What are my options?

[Irishbeat]

Greetings from South East Ireland

I have undergone two Ablations in the last 6 months, having had permanent Afib before my first procedure.

I did improve somewhat after each intervention but unfortunately am still experiencing daily episodes. My last Ablation was on November 10th.

My cardiologist has previously informed me that she wouldn't be happy to do any more than two Ablations.

I am meeting her again next week and am just wondering has anybody been in the same situation and what my possible options might be.

The only medication that I take is Apixaban.

Thanks in advance.

[CDreamer]

Sorry to hear that. Treatments for AF tend to be limited to, as far as I am currently aware:-

- Lifestyle adaptations for some does decrease or even eliminate AF but depends really what your current lifestyle is like. Some have very healthy lifestyles and still suffer AF.

- Drugs such as antiarrythmic and heart rate control drugs.

- Ablation - in UK the current advice is no more than 2 ablations within 5 years so it sounds like your EP is in accord with that view.

- Mini-maze type hybrid ablation which is a surgical procedure with ablation on the outside of the heart

- Pacemaker.

Having been through the Drugs and Ablation routes which gave me some relief for some years, I had Pacemaker implanted in 2018 which hasn’t completely cured AF but the burden was reduced from about 70% down currently to 2%.

Hope that helps.

[Irishbeat in reply to CDreamer]

Thank you CDreamer,

I have a fairly healthy lifestyle (Non smoker and very occasional drinker) and had just walked 150k from France to Spain and along the Camino before my initial Ablation, so I think AF was our to get me no matter what. I don't need a pacemaker as I have never has Tachycardia. I will take a look at the Mini -Maze option.

Kind regards

[CDreamer in reply to Irishbeat]

I think the Mini-maze may be a good option for you. Several forum members have had successful outcomes but you may have to travel, one member went to Japan. In the UK the person to get info from is MummyLuv now I have tagged her she may respond.

In the meantime you may find this post of hers from a few years ago useful & suggest you put mini maze hybrid procedure in the search box and you will get quite a few posts from people who have had the procedure healthunlocked.com/afassoci...

Never heard of anyone having it in Ireland but it is available in UK, US & Japan - I think saulger travelled there so have a look at their posts - it was a good experience and much less expensive than the US.

[CDreamer in reply to CDreamer]

PS - my step-daughter and her husband are preparing to do the Camino in March, they live near Skibbereen, it seems to be very popular!

[MummyLuv in reply to CDreamer]

Thanks C Dreamer; definitely worth consulting with a mini maze surgeon. They do the ablation from the outside of the heart so gives more firm lessions. It does depend where your rogue afib is coming from though. As you are in Ireland you wouldn’t be able to access mini maze on the NHS with Mr Hunter which leaves you just with private options. dr O in Japan is very experienced and if you read Saul’s posts you will see also more affordable than you may think: the other option nearer to home is via Mr Birdi at the keyhole heart clinic in London.

[mjames1]

If your ep giving up at two, it's probably time for a new ep or cardiac surgeon. At least for a second opinion. Some promising results from ablating the ganglia plexi in addition to a standard PVI. You may have to travel to a leading afib center for this. Another option is a surgical ablation such as mini maze or hybrid. They can sometimes work when a catheter ablation wont.

I understand that two seemingly failed ablations in six months can be depressing, but I would look at it as simply the beginning of the journey and nowhere near the end. Especially with today's advances.

Jim

[Irishbeat in reply to mjames1]

Many thanks for the support Jim.

[dmac4646]

Presumably if she is against doing more than 2 ablations she will have a plan to see if drugs can help or indeed a pacemaker - there are quite a few EP's now showing reluctance to do more than 2 ablations particularly if they are state funded..but the EP may have other reasosn as to why no more than 2 in your case ?

[Irishbeat in reply to dmac4646]

Thanks dmac,

I am hoping that she has other plans. State funding would be amazing but sadly not available to me. I'm a stubborn old boy, so won't give up just yet.

Thanks again

[Quovadisuk]

you need to pursue the option to have a pacemaker . Had similar symptoms as yourself that was getting worse … now no problem . Apixiban had to be stopped as it was causing considerable itching over the body . It was changed to Adoxipan with no issues Rrgwrds