Ablation or ammiodorone…

[pmac22]

My last (3rd) ablation was 5 years ago, which went really well. Afib has been pretty much under control. I have only had one electrocardioversion about 1 1/2 years ago. About 3 1/2 years ago I developed an auto immune disease, Giant Cell Arteritis, then Covid pretty bad. It’s been rough but my heart held up very well until lately. I have ectopic beats almost 24/7 and feel everyone of them, pvc’s have picked up along with short runs of v tach and svt. I have tried several different rhythm meds. EP has suggested another ablation or ammiodorone. I’m almost 68 years old. I really do not want to start ammiodorone, I’m already on a blood thinner, steroid dependent from auto immune treatment, biologic for auto immune diesease, just don’t want to add another “black box” drug. Has anyone had a 4th ablation? This would be for PVC’s and Svt’s. Thank you.

[CDreamer]

I understand you dilemma and indeed was in a very similar position in 2018 but because the sedation and the drugs I had been taking - Flecainide and Bisoprolol were thought to cause my autoimmune condition and I was advised to NOT take any steroids my choice was Pace and Ablate or Amiodarone. I went for Pace and Ablate -implant procedure done under local anaesthesia - the CRT pacemaker helped more than anything in improving quality of life so I cancelled the Ablate procedure. I now take no heart drugs other than anticoagulant, I am titrating down the immune suppressants which I have been taking for over 10 years as they now pose the greatest threat to my health because of risk of cancer and multiple infections. So far - so good and I remain stable.

In your situation I don’t think either option is appealing.

What I would add is that I do think some people have a much higher tolerance for drug treatment than others - my husband tolerates Amiodarone well and has been taking it since 2018 and seem to have little or no reaction to vaccines or drugs that have me on my knees. Amiodarone worked well for him and has kept him stable but he is now 90, with little or no AF, stable aortic stenosis and mild leakage from Mitral valve.

I would consider which and work through from the perspective of risk:benefit.