Ablation and it’s fear factor

[Leilani63]

concerned about the safety of having a catheter ablation. Google not helping. Seems like abundance of positives on this forum. Any negatives? First one eight years ago and thinking about a second. I am in US and some excellent eps here.

[Cliff_G]

Definitely don't Google it!

I've had two ablations, well, 3 really - first "one" was an ablation and a top-up. Even my last one was classified as "complex", needing a general anaesthetic, but was a breeze.

The consent form I had to sign for the one mid-September was a bit scary, but they have to be candid about all the risks, the risk percentages were very low. I think the risks are probably a lot lower than they originally were when it was first invented and practised by some EPs who didn't do that many of them.

Even on my first ones in 2002, I disregarded the risks as the prospect of remaining in the state I was was not a pleasant prospect.

[Leilani63 in reply to Cliff_G]

Thanks Cliff G….reading the probability statistics compulsively is not helping but I see the odds are favorable .trying to convince myself to do this again.

[mjames1]

All procedures have risks, but catheter ablation is a minimally invasive procedure, where benefits usually outweigh those risks.

Yes, we have a lot of good EP's to choose from in the United, and the best results (and fewer complications ) come from high volume cardiac centers, which would be found in the top 10 to 15 nationally ranked cardiac hospitals.

My ep does over 300 oblations a year and thousands in his lifetime. That is what you are looking for. If they do PFA (pulse Field ablation) that also can be a plus with arguably a better safety profile and less procedure time, but not entirely necessary.

Jim

[Leilani63 in reply to mjames1]

Can you share your EP? I am seeing Dr Sauer at Brigham and Women’s in Boston.

[mjames1]

I'm not in your area, but both your hospital and doctor are highly ranked. So if you are happy with him, i'd let him do the next ablation. But if you're looking for another opinion, Mass General is also very highly ranked.

Jim

[Leilani63 in reply to mjames1]

Thanks Jim!

[Leilani63 in reply to mjames1]

which dr did you use?

[secondtry]

Last month my EP recommended 'a PAF ablation under general anaesthetic'. He quoted 85% chance of 'significant improvement' with associated risks which include 1 in 200 chance of complications (such as stroke, pericardial tamponade, groin haematoma and bleeding) and a mortality risk of 1 in 1000.

Hope that helps and good luck with whatever you choose 🤞🙏😀.

[Leilani63 in reply to secondtry]

Thank you. Pulsed Field seems to minimize risks but seems to be best for newly diagnosed, mine has been around for awhile.

[Kbkk]

Hi, I’ve just received my consent form for a pulse field ablation. I had decided to go ahead with my first ever ablation after my EP recommended one for my PAF ( very well controlled with flecanide 100mg daily, plus PIP and verapamil) hardly get an episode now. I was stopped in my tracks when I read the statistics…… 1 in a 100 suffer a ‘major’ stroke during ablation?! I decided that was a very big negative and didn’t sign it…. now don’t know what to do! We hear lots of good results from ablations but I’m very worried we don’t hear about the ones that have gone very wrong. Is it worth the risk especially if meds are controlling PAF…..

[Leilani63 in reply to Kbkk]

Your Afib sounds manageable….mine is crazy!

[Karendeena in reply to Kbkk]

I had the same fears as you and some! The statistics were all I could think of coming up to my ablation. I was particularly concerned about the risk of oesophageal fistula which of course can kill and often goes undiagnosed. I weighed up the risks and I was still too scared so I spoke to my EP a couple of weeks before my scheduled ablation and although he couldn't tell me that there wasn't these risks he did say to me "Just think you have boarded a plane to Barbados and your AF starts", now that is scary and I love to travel. I did go through with it and so pleased I did, no episodes that I know of since!! 🙂

[Kbkk in reply to Karendeena]

Hi, thank you so much for your reply. Well done for going ahead and pleased it worked well for you 😊 I find myself in this dilemma because my PAF is so infrequent now, stops within an hour of taking 100mg flecanide and doesn’t affect my quality of life at all….at the moment. This will probably change in time. I know ablation has fairly good results for PAF especially having sooner rather than later. My mother had a catastrophic stroke so 1 in a 100 chance of stroke during ablation (according to my consent form) fills me with fear….especially when my PAF isn’t that bad….but my EP is pushing it. What to do!!! Hopefully I’ll be brave enough to do it!! Hope you stay AF free 🙏🏼😊

[Karendeena in reply to Kbkk]

Hi again, yes I was told it's much easier to treat in the early stages and whilst paroxysmal, once progressing to persistent makes it much more difficult as often the heart has remodelled.I think the statistics on strike risk etc are scary but they keep you in anticoagulants now so this has reduced the risks even further.

I dread the beast coming back but if it did I would go for it again even though I would still be scared and anxious. My episodes were very symptomatic though and used to last for 36 hours!

Will you have to wait long if you decide to go ahead? I waited 16 months

[Kbkk in reply to Karendeena]

Hi 😊 I was told about 6 months. They were expecting the new Pulse field ablation machine in October this year …..they said to send the consent form in anyway and to think about it in the meantime. I’ve actually made an appointment to see a private cardiologist so I can find out the pros and cons of staying on medication and then make a decision. I would really like to go ahead with the ablation……I just can’t get my head round the fact if something awful happened I was only getting 2 episodes a year that although highly symptomatic stopped within an hour of taking my PIP. I suppose everything could change at any point and then its possibly too late to get a good result from ablation. Decisions decisions!!! I’m really pleased yours has worked so well…. long may it continue 🙏🏼😊

[Karendeena in reply to Kbkk]

Thank you. I know they are doing pulse field now at Glenfield but not sure my EP favours it.I found it incredibly hard to make the decision because I am a really anxious person but I couldn't cope with the episodes and the thought of it getting worse and then difficult to treat.

Make sure you see an EP privately not just a cardiologist. I transferred from a cardiologist to an EP as they are the specialist

[Kbkk in reply to Karendeena]

Hi 😊 yes my cardiologist on the NHS is also an EP and he’s the one recommending the ablation. I waited to see him originally for such a long time that I went privately to see a cardiologist and received my PAF diagnosis. I’ve seen the EP privately also to discuss things in more detail…..and now I’m going to see the private cardiologist again in Dec to get his views on staying on medication and not ablating. I thought I’d get the views from both sides…but maybe it’ll just make my decision harder as the cardiologist might not be so keen!. I think I’ll probably end up having it but will try and put off for more than 6 months as they’ve only just started pulse field 🤞🏼🤞🏼🤞🏼🤞🏼 but good to hear yours worked and so many more on this forum 😊

[Karendeena in reply to Kbkk]

Good idea, if I have to go again I want pulse field. Keep us posted on progress. I am currently in Cyprus and would never have had the confidence to do this before the ablation

[Kbkk in reply to Karendeena]

Thank you 😊I will. Enjoy beautiful Cyprus 🌞

[Buzby62]

It’s an individual decision but what helped me was that everything has its risks including doing nothing as someone said on here.

Best wishes

[Leilani63 in reply to Buzby62]

Thank you. You are exactly right and finding that balance of risk reward is key.

[DKBX]

I’ve been through six of them. No worries for me now because of such familiarity with the procedure and expecting only temporary relief.

My EP is good and but the beast is just unpredictable and so there really is no ‘fix’. We just deal with it the best we can.

Time in rhythm is great; enjoy it while you can knowing another completely random episode will hit eventually.

[Leilani63]

thanks…wow 6 with no issues. This helps me to put everything into perspective.

[Karenjaninaz]

Retired nurse anesthetist here. Forget about Google. I had the new pulse field ablation technique April 15 at age 81 even though I am a high risk anesthetic because of scoliotic restrictive lung disease I came out fine. It was done at Mount Sinai in New York by Dr. Vivek Reddt. I am doing well. It was a period of time where I had ectopics in the healing period.. But right now 6 months later, and no a fib on the ZiO monitors every 3 months. The.experience was fine. It didn’t take as long as the old technique.

[Leilani63 in reply to Karenjaninaz]

Thank you for your answer. Think I feel more comfortable with your insight. I believe Dr Reddy was one of the inventors of the pulsed field ablation technique.

[Ppiman]

I have read that the latest technology using "pulsed field" is significantly safer as it does not use heat so no transference of heat through the thin atrial wall can happen. Other risks are slight. I think we all have the same fears!

Steve

[Palpman]

I regard an ablation as a necessary inconvenience.

[Leilani63]

hahaha…nice way to put it in its place.