Third Ablation -- Pulse Field

[Kernowafibber]

I am on the waiting list for a 3rd ablation, which will be pulse field and carried out by Prof Schilling at Barts. I have had AF for over 20 years, initially controlled with Flecainide. After 2 failed ablations I was on Dronaderone, with limited success. After a long period of sustained AF I was admitted to hospital where my AF was brought under control by IV Amiodarone. Due to a reduced EF I was formally diagnosed with heart failure due only to the AF. I also have left bundle branch block.

I now take Amiodarone, Bisoprolol, Edoxaban and Valsartan, Dapagliflozin did not suit me. I have not yet had any information regarding my current EF. I am currently in sinus rhythm.

My question is what I am likely to gain from the 3rd ablation. Am I likely to be free of Amiodarone and the Beta Blockers? Is there a chance that the ablation could bring back the AF?

I am 59 years old with no other health issues.

[BobD Volunteer]

As Prof Schilling is one of the foremost EPs in UK one can only presume that if he suggested the next ablation then he thinks it will be successful. Those questions are best directed to him I think.

[Ossie7]

I know what you mean Kerno , when I had my 3rd ablation this year I was on dronedarone and beta blockers , in sinus rhythm but really wanting to come off the meds . I am 59 . Following the ablation I remain in sinus rhythm so far but EP advised to stay on the meds as the AF will more than likely return . The ablation was 75 % successful but the EP was not able to fully isolate the superior vena cava as it was too close to the phrenic nerve and another important structure ( I do wonder wether the pulsed field technique would have been more successful ) . I was previously on amiodarone for 16 months . However in retrospect I am glad that I had the 3rd ablation as I have come off the 2.5 mgs of bisoprolol , but my resting heart rate is now in the 60 ‘s and generally it is much higher with all activities . But I do feel that I have more energy and feel less fatigued .

[Ossie7]

sorry , me again ! Another important reason to go for this ablation is that it will more than likely get you off the amiodarone , usually after the blanking period . As you will be aware this drug really is for shorter term use only x

[Abbyroza in reply to Ossie7]

One of my best friends is a retired cardiologist. He has AF and takes Amiodarone long term. It is very efficient. As long as thyroid and lungs are checked on a regular basis, there’s no reason to state that this ‘medication is for shorter use only’.

[Ossie7 in reply to Abbyroza]

My brother also took it longer term ( 10 years ) but he had a complex heart defect . He did get a lot of side effects but ultimately it kept him alive . However I did think that generally amiodarone is a drug used for a shorter time frame . There are exceptions of course .