PFA ablation

[priya_uk]

Hi all, just wondering if anyone has had PFA ablation in London for persistent AF and how successful it was as I am considering it as an option for my dad who is 72 and has gone into persistent AF since early June 2024 and has now been diagnosed with heart failure possibly caused by the AF. I'm not sure it's available on the NHS and we don't have private insurance so would be interested in knowing approximate cost and hospitals that offer it.

[CDreamer]

Technically yes, as per NHS England Commissioning Body Document

Catheter ablation is recommended to be available as a routine commissioning treatment option for paroxysmal and persistent atrial fibrillation’ within the criteria set out in this document.

You may find this document useful

england.nhs.uk/wp-content/u...

However, this does not mean that everyone would be a suitable candidate. Your father would need to be referred to an EP - electrophysiologist for assessment. Other types of treatment to consider would be Mini-Maze, which has more success for persistent AF but again will have an assessment criteria and is still fairly new in UK so very few thoracic surgeons/EPs offer.

A lot will depend upon age, fitness, how symptomatic, other treatment options, structure of heart, co-morbidities and life style factors eg: if you smoke and drink it is unlikely you will be offered ablation simply because they are known causes of AF.

The other consideration would be CRT - cardiac resynchronisation therapy pacemaker which is also an option. I had two ablations, first made things a whole lot worse, second gave me three years free of AF which eventually returned and exacerbated a then unknown condition. I cannot take any heart meds so was given CRT pacemaker in 2018 and not looked back. I am similar age to your Dad. My only wish would have been to have had CRT in the first instance.

Know that Ablation doesn’t work for all, is not suitable for all and often people need several. Recovery time can be variable.

I also suggest that you visit the AFA site and look at signing up to Patient’s Day and looking at the vast amount of information about various treatment available on that site.

Hope that helps.

[priya_uk in reply to CDreamer]

Hi CDreamer , thank you so much. I was not aware of some of the options you mentioned so that's very helpful and I will look it up. Patient Day is a great idea and will sign up. The NHS guidelines you shared is really helpful, thank you. Wishing you good health.

[Genetee]

I'm 70 now and had a CV = cardioversion, took twice to make it stick Sorry but I'm from LoUiSiAna and my insurance covers all $$,$$$, it better for all the money I give the Insurance Company.

Had AF for a long time before I even knew what I had way over 10 years. Was constantly exposed to Covid so thought it might be that, but the real culprit was fungus/mold exposure beginning back after Hurricane Andrew in 1992 never quite shook it. Caused part over my heart to enlarge and beat out of sinc, Afib

[priya_uk in reply to Genetee]

Genetee thank you. Very interesting about fungus/mould exposure. How did you determine it was the cause, were there any specific tests for it? Is it the mycotoxins blood test IgE/IgG?

There was a leak in my dad's flat from the flat above a few years ago which later resulted in mold. I cleaned it all up when I noticed it. Really appreciate this information that had not occured to me.

Also good to know that cardioversion worked for you so I will explore that. Wishing you good health.

[Genetee in reply to priya_uk]

GP was finishing workweek, so he said "you work in a prison. There's plenty of mold in a prison, let's try this..." wrote a script for Fluconazol, first pill did the trick.Had relapses, Fluconazole worked time and again, but I waited till I had difficulty breathing and the damage compounded till Afib got the best of me.

[priya_uk in reply to Genetee]

Thanks for sharing. Had no idea mold can cause such damage. Wishing you good health.

[En85]

Hello, the past year an ablation in the UK was about £15k. I was looking into having it done at Cleveland in London but then I opted for Auxologico in Milan.

See an EP privately, consider that you can call anyone in the country once you have a referral , some will speak to you within a week. And then you'll have the EP opinion to make a better decision.

[priya_uk in reply to En85]

Thanks. Did you have Pulse Field Ablation?

[En85 in reply to priya_uk]

No, at the time I think I enquired about radiofrequency/cryoablation. I had in the end cryoablation, on this I blindly trusted the team as I thought they'd have the experience in performing it.

[priya_uk in reply to En85]

I think it was the best available at the time and it's still probably the one they still offer in most hospitals today.

[En85 in reply to priya_uk]

I can't advise on this, I didn't research on different types of ablation. I focussed more in finding a team that would have my same way of thinking, as my first EP just wanted to stick me on Flecainide for life and not even attempt the ablation. That same EP said minutes before my first cardioversion "I'm not holding my breath, as you had this long time now". For me was about trust, I didn't want to be treated by someone that thinks I'm a lost cause lol

Maybe someone can advise better about types of ablation around.

[Borderterriorist]

Hi, I've just seen this recent post. I saw a consultant privately and asked about ablation. He wouldn't do it privately because he felt he could not guarantee that I would have a good result and be symptom free. I was on the NHS waiting list and after several months I went in for an ablation in 2020. I had atrial flutter at that time, not fibrillation but because they discovered I had atypical flutter, which is on the left side of the heart, they were unable to do it and I had a cardioversion which kept me symptom free for 2 years or more. Is you father on the waitlist for an NHS ablation? If he isn't then I'd want to understand why especially if you are thinking about getting it done privately.