I was just diagnosed with paroxysmal afib after having PAC for a couple years. My PA never gave me any meds when he diagnosed PAC issues which were quite bothersome, he said it was nothing to worry about. I am thinking now that maybe closer attention should have been done but as I was taking ADT for prostate cancer, I figured that might have been a factor.
Anyway, I am quite nervous about taking blood thinners & beta blockers as I do not do well on meds and seem to suffer all of the side effects they mention. I was reading about PFA as a new treatment type that seems safer, has anyone had this done in the US or know of a location that has been doing a fair amount of this treatment type?
So far, I am not taking any meds, I just can't get over the hurdle, I am on aspirin therapy for a blood clot many years ago, I know that is not the same as a blood thinner but hoping it may help until I can wrap my head around this.
Thanks to all for your feed back.
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watertender
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I would give the medications a try before a rush to surgery. Bisoprolol can cause fatigue and edoxaban increases bleed risk. These risks are often discussed on this forum. I think that most people tolerate them well. both have a short half life. It is therefore easy to discontinue them. It looks like you have gone through a lot already to treat your Ca prostate. To my mind ablation is a further trauma and it is not necessarily a cure. Good luck.
If you have AF then your chance of stroke is five times normal which is why anticoagaulants (they don't really thin blood) are so important, especially if your doctor has suggested them.
It is also very important to control your heart rate when in AF as failure can cause all sorts of other problems such as heart failure itself.
Pulse field ablation is a relatively new form of the procedure and whilst recovery may be silghtly easier than with other forms, overall results are comparable with Cryo and RF.
Just a comment on taking aspirin- it has a higher risk of causing gastric ulcers & bleeds compared with anticoagulants (asprin is an antiplatelet, useful for helping dissolve clots but of little or no help preventing clots forming) - which is the function of anticoaglants. In taking Asprin you have higher risk for little or no benefit.
I had a TIA when I came off anticoagulants after what I thought was successful ablation, I had at that time no risk factors. I now think of anticoagulants as my best friend as I can stop them anytime, a stroke can’t be undone.
Even IF ablation is successful, there is still a good chance you would be taking drugs for heart rate both before and following ablation.
In the UK you need to be taking anticoagulants for some weeks before ablation is an offered.
I’ve taken them now for over 10 years (Apixaban) with no problems.
I cannot tolerate ANY of the HR or anti-arrythmia drugs and many people struggle with their effect for sure but you always need to weigh up risk: benefit and although doing nothing or relying on life style changes is an option, it’s a difficult one to live with and as the others have said, you risk going into heart failure livening with high heart rates ie: 100+. I can cope with HR up to 135 for an hour or two but can do nothing much when it exceeds that so you also need to consider quality of life that you want.
Everyone’s AF is different and so is treatment so generalising is not always helpful. I had 2 ablations and still AF returned after 3 years.
Thanks to everyone who responded. I have read that a 3.5 mg dose is for those over 80 (which I am not) would that be something to pose to my cardiologist as a bridge to see how it goes or is that low of a dose not effective. The problem I think is because I cannot feel anything at all and am doing just fine. What does afib feel like when it happens? I was told my risk factor is a 3-3.5 which I guess is pretty high but that was not explained to me to much.
My PAC episodes have disappeared after I stopped the ADT drugs but I suppose maybe I just do not feel them anymore, not sure.
I had a Stroke - Embolic type. I take PRADAXA as I figure 1/2 a dose and 1/2 dose is better than all at once. And 110mg not 150mg twice day. Also has an antidote.
CCB Diltiazem 120mg CD for control Heart Rate.
BB Bisoprolol 2.5mg for control BP.
Been on this regime 2.5 years and stable.
Was diagnosed with Rapid and Persistent AF along with Ca Thyroidectomy.
My symptoms mean slow walking and stopping due to exertion momentarily.
No pain, no flutters, no palpations.
cherio JOY. 75. (NZ)
Aspirin is used for those who have had heart attack.
The better anti-co.agulants work better needing no tests like Warfarin does.
interesting as I’ve questioned my cardiologist and he has me on aspirin he says my risk is lower due to general health and Chad score is 1. My AF has been less frequent than most since 2022 only 3 episodes and each time a cardioversion to revert. He does an ultrasound of the heart prior to CV it’s called a TOE to establish if there is any clot forming before he does CV. He did say if my episodes become more frequent or I turn 75 then I go onto Apixiban. In my case when I go into AF I can feel it and I now have Apple Watch which also notifies me. I’m told to start Apixiban immediately then continue for a month after it reverts to sinus.
Some people don’t know when they’re in AF and that’s where Anticoagulants are so important as my cardiologist says a clot can start to form around 48 hours after you go into AF. This is not a hard and fast rule some can be quicker forming and others can take weeks to form.
If you want to be on the safe side as your not sure then starting something like apixiban should be seriously considered
I had PFA in the US in Austin in April. They ran many of the trials and so had plenty of experience. I only took Eliquis for a few weeks preceding surgery and for four months after. I’m now med free. My heart is not the same during high cardio but it doesn’t stop me from doing the same workouts I did prior to the ablation. I do take the occasional propranolol for tachycardia either when I am at altitude like flying long haul, or after a glass of wine that my heart doesn’t like…
The EP is Dr.Natale at Texas Arrhythmia Center He is a very skilled EP but I have had very little communication with him and I feel like I was on an assembly line….
Assembly line, yeah, I can relate, kind of when I had cataract surgery. Glad to hear you are doing well. So you only took Eliquis for a short while before PFA? Was your afib paroxysmal when you decided to go that direction? How was the recovery period?
It was paroxysmal, yes. And very infrequent. The EPs said it is easier to stop it early on. I think it was in the guidelines that were released earlier this year, to offer ablation as front line treatment for cases like me. I think I took Eliquis for four weeks prior , maybe six. I was wiped out for a week or two and went back to CrossFit after 10 days but it took a few weeks to get my stamina back. I also struggled at altitude and went for two trips to Colorado, one at week four, the second at week 8. But propananol really helped
I had PFA on Friday with a crack Harvard team at Mass General Hospital . I am an 84 yr old woman who followed this research closely. I disagree with those here who downplay easier recovery, and good results. Shorter anesthesia: a big deal for elders, little to zero chance of damage to other tissue like nerve damage , again on smaller or aging bodies( read , women)!
And with multiple issues never had an Ep say likely he could do it all. He did, and i am praying. NSR, no pain, no rhythm meds, just eliquis and propranolol 🤞. Time will tell but a fighting chance. There is a reason USA premier hospitals all want approval.
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