Morning everyone,I saw an EP this week as I have been back in persistent AF for a couple of months now, we discussed having another ablation as my first one was a success and it kept me in sinus for 3 years.
He said the chances of another ablation working were about 60% and he would know more once the procedure had started as he could see if I had any scarring on the heart, he also said that my last echo showed a mildly dilated left atrium and this could affect the chances of success as well.
I don't know what I am asking for here but I came out of the appointment feeling a bit down and not sure if I should risk the ablation but instead try and manage my AF with meds?
I'm pretty fit for my age (55) and would rather risk the procedure over more meds as being in sinus is great and the meds cannot give me that.
I find that the consultants can sometimes come across as quite cold and very matter of fact and maybe he was just preparing me for the fact that it's not guaranteed to work.
Thanks for listening
Paul
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Bigredhear
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Best to understand the risk/benefit equation. Personally I would go again,. I had three before my AF was stopped in 2008 and a young man like you doesn't want to be on any more drugs than absolutely necessary.
It is a tested procedure. To my knowledge available almost everywhere. There are also different execution approaches. I.e. from an open heart surgery to much less invasive aproach. All having advantages and disadvantages of their own.
Your specialist has not discussed that option with you?!? Sorry but you seem very poorly informed.
Its your health, your life so learn about the affliction. From what I gather, the ablation success rate is relatively low.
I must have got that procedure confused with something else, I can see that it's quite common although it looks a bit more serious in terms of an op than an ablation.Thanks for the info and I will definitely do a bit more research
Most likely the Maze has not been discussed because 1)eps cannot do the procedure and tend to lean toward what they can do. additionally I have found that many of them are not even aware of it or don’t understand it
That is correct, Mr Hunter does do mini maze at the northern general and will accept referrals from across England. I and others on here have had his procedure successfully.
The maze procedure is a different procedure and done by open heart by many surgeons .when doing other heart procedures.
I know what you mean about consultants appearing quite cold as they discuss matters re your heart. I think it's because they've never experienced what it's like having a heart that's not beating quite as it should and also the draining effect it can have on us both physically and mentally. When you think about it, it's hard to understand anything in life if you haven't experienced it.
We're lucky on this forum because we can talk to people who totally understand what it's like having atrial fibrillation (AF).
As your first ablation was so successful I know that I myself would have another one.
Have you tried avoiding all the things that can help reduce, or stop attacks such as artificial additives in what we eat and drink? I wish someone on here had told me at the start of my AF journey how much that can help.
Hi Jean,Yes I have started to look a bit more into what I eat and drink, I do still have a beer or wine sometimes and I know this is probably not great for me but I'm of the opinion that as long as its in moderation and I enjoy it then Its OK.
Hi Jean , I’ve seen you mention artificial additives on several occasions do you know which ones in particular need to be avoided or could you point me in the right direction for someone me research please .
I enjoy reading your responses as you always seem to offer such good advice and reassurance.
It's quite a long story. I began to realise that anything with artificial sweeteners would set off an AF attack. I had lunch at work and every time I had apple crumble for desert so I'd get AF. I asked our cook if there were artificial sweeteners in it and she said there were none. A few weeks later she came and apologised to me saying she used them in the custard so that it was suitable for diabetic patients. I stopped having the custard and it never happened again.
Every Sunday night I never slept well and put this down to going back to work the next day. Then when I retired I still didn't sleep well and wondered why. What was different about a Sunday. The answer was a roast dinner. I tracked it down to maltodextrin in the well known gravy powder I used. I make my own gravy now and that solved the problem. With this knowledge I now avoid anything containing artificial additives and am so much better.
Just wish that someone could have told me this before having 3 ablations.
Hi Jeanjeannie( i am humming it now 😄 ) I appreciate your answer,sometimes its the little things we haven"t thought about that turn out to be the most important.By the way,I have only had 1 ablation,didn't work but I never want to go through that again!Wishing you the best!
That’s interesting, it’s good you could pinpoint the additives and make those changes!
I know stress and anger /frustration is a trigger for me especially my job , I work with work shy idiots !! If only I could cut them out my life would be stress free .
Nevertheless I think cutting out additives and artificial sweeteners can only be a beneficial thing for all of us .
I've had the same dilemma to consider whether my dad should go ahead due to risks of ablation. However I would agree with others that you are very young so probably worthwhile doing it for better quality of life. There is pulse field ablation now which apparently takes shorter time and has less risks, is that what they have suggested?
I've had similar experience with consultants. Some are better than others with empathy and answering questions that may be trivial for them. However it's probably because they see so many patients. I love this forum as patients share they real life experience of conditions and treatments and it's better than what any doctor can tell you.
I agree that forums like this are invaluable.The type of ablation hasn't been mentioned and I feel like I could have been a bit more pushy in the consultation but I do find that the specialists have a way of keeping the discussions short but I understand they see so many people and they have limited time.
I did that thing where I came out and thought of a million questions all of a sudden.
Ik going to wait for confirmation of the procedure date and in the meantime do a bit more research, once the clinic contact me I will have my questions ready.
I agree, I had the same experience and left with many questions even though it was a private consultation. This forum, recordings from arythmia alliance and YouTube channels like cardiologist Sanjay Gupta have been excellent resources to help me learn more about AF and also equipped me to get the most from consultation.
I wish you the very best for your health too and hope you return to Sinus rythm soon.
l can understand you coming out of your appointment and feeling down. AF does make us all feel down at times. I think it’s the nature and complexity of the condition. This forum is excellent to ask questions and get things off your chest. If l was in your situation, l would go for it. Age and good health are in your favour and it has worked before. Bob is a good encouragement to what can be achieved and you said yourself that being in sinus is great. Much better than meds. at your young age. Best wishes to you.
Google Dr Steven Hunter, UK cardiologist. He performed a successful maze procedure on MummyLuv (forum member) who also had persistent afib. If I recall, she is about your age. Perhaps she may opine. If not, google her Health Unlocked profile for info.
Would be well worth your time even for just a consult.
Yeah I remember he was. I had always thought he was a surgeon but above implied he was a cardiologist. That’s the only reason I even commented. Hope you are doing well!
I believe that all medics need to tell the truth on any procedure they are going to undertake, show all the risks exactly for what they are and not to give false hope and that's what your man is doing, he is telling you what you can and cannot expect from another ablation. I had one ablation, told it was a resounding success and it wasn't so thats what forms this opinion from me, at the end of the day we have to make our own decisions based on balance of probabilities. at 55 you are young so its worth a try but remember there are no guarantees in this life.
Yea they do need to be honest and I understand they don't want to get peoples hopes up as we are all very different.I'm quite a pragmatic person and I think I was just feeling quite vulnerable on the day of the appt.
No one can make the decision apart from me and given my previous positive experience it will help form that.
I think 60% is still reasonable. That was what they told me on my first two. It was lower on my third.I had 3 a couple years back. Only the third was successful and only 5 months after the ablation. Surprised us all!!
And...It was well worth it.
I have significant scarring and enlarged left atrium. If and when I got back into AF, I'd have another ablation, for all the reasons you note.
I should probably add that no medication worked for me and I'd been in persistent AF for 10 years which had led to heart failure so it was a no brainer for me really. The alternative was to hope a big combo of meds would bring heart rate down to 110 or lower and bide time before they'd do a pacemaker. I was due to start heart failure meds when I went into sinus rhythm.If my AF had been every now and then, a lower rate, or if I was less symptomatic I'd probably be less keen on a 4th ablation.
I wouldn't just dive right in without weighing up options.
It’s certainly a dilemma and everyone comes to a different conclusion, as well as ablation performed by an EP you could consider a minimaze performed by a cardiothoracic surgeon,or a combination of the 2 hybrid minimaze where both experts get in on the act. All are available in the UK and on the NHS, but you may have to be persistent and prepared to travel if choosing minimaze etc.
only you and the specialist can decide which option is best for you. I certainly never regret having a hybrid minimaze instead of a 5th ablation.
The minimaze should have a better outcome for persistent AF
I was still in nsr and off all medication until I contracted pneumonia in December, which caused some AF, since then I have had AF x 3 all in association with chest infections and all self termination after between 1 hr and 7hrs.
Go for it. I've just had another 5 years good quality of life after my second ablation. Not a total cure but bouts few and far between with no rate or rhythm control drugs. Although, as time ticks by, I'm back on them very recently. Good luck.
Mmmm difficult. Most comments here have had an ablation and favour it. I haven't and am not in favour!
So to balance out your responses:
I was 60yo, fit, no comorbidities, heart etc fine, prescribed 200mgs Flecainide only and had 10 years no AF, save 2 half hour sessions, which I triggered due to complacence. I did also make many lifestyle changes.
I was offered an ablation quoted 70% success (I understand the medics regard one year AF free as a 'success'). Also no guarantee medication will be stopped afterwards.
Sure you don't want to be on medication for life at your age but you could go for 5 years and see if new procedures are less invasive and more successful then. Alternatively, if you research you may find another 'cure' outside of mainstream medicine.
Final decision is not with the medics but your gut feel after asking tough questions diplomatically but firmly and after researching until squinty eyed 😆.
Its good to hear another angle and I am certainly open to the idea of alternative medicine.I think you're right, I do need to be firm with my questions and approach.
It's hard being in persistent AF and never quite feeling right so the ablation is an attractive option as it worked before.
my cardiologist and EP both said my mildly dilated Left Atria would be fine. I’m currently in Sinus last 7 months deciding what to do. If my AF becomes more regular then more dilating could theoretically get worse.
I should add I’ve made lifestyle changes like exercise daily, a brisk walk and now drink zero beer and decaf which I will say has improved 100% on what it was years ago. Both those measures alone brought down my average and resting HR over a few months. Obviously if yr currently in AF you have to be careful not to spike up the HR. These are all measures that you should consider once back in Sinus to give yourself a better chance of staying in sinus
hi big red, Iv had 3 so far and would sway towards having another if offered.! My last echo this year also showed a slightly enlarged atrium, I believe the slight enlarging is a normal occurrence in afib and been told not to worry about it. Iv got a phone call appointment in the near future with the cardiologist so I’ll see where he thinks I should go.?
I’m a lot better than I was but have always had breakthroughs unfortunately. But I still consider it a success of sorts because it’s all about quality of life managing afib and I’m still able to work and look after grandkids and go on holidays etc so life is good even though Iv got the chance of a Afib episode making an appearance whenever it decides to .?😂
Being in NSR is what matters to me also. I couldn't give a toss if they get my heart rate below the magical 100 level with meds, if at the same time my heart is doing the St Vitus dance all over my chest. I take it therefore you, like me, have very obvious symptoms all the time? I've been in SVR since my first ablation last July (2023) and dread the thought of going back into AFib. I'd go for a second ablation at the drop of a hat if it came back!
I've been back in persistent AF for about 9 weeks now and the symptoms have subsided a bit, my average HR is around 100 and I definitely don't have the same energy levels as before.Like you I just want to be back in sinus again.
I used to be a big drinker but have cut down considerably, I still have the odd beer and feel guilty when I do but it's something I enjoy.
Hope you maintain sinus rhythm for a very long time
I know people who have afib and never drank.! But I also know folk who drink like fish and they haven’t got afib. Unless they have it and can’t feel it of course.?
I was a big drinker as well and although I can now have an occasional beer, every time I do I get warning flutters and bumps. Prior to my ablation having a drink was always my trigger for an attack and eventually it sent me into persistent AFib. Pre-ablation I thought, if only I could get rid of this but still be able to have a little pint at the weekend, I would be happy. And that's exactly what has happened so far, so best not to be greedy and push it. Even though I'd love to have a little session with my mates., I've had mine and other people's share of alcohol for one lifetime and always thought I should cut down. Now I've got the motivation to keep do so. Good luck with that Big.
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