreadful. They left me feeling lifeless for days and I'd often be admitted to hospital.
Now I'm not too sure whether my feeling better could be because of changing my diet to one that contains no artificial additives at all, or that third ablation. I would certainly try the additive free diet before you consider having an ablation. Wine contains sulphites (preservative) and that can be a trigger too as can any alcohol.
I "folded" for ablation after over 30 years of afib. The turning point for me was when my episodes increased to weekly when in the past they were every few years and then later every few months. While afib is not always progressive, it became evident I fell into the progressive category, so I took action. First with daily anti-arrhythmics, and a year later with ablation. The ablation was a success so from a monday morning quarterback's perspective, I made the right decision That said, there are more successes than failures and forums like this are more stacked with those that failed, because people with successful ablations often leave and move on.
One of the reasons I went off the anti-arrythmics was because well into my 70's, I felt the earlier I had the procedure, the better I would heal from it, because make no mistake ablation is a bigger procedure than the average ep makes it out to be. It took me close to a year to recover from the effects of the general anathesia alone although in the UK an Europe, they thankfully offer lighter sedations.
Unlike with me, you seem seem less symptomatic with your episodes with a good quality of life. So, why now? One reason might be if you feel it might progress and want to get ahead of things. Another is because afib over long periods of time has been associated with a higher rate of heart failure, so the saying "afib treatment is for quality of life only" is not really accurate in many cases.
Because my afib progressed in front of my eyes, my decision was easier than the one you are facing as your afib burden is still manageable.
I have generally felt well too, although since August 2023 I have noticed some unidentifiable changes going on within my chest. Things were made a little obscure by my having bad pain from a left shoulder injury which put me off work for some 6 weeks or so.
Eventually I bit the bullet, and acting with little faith in my GP and the UK NHS, I paid for a private consultation with a Cardiac Consultant : the upshot of that was ........ no matter how well I felt, once the shoulder injury had been dealt with, my latest Cardiac CT Scan and Echocardiogram revealed .............
1) Peripheral vascular disease
2) Ectopics on holter monitor
3) Calcified coronary arteries but onty mild corcnary stenosis
Don't be too carried a way with how well you feel, it is the state of the heart in a physical form that matters. Looks/feelings can be deceptive ...... and in my view AF is a very treacherous/mischievous/devious condition..... never ever to be trusted.
Meanwhile I hope you stay well, but be aware, very aware.
This is a little harsh isn’t it? According to the BHF, one in five people over 60 have some degree of peripheral vascular disease. Also a recent study showed most men in their early 60s will have CAC show on CT & nearly everyone,male & female will have CAC by their early 80s. I would argue that how you feel is far more important. Scans showing scary things that are unfortunately just common occurrences as we age can often cause undue anxiety & stress which can be hugely detrimental to health.
not really, my own experience is that in the beginning I was going down with flu. Much later on that day I found my BP had dropped. My GP saw me immediately and promptly consigned me to A & E where AF was diagnosed. Just because I figured I was starting flu. The only clue was the dramatic fall in BP but that was much later. I have also been on this forum ( incl. its predecessor hosted by Yahoo ) some 14 years reading victims comments ... seen nothing yet to make me reverse my comments on AF.
Next of course is the situation where a victim can go on feeling well ( as you describe ) while being asymptomatic with AF. Feel well but with AF banging away regardless. Again how you feel is misleading. At least, even now, I know I can be asymptomatic.
BenHall: Don't be too carried a way with how well you feel, it is the state of the heart in a physical form that matters. Looks/feelings can be deceptive ...... and in my view AF is a very treacherous/mischievous/devious condition..... never ever to be trusted.
Well said. If you have afib you must be monitored as it's associated with a number of conditions including heart failure, especially if not treated properly. That's why proper treatment -- preferably rhythm control in most cases -- is important.
I don’t have advice for you, as I’m very new to this. But, your post is exactly how I feel. I am on an anticoagulant, xarelto, as well as flecainide. So far, I feel good on these meds, though it may be too early on for me to know. I am 65, quite active, and have been able to remain active. My AFib episodes were quite short, but my rate would go quite high, and it happens about once per week. Hope if the flecainide stops the episodes. But, I am waiting on a referral with an EP, and I am weighing the pros and cons and gathering info and questions in preparation for my appt. I should know by then if the flecainide is working at keep my heart in rhythm. Anyway, all that to say - good luck with the decision making. I agree, there is a lot to be said for not “rocking the boat”.
I was put on Flecainide 100gms which did not stop AF at all, asked if I could increase it to 200gms (a medium dose) and it stopped it for 11 yrs! However, I did also add big changes to lifestyle as I believe in a large proportion of AF is caused by poor choices.
80 with a good quality of life and enjoying it then I personally would advise you to stay that way until you can't, in other words leave well enough alone. I too am 80 and up to 2 years ago was regularly playing competitive table tennis, did two keep fit classes a week, enjoyed shopping, walking everything in fact, then I broke my hip and all changed so, enjoy what you are doing, if the AF is not causing much of a problem go with it until such times as you do need intervention.....it may well be never!!! ps Grandmother used to say 'don't upset the Apple Cart', and she was always right lol
My A-fib started to appear twice weekly before I had my first ablation. Afterwards, when I came off my meds it appeared again, but not as the black beast it was which hospitalised me regularly. Although I am still on small doses of my meds. The doctor is checking up on me once at year and told me that if it isn't broken, don't mend it, so I'll hold off on having another ablation until I need one. I'm glad I had the first as my QOL is so much improved and I feel really well at the moment. It depends how you are feeling whether or not you choose to have another ablation.
Contrary to the actual protocol, I don’t consider ablation a first –or even second- option in the treatment of atrial fibrillation.
Let me explain you why: one of my best friends is a retired cardiologist with +30 years of experience and suffering from AF himself. I share his professional opinion that ablation is a very invasive procedure, that carries too high a risk for very serious complications, has a rather high mortality rate, and is often inefficient. Moreover there often is a massive dose of radiation involved, it often implies general aenesthetic, and a long recovery period, with no guarantee whatsoever for succes.
If it would be the treatment for a deadly disease, one would have no choice, but patients with AF can live a long and active life (my mother lived to be 94 with the condition) with proper rate control and anti-coagulation medication.
So, unless I would be so symptomatic that AF made my life completely miserable, or that the chances of developing into heart failure were excessive, I would never consider having my heart damaged on purpose, after my medical team did everything in their power – after my heart attack- to limit the damage to this important muscle to the absolute minimum.
I’m baffled to see how many people are willing to undergo this procedure, sometimes even after having ‘only an AF-episode once in a blue moon’.
In fact, I should not be surprised, however,since I have seen 5 cardiologists/EP’s, besides my friend, and they all immediately suggested I have an ablation done for my paroxysmal AF. My friend’s reaction to their suggestion is clear: ‘it’s a booming business, the cathlabs have to make a profit’.
But… that’s only my opinion, and that of my friend cardiologist.
I agree with you. I was told by the arrythmia nurse I could ask to have one if I wanted but it's a horrible thing to go through with no guarantee of success. My echocardiogram shows my heart is in reasonable condition for my age so the thought of deliberately damaging it doesn't appeal.
About recovery period: just read the stories of patients here. Some even mention a full year!
About succes rates: 79% success rate is after 1,5 ablations on average. After one, it is slightly higher than 50%: ahajournals.org/doi/10.1161...
As far as radiation is concerned. “Cardiac catheterisation laboratory lab procedures account for around 12% of all radiological examinations but 48% of the total dose received by patients.”
“This latest study by Cheng and colleagues “should serve as a wake-up call to all electrophysiologists who perform AF ablation, all cardiologists who refer patients for this procedure, and all patients who are considering undergoing AF ablation. What is clear is that AF ablation is not a benign procedure, and mortality is a very real complication of the procedure.”
And shall we discuss fluorescence cardiac procedures mentioned in one of your link? Do not think so. This nuclear procedures are not used for ablations. Just stop spreading your negativity about ablations. It helps a lot of people, not only general public but sportsmen
Have to say I rejected any notion of an ablation right at the beginning ...... Jan 2010. Stayed with meds and lifestyle changes. I certainly didn't want anyone prodding, probing and burning away at my heart.
Flecainide taken as a PIP worked very well at stopping episodes in a few hours for me and now taking it regularly has ended my episodes apart from the one around the time I must have been infected with covid with no other symptoms but a positive test!An extra one taken then ended the episode in a few hours. Good luck finding what works for you.
Hope it works as well for you as it seems to do for me (100mg x2) but I think it might add to my fatigue and affect my digestion which was not a problem previously.
This one is a grandfather saying, ‘When in doubt, don’t’. Often uttered by my husband. I’m coming up for 80 and have had one ablation which lasted nearly/only two years. That was in Dec2015 and I have found that with a low dose of medication my episodes are getting more and more like yours and as I have other issues which I think would affect the result I have no plans to have another.
We have - now had - many things in common. I am 80, have had AFib for several years with increasing frequency and duration, taking Flecainide to control the episodes and living with the constant concern of a forthcoming episode.
I always had an ablation as "Plan B" when the medication became less effective. I was also aware that a "game changer" new ablation technique was on the horizon so I put up with the meds until the Farapulse Pulsed Field Ablation (PFA) became available at a hospital near me.
My EP agreed that it was time for me to have it done and so it was a month ago. Before I left the hospital, I asked him to how long might it be before I could get back on the tennis court and he said, "give it a week". Well, I gave it 2 weeks actually, just to let the groin insertion area heal a bit more. I am also playing golf again too. If nothing else, my quality of life and loss of that worry of an impending AF attack was well worth it. Many EPs are saying that earlier ablation intervention is more successful also.
I recommend that if you have access to the internet and YouTube, you search and watch some of the Pulsed Field Ablation for Atrial Fibrillation videos. It's far safer, quicker, and more successful than previous methods used for decades.
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That said, there are more successes than failures and forums like this are more stacked with those that failed, because people with successful ablations often leave and move on. 
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