I have had afib since 2001. The first ablation was in 2002, and the sixth was in 2024. I am being offered the choice between a seventh ablation (this time using Pulse Field technology) or a Pacemaker.
I would like to hear comments from anyone that has had a pacemaker installed in the last five years.
Thanks.
Personally, I'd pass on a 7th catheter ablation, PFA or not. Before going the Pacemaker route, you might want to get a consult regarding a surgical ablation. They can often work when catheter ablations fail as the approach is very different. Several of our members have had successful surgical ablations and I've tagged MummyLuv who is very knowledgeable.
Jim
So sorry for late response, Jwe727678 that’s a lot of ablations and resultant scar tissue. You are in the US, have you heard of Wolf Mini Maze? It’s worth researching that and if you have surgeons doing mini maze in your area. Basically the scarring to stop electrical misfiring is done on the outside of the heart where it is more accurate and robust.
I'd go for the pulse field ablation, before considering a pacemaker.
I had a PM fitted in 2022 but not for AF as they really don't often help unless it is a high spec re synchronising one. Even a pace and ablate group procedure will not stop AF but it should greatly improve QOL. My PM was to offset 2nd degree heart block which caused occasional longish pauses which my EP thought may get worse.
I’m unusual in that I had a RST Pacemaker fitted in 2018. It stopped the AF almost immediately. There were a few hiccups in that I had COVID quite badly in 2021 with pneumonia so AF kicked off again then but it settled after a few weeks and I now have AF burden of less than 2%, best thing I ever did, no regrets. I take no anti-arrhythmias nor rate control, just anticoagulants. I didn’t recover well from the sedatives after my second ablation and cannot take the meds so was left with little choice. Fairly quick procedure done under local anaesthetic
Not sure I would want to go for 7 ablations, pulsed field or other but we all have different circumstances so what suits one, may not for another. Have you been offered pacemaker? If so which type?
One failed ablation so no more for me, so they fitted a Pacemaker and it has definitely been a life changer but of course all of our experiences are different.
Hello
I just sent the following to 'sailblue' but felt it was just as relevant to you .....
For what its worth I have had AF for around 15 years progressing steadily from paroxysmal to permanent, have never been offered cardioversion or ablation but after about five years following faints & blackouts had a pacemaker fitted. Now I'm on my second one (they last 7-10 years) - still in permanent AF - and I keep seeing people on here commenting on multiple cardioversions and ablations and think quietly to myself - what's the point?
I am sure the members of the Forum will offer their advice and support based upon their own experiences, however, if you prefer to contact our Patient Services Team, please do not hesitate to contact us: heartrhythmalliance.org/afa...
Kind regards
TracyAdmin
I had a pacemaker implanted 4 years ago. The surgery was easy and it has worked well. The goal at that time was to keep my heart rate from getting too low during an AFIB attack. At the time I had paroxysmal AFIB. the good thing about having a pm is that with the machine that you bring home alliws your Dr to pull your data at any time. Or you can send data if you have any issue and they can determine what's going on. I love my PM. I only have wires in my ventricles and maybe one atrium? This year my AFIB transitioned to persistent and after much consideration i will be going for an AV node ablation. The good thing is that i have several years experience with the pm before this important procedure.Back to your question.....my pm has been a "breeze" for me. The procedure and the experience. I guess it depends upon the reason your Dr is recommending it but for me it has been very beneficial.
Pacemaker after ablation
Pacemaker adjustment after AV Node Ablation. 
Pacemaker and AV Node Ablation
Ablation v Pacemaker
