Pulsed Field Ablation in UK

[elkewilliams]

Have been diagnosed with paroxysmal Atrial Fibrillation (July 2023), very frequent episodes at first but then getting more frequent in last 4 months. Was on Bisoprolol initially, then Dronedarone but frequency of episodes increased. Now on Flecainide and Bisoprolol for last 4 weeks without an AF occurrence. My EP has recommended an ablation and I am now on a waiting list (12 months+).

I am considering private ablation, Pulsed Field Ablation, and am willing to travel to Berlin for it but wondered if there are facilities in UK ( I live in Scotland) which offer this kind of ablation and what the costs are for a private procedure. Has anyone on this forum experience or knowledge about this?

[mjames1]

Yes, Royal Papworth in Cambridge. They did first PFA's in UK. I know they do private and assume akso NHS.

Jim

[elkewilliams in reply to mjames1]

Thank you for replying, I will look into that. Problem is that I won’t get a referral from NHS Scotland to a hospital in England. So would be private and I found that private is cheaper in Germany, believe it or not.

[MikeThePike in reply to elkewilliams]

I would think twice about treatment abroad because if you have any complications later or require follow up it may prove difficult and expensive. Also, if you want to pursue legal action if your treatment goes wrong or does not meet your expectations doing so in another country again could be difficult and expensive. Overall it could prove to be a false economy. Also, I'm not sure if you are aware of this already but PFA is no more effective at curing AF than any other ablation method, just reportedly less risky. Best wishes.

[Jalia]

I would imagine you could be looking at 20k in the UK although could ne less. It was 15k 16 years ago fir RF ablation. Alot now are done as day cases which brings the price down

[elkewilliams in reply to Jalia]

I am waiting for an estimate from Charité in Berlin, had a quote from a Frankfurt hospital of 13500 approx. Private in Germany is cheaper than in UK.

[Franky999]

Cost me less than £15,000 for PFA in January this year. I did a search for leading ablation consultants in London and was fortunate to choose one that did PFA.I was lucky to get a cancellation two weeks after my initial consultation, and on the day of the op was on my way home just after midday.

[elkewilliams in reply to Franky999]

Which clinic did you have it done in London? Will definitely try and search. Could you send me a private message with name of consultant and clinic?

[Franky999 in reply to elkewilliams]

How do I send a private message?

[elkewilliams in reply to Franky999]

Click on my icon which leads to profile page , then click on blue ‘chat’ button,

I think

[mjames1]

Quoted 12-15,000 pounds 19 months ago.

Dr's, Martin, Begley and Hect.

Jim

[elkewilliams in reply to mjames1]

Thanks! Very useful to get that info!

[mjames1]

Those are the three EP's involved in the initial PFA trials, so they probably have the most experience with the procedure. They can be contacted individually.

Jim

[Model52]

4 weeks in sinus. UT seems the Flecainide and Bisoprolol are working well. I would seriously reconsider an ablation in that case. Unless you would have intolerable side effects from the medication.

[LadyLawson]

Elke I think the jury is out on PFA. It seems to be no more effective than cryo / RF tho it may have a slightly better safety profile. But there seems to be nothing in it.

As you are in Scotland I would recommend that you make an appt to see Dr Gary Wright at Ross Hall Clinic Braehead in Glasgow. He will tell you everything you need to know in language you can understand so you can make an informed decision.

He is a very experienced EP / Cardiologist with a great reputation.

[Ppiman]

I am in the same position. I would not go the private route myself, partly owing to cost and partly owing to the fact that it (in the UK) will most often be in an NHS suite anyway. Also, not to be in any way dramatic, but all heart procedures carry an increased risk of needing extended emergency care and a government hospital is far better resourced for such a rare eventuality. PFA is carried out at our Leicester Gelfield hospital, but I doubt the kind of ablation makes much overall difference to the outcome.

Steve

[Karendeena in reply to Ppiman]

I was told the same Steve. PFA quicker but no improvement on success rates so far

[Ppiman in reply to Karendeena]

I’m in the queue, Karen!

Steve

[Karendeena in reply to Ppiman]

Nice one Steve, you must be so close to me. I live in Wigston (although my house is in Blackfordby near Ashby)

[Ppiman in reply to Karendeena]

We’re in Loughborough. I had a phone call from Dr S to say I’m safe to press on with flecainide but I emailed him after to ask him please to confirm thus my GP in writing but he never did. I wonder if I have upset him in asking?

Steve

[Karendeena in reply to Ppiman]

Not far away then.I doubt you've upset him, I think they are just too pressurised.

Will you be chasing him up?

[Ppiman in reply to Karendeena]

Hi Karen. Yes - I taught English and Media Studies for many years at nearby Beauchamp College where many Wigstonians went!

I would like to know from Dr S if flecainide as PIP is okay for me but my GP told me most people take it regularly so I can guess his likely response. I can’t help feeling that it’s a potentially risky drug so I’m hesitant to take it when I’m coping well without it. For now I’m nursing a cold and my palpitations are none too bad.

Steve

[ChrissieMT in reply to Ppiman]

I take Bisoprolol daily, last December my cardiologist also prescribed Flecainide to be taken as a PIP whenever I felt an episode coming on. It does seems to make the episode a lot, lot shorter but not stop it.

[Ppiman in reply to ChrissieMT]

I think using flecainide as PIP might be a local approach, perhaps given what my doctor said. I was given it as 50mg bd after I found that doubling to 2.5mg of bisoprolol did little for the arrhythmias and dropped my heart rate a bit too far (as I already have episodes of bradycardia). The one day I took it, I was clear of arrhythmia but did have some periods of worryingly heavy heart beats (presumably caused by the LBBB?).

Steve

[ChrissieMT in reply to Ppiman]

I suppose each cardiologist has their own take on things, I have only ever seen mine once and am awaiting my next appointment, goodness how long that will be.

[Ppiman in reply to ChrissieMT]

Hi Chrissie. I couldn't wait and my GP said to see the cardiologist "pronto" so ended up paying privately to set things off at a cost of £200. That worked well as everything else has been on the NHS and has moved quite quickly. The ablation, however, looks like a year wait.

Steve

[elkewilliams in reply to Ppiman]

Your concern is also one of mine! It also seems that PFA hasn’t quite reached Scotland yet. Thanks for replying!

[Ppiman in reply to elkewilliams]

The cost is high I gather and I think it’s only being trialled at a few teaching hospitals first. I’m surprised Edinburgh and Glasgow haven’t got it.

Steve

[Karendeena]

I waited 12 months for my ablation.Glenfield Hospital in Leicester is now offering Pulse Field ablation.

This is one of the top heart hospitals on the UK and people travel from all over the UK to attend there. They are leaders in research too and my EP is President of the British Cardiovascular Society.

[elkewilliams in reply to Karendeena]

From all over UK probably only means England. Good to hear that more hospitals are offering it, as in Germany it is regarded as the procedure of the future, mainly because it is safer, less risk of damaging other parts, and also is a shorter procedure, although the success rate at the moment seems to be similar to Cryogenic/RF ablation.

Thank you for replying, I will follow up all suggestions made.

[Jajarunner]

Royal Papworth in Cambridge does them. I'm waiting for an NHS one ..

[manabouttown]

If you are going private then my advice would be to choose a large specialist heart hospital like Papworth or Harefield or Hammersmith. Do ask your consultant how many PFAs and RFs he/she has done as PFA is relatively new whereas RF is a well worn path .Good luck

[ainslie]

can I ask you who your EP is in Scotland, I am in Edinburgh and looking for a good EP ideally in Scotland but will travel anywhere

[iris1205]

Having had a successful PFA recently (after six unsucessful), I do understand that it has not been proven to be more successful that cryo or RF. BUT...

It seems it causes less peripheral damage, and for that alone - if there is the possibility for needing repeat ablations, this is the path I would choose! (and I did.. 😆).

[elkewilliams in reply to iris1205]

Good that you had a choice! I will have to wait until my next appointment with EP to find out more about ablations and different procedures but not hopeful PFA is available in Scotland, private or otherwise. Shorter procedure and less risks drew me towards it.

[iris1205 in reply to elkewilliams]

Agreed, I am very grateful!

[Wilkie1]

Hi I've been quoted £8.5k for PFA privately in Belfast.

[elkewilliams in reply to Wilkie1]

That is astonishing- that it is offered for once and at that figure!

[Profound15 in reply to elkewilliams]

Hi Elke I contacted the Dorset Heart Clinic, Bournemouth Hospital a number of months ago about the cost of a PFA and it came out between 18-19k. They seem to be doing them regularly but I’m not sure on success rates. I’m also on a maintenance dose of 50mg twice a day and 1.25mg of bisoprolol as well. The medication works well although I do get ectopics (particularly PVC’s) which I’m trying to find out if the ablation can sort them out as well.

[elkewilliams in reply to Profound15]

It always surprises me that ‘private’ in this country cost so much more than Germany where doctors are better paid but somehow there isn’t so much profiteering going on.

I am also on Flecainide and Bisoprolol and it seems to work, no more AF and no ectopics. Not really looking forward to an ablation, the Pulsed Field Ablation seems to be less risky- and a shorter procedure as well. Still undecided what to do. It seems to be risky to travel to another country to have it done, complications can always happen.

[Profound15 in reply to elkewilliams]

Have you decided where you’ll get the PFA done.

[elkewilliams in reply to Profound15]

No, I haven’t. Have an appointment with my NHS EP on 15/8, who I saw privately before and who had put me on NHS waiting list. Gathering Information in the meantime…….