Was diagnosed with AFib in December 2024 but I suspect i had this for quite a while before the diagnosis. Am on anticoagulants (Apixaban) and Betablockers (Bisoprolol). Bisoprolol makes me feel unwell, total exhaustion and no energy at all. The EP cardiologist i saw privately (to avoid the long NHS wait) suggested i could have ablation and a pacemaker but inamovible not that keen on this idea. Having read about these procedures, I undertand the rate of success is limited to a short period of time and it is likely ablation will need to be repeated . Also, there is the risk of damage to the heart muscle and structures.
The new treatment was lauchex in 2024. It is called mPEF (micro pulsed electric field pulse ablation). The technology selectively targets the origin of the problem from the outside rather than inside the heart. It uses a catheter to deliver short pulses of electrical energy into the clusters of neuronal cells in which the arrhythmia originates. It destroyed these cells without damaging the heart muscle and as such will provide a safe, durable and long-term solution for the treatment of AFib.
So I would appreciate to know whether this new and safer procedure is offered at any NHS hospital? Has anyone had this procedure (privately or within the NHS) and any comments following the procedure.
Thank you in advance.
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You might want to doublecheck, but I'm pretty sure it's the same as PFA (pulse field ablation). In any event, it's from the inside of the heart, like catheter ablation, not from the outside. It is available in the UK and Royal Papworth in Cambridge was the first hospital to do it, so you might start by looking there.
Hi mjames1 and thank you for replying to my post. Yes, it is the same as PFA. Indeed I have now found out it has to be carried out from inside the heart (it makes sense really). However it is a safer procedure with reduced risk of damage to surrounding tissues and less pain during recovery plus a faster recovery.
Thanks for mentions Papworth hospital. I now understand a few other hospitals offer this procedure too.
In one of the Arrhythmia Alliance. zoom meetings a while ago there was a video presentation about ablations given by an electrophysiologist from Papworth. From my recollections the pulse field ablation requires a general anaesthetic as it is extremely painful during the procedure though no pain afterwards. It also requires massive electric current. His view was that there are so few people doing it that an experienced person doing a more established procedure is safer than someone with little experience doing a PFA.
Yes I am already taking this dose. I need a different betablocker. One would expect a GP to suggest that but as usual it is left to the patients to push and demand better treatments.
Not that I’m an expert lol but I take metoprolol 25 mg in am and 12 mg in evening along with Flecainide 50 twice a day and Eliquis 5 mg twice a day. It does the trick and I still have energy! I’m 68 and AF free for years with this combo. I wish you the best ❤️
Thanks for your input. It’s good you have found a combination treatment that is working for you. Did your EP worked this out? Which area of the UK do you live in, if I may ask.
Thanks for your kind words and may your treatment keep on helping in giving you a good quality of life.
I talked about the incredible exhaustion, dizziness and utter lack of energy with my EP when I saw him last month. He suggested trying half the dose, which I have been taking since then but no difference with utter exhaustion and dizziness. One would have thought he would have suggested a different betablocker… especially as I was seeing him privately (by that I mean having more time for the consultation than one would have when seen on the NHS). But he did not suggest a different betablocker. Rather disappointed . Will ask my GP to prescribe a different betablocker when I see her next week.
Good to know it is offered at Glenfield Hospital Leicester. Is Professor André Ng offering this procedure ? Although the success rate might not be different from that of other forms of ablation, I understand the procedure is more gentle on patients (but requires full anaesthetic ) and at a lesser risk of destroying surrounding structures/tissues plus a quicker and less painful recovery.
Yes, Professor Ng is doing this procedure, he is my consultant and did my RF ablation in March 2024. I have the utmost respect for him.He was the one who told me that there is little difference in the success rates.
I have not (knowingly) had an AF episode since I had my ablation 🤞
I thought he would be doing this procedure. I too have much respect for him and am thinking of making an appointment to see him again. Did you have the procedure under the NHS and if So how long did you have to wait? I assume you are still taking the anticoagulant but not the betablocker ?
Hi, yes I see him privately, seems to be the only way to get to see him personally. I had the ablation under the NHS but waited 12 months. I think because I see him privately he made sure he did my ablation as often it's one of his team.He told me I would be on the anticoagulants for life 🙁
He said he likes 'belt and braces' so has kept me on Sotalol as well (for now) but a lower dose, think he just likes to take things slowly.
I am due to see him again on the 14th of April. I sed him every 4 months at the moment. He is looking after me very well ❤️
Do you get any side effects from Sotalol? Did Professor Ng prescribe this betablocker? Am taking Bisoprolol which makes me feel like a zombie, so tired, weak, dizzy and no energy. Am going to request a different betablocker when I see my GP next week. Let me know how you get on at your forthcoming appointment.
No side effects that I am aware of. It's a combined beta blocker and antiarrhythmic and I know Professor Ng favours this drug. He took me off Bisoprolol and put me on Sotalol when I first saw him in 2020..Bisoprolol didn't suit me either I became breathless and dragged myself around.
Indeed PFA is available in lots of centres in UK. It is proving less traumaatic than previouos methods of ablation with a slightly faster recovery but so far no better overall results though many are hopeful. FYI after three RF ablations from 2005 to 8 I have been AF free so I would not agree with your analysis of ablation failures. .
Hi BobD, thank you for replying. With due respect you have had 3 ablations within 3 years… Although AF free now following your latest ablation in 2008 if I understood correctly. PFA is supposed to have a better success rate plus it is less painffor the patients during recovery and a quicker recovery, so in my books it must be progress on the other forms of ablation .
Actually the opposite. I'm off anticoagulants. I'm still on bisoprolol for heart rate. My afib has rvr which causes my hr to sky rocket. I have mental health conditions that contribute to stress on my cardiovascular and nervous system as well. I was on metoprolol 2x daily but I needed I need extended release. The metoprolol was leaving my system too quickly. I've been a lot better on the bisoprolol.
Hi glis, You mentioned that you have some mental health conditions. I don't want to overstep, but, I also have some MH issues and found that Metoprolol made it MUCH worse. Did you find that you got worse on Metoprolol? If so was the bisoprolol a better fit? Thank you
I'm not sure. I had afib (2018) before I started (realized that I needed) my mh journey (2020). I believe I was switched over by the time I got diagnosed with depression, panic and ptsd. I just got diagnosed with autism and adhd last year. I would t be surprised if it did though. After my stints of 180 bpm, an elevated hr always starts an anxiety cycle. The metoprolol would wear off a lot sooner and my hr would elevate. Then the lovely cycle of panic, hr react to neurotransmitters, more panic, etc. For me, bisoprolol is a lot smoother and consistent with my response.
Mine failed after 5 months! EP thought it might still be in the blanking period so I have had to wait 6 months for a third cardioversion, due mid April! The joy of persistent AF...
Thanks for your post and pls keep us advised of how your request is handled. I am planning to request the same inApril. I believe Bournemouth may be another place for it.
Hi, I will keep in touch regarding any procedure I may have. I am only looking for a possible procedure at this stage, having only been diagnosed a fea months ago.
Thanks for getting in touch. May I ask if you live near Bournmouth and are you considering being referred there? How long have you had AF?
I still have to do a bit of homework to do but currently considering referral to NHS Bournemouth, actually live in Hampshire or if essential at short notice a private clinic in London.
I have had AF for around 16yrs, diagnosed and prescribed Flecainide (200mgs) in 2013, made lots of lifestyle changes resulting in 10yrs AF free but last 15months it has returned on a daily basis albeit not as debilitating. So exploring more possibilities to see if 'the beast can be put back in the cage' without ablation - unlikely!
Thank you. So you eat very little Bread, cakes, biscuits … difficult with bread … I do have a sweet tooth… that Will be quite a change. I eat dark chocolate… and I now drink decaffeinated coffee. Do you use butter and eat cheese and eggs? I must look up for a diet guidance in order to alter my diet. Do you know of any?
I eat plenty of fatty fish (Salmon, Mackrel , sardines, and plenty of green vegetables and fruits.
Specialist gluten free bakeries exist and I use them by mail order eg Knife and fork bakery. Try cutting out snacks between meals. Decaff better by water rather than chemicals. I reduce my high dairy diet by using olive oil on toast instead of butter. Eggs no problem. Sweet tooth, I am also guilty and every so often I go cold turkey on cakes, chocs etc; it may help to tell yourself post 50 we can't get away with what we used to do if we want to maintain the same QOL.
I am no nutrionist and you need to find an experienced one as the gastro engine is possibly the most important to sort out particularly for vagally mediated PAFers.
Thank you again for all this useful information. Have you consulted a nutritionist who has experience of AFib patients? Would it be acceptable if I contacted you via PM?
It’s the 3 month recovery period that any AF episodes do not necessarily mean the ablation has failed. It takes time for the scar tissue to form which isolates the electrical paths causing the rogue beats in AF.
l have not had PFA., but on the waiting list. I recently saw EP from Royal Papworth Hospital. The outcome from this procedure is no different from previous ablations, but PFA is quicker and less invasive to the surrounding organs. Recovery is quicker too. Good luck.
Thank you. How long is the waiting list at Papworth and do you live in that area or was it easy from your GP to refer you to an EP cardiologist at Papworth hospital? Do Hope you won’t wait to long and wishing you good luck.
I have to wait 9 months unless, of course, l get a cancellation appointment.
I live 30 miles from Cambridge. My referral was a bit long-winded. I was referred to Peterborough Hospital (my local) Cardiology Investigations by a Dr. from AE., when l had a fast and very symptomatic episode of AF. Unusual, l know, but it had been a long time since l was first diagnosed with AF. and needed a check up.
I had tests including an echocardiogram to determine the health of my heart and as my episodes had increased, they gave me a referral to see an EP from Papworth Hospital in order see if l was eligible for an ablation. Fortunately, my heart is healthy.
Your GP would be the first port of call for a referral, but to hasten things you could see an EP privately initially and then he could refer you back to nhs. for treatment.
If your drugs are making you ill, l would go back to your GP. There are alternatives and it is just trial and error with most of them until you stabilise on ones that suit you. Don’t suffer in silence. Good luck on this journey.
Thank you very much for All The useful information. I saw an EP privately but he never suggested an alternative to Bisoprolol… neither did he mention pulse ablation. I feel I wasted my money! Seeing my GP next Monday so will request a different betablocker. One needs to be one’s own doctor nowadays.
I had to ask my GP to refer me to an EP privately. It did not occurred to her I needed to see an EP. I have to push for everything.
It’s great you live close to Papworth hospital. Hope it will happen soon. Much luck.
Thank you for your reply concerning Nebivolol. I will mention this to my GP at my next appointment next week. I wonder why she did not suggested this when I last saw her, neither did the EP cardiologist i saw privately….
It is good to know your ablation kept you AF free for such a length of time. May I ask you, Did you have a pacemaker fitted too, and how is your AF treated now?
Bisoprolol seems to be the first beta blocker they try. I said it made me tired and breathless so EP said try this. I am on very low dose (1.25mg quarter of a tablet) but agree to take extra as pip if in af and hb goes above 100. He said it’s often given to asthma sufferers as doesn’t impact lungs.
I do not have a pacemaker. my AF this time round is less often, less severe and less symptomatic. So I am on statin, nebivolol and Apixaban . I am in Ireland - moved from uk 2014 am 76.
Works for me so far. Of course it may get worse and I badly need to do some lifestyle change re diet/exercise.
Thank you again. Keep well. Unfortunately I cannot exercise as I am losing my mobility due to the progression of rheumatoid arthritis. Best wishes to you.
If you wanted a procedure that ablates the outside of the heart rather than the inside, then I recommend you investigate the surgical minimaze (performed by a cardiac surgeon, not an EP!) invented by Dr Wolf in Houston. And it's worth noting there are a small but growing number of Forum members who have had similar procedures here in UK, both on NHS and privately ...
Thank you so much for your input and sending the link which I will look at. Will have to write another post regarding the surgical minimaze procedure in the UK and feedback from the members of this forum who have had the procedure. There is so much to learn before making a decision. Take care.
Thanks Ozziebob. That has also given me food for thought.
It will be interesting to read the testimonials of some of the members. It would be great for yourself, not having to take an anticoagulant after the procedure is done. I would be first in the queue not to have to take an anticoagulant as l always have a slight malaise and loss of vitality, but not complaining because of the protection it gives.
MummyLuv is the best source for answers to your queries, and there is a link to a related Facebook Group given by another member in a reply today. I don't have Facebook so have never visited the Group where you would find more information about locations and surgeons.
I do know MummyLuv had a related procedure in London privately with Dr Hunter from Sheffield. He also does the same procedure on the NHS.
You might find the following link useful for further details from Forum members. It gives all previous Forum Posts that refer to "minimaze" ...
Indeed I would be most interested too… no more anticoagulants and Betablockers would be wonderful as I already take rather a lot of medication for other health issues.
US nurse anesthetist here. I had the pulse field ablation last year at the age of 81 so far I am thrilled with the results. It will be a year this April 15. I was a very poor anesthetic risk because of restrictive lung disease from scoliosis. So I went to a large hospital. The surgeon was REDDY one of the pioneers in this technique.. every three months they provided me with a Zio monitor to check my rhythm over the period of a week. During my healing time I did have ectopics, fatigue, and chest ache. But right now I feel really great. An advantage to the old way is the PF procedure takes less time.
I wouldn’t hesitate to have it done again if necessary even at my advanced age.
How wonderful for you. Thank you for your most useful feedback. I suppose this procedure happens more regularly in the US as it does in other European countries too. Less prominent in the UK unfortunately. I would rather have that firm of ablation rather than the 2 other forms.
I am 78 (79 in May and have many comorbidities) so am quite nervous.
Wishing you continuous progress in your healing process.
I had a PFA end of last May at Liverpool heart and chest hospital. I was told beforehand it lessens the risk of damage to the oesophagus. the other risks..stroke etc ..are the same as other methods
Thank you for getting in touch. Hope you are feeling AF free. Do you still have to take anticoagulants? I thought it wasn’t necessary to take these if one has a PFA procedure.
I had a PFA in Oct 2024 and am feeling good. I spoke with two EPs before having the procedure and both presented PFA as a method for slowing down the progression of atrial fibrillation and not a cure. My EP was fine with me going off anticoagulants at 3 months post ablation with the understanding that should I experience a long episode of afib in the future I would need to take the anticoagulant for 30 days.
Thank you for your reply. I believe PFA procedures are quite the norm in the US and some parts of Europe rather than in the UK. Wishing you success in your recovery and hope you won’t have to take anticoagulants again.
Actually, the PFA is not yet the norm in the US. My, very respected regional medical center, only started last Fall. It is not yet available in Vermont for my brother-in-law.
I had mine done in New York City by Dr. Vivek Reddy, a noted PFA researcher.
Just a newer, safer ablation technique. Understand it is still an ablation. The negative things you’ve heard about ablations are just worse case, like all medical procedures have. When you get a prescription, if you read the warning label it sounds awful! But these things are rare. An ablation, while something to take seriously, is not major surgery, it’s considered out-patient many times, and usually only requires 1 night stay at most in hospital. They are not “temporary” fixes, but can last many years or decades or more. The key is to find the best EP you can that has many ablations under his belt, as it is a nuanced procedure to get it right. The tech is SO much better now the success rate is much better.
Hello dweller and thank you for your input. Much appreciated.
I understand it is always best to know all the positives and negatives of any procedure, as it is with the effects of medication and try to keep everything in balance.
However, I am 78 and do have many comorbidities as well as living with much pain and living alone, my family live a long distance from where I live. Therefore a slightly less invasive procedure from which one can recover more rapidly while feeling less pain would definitely be my choice.
I understand that if one goes the pulse therapy way one needs to find a very good cardiac surgeon rather than an EP. Are you aware of this fact? Still try to find out as much information as possible so that I can make a good informed choice.
I am pretty sure an EP does Pulse Field Ablations, (mine does)... and PFA... Pulse Field Ablation, is still an ablation, and not really less invasive than a standard ablation. But yes, it is a safer ablation generally, less potential negative side effects so that is good and totally understandable that you would rather have that type of ablation! My EP is doing Pulse Field Ablations, (and my last EP is doing them also)... neither are "cardiac surgeons". It is safer... but I don't believe it has proven to be more effective, the jury is still out on that so far I believe. From what I've read, many believe that it will possibly prove to be more effective with time, as the docs performing them will be able to be more precise, and therefore more effective with their ablations. Maybe you're confusing PFA with the Mini Maze procedure, or the Hybrid Surgical-Catheter Ablation... both which I do believe require a surgeon and the latter a surgeon AND an EP for the procedures.
Hi again, My apologies for confusing FPA and the mini maze procedure… and thank you so much to correct my error. I am new to this AFib situation and desperately trying to find the best possible procedure and outcome. I think I have read too much today… it’s all getting muddled up in my mind. Of course EPs practise FPAs, not a cardiac surgeon. I feel quite relieved now… I feel quite stressed about adding AFib to my list of comorbidities. Thanks again.
I understand completely! I’ve been dealing with Afib for 25 years at least and it’s still confusing at times! Can I ask, how do you feel when you are in Afib? I ask because many feel ok, not overly tired, not much at all, or do you feel bad when you go into it? Honestly, many many people are in permanent Afib, and manage it with blood thinners, and live a normal life. This is not unusual. I’m saying this because I understand it can be daunting… but it doesn’t necessarily have to be. You are FAR from alone, the numbers of Americans who have Afib is very high, and it IS quite manageable for most of us. Afib is known to cause stress, so it’s important to step back, take a breath, and learn about this thing. Your EP can help obviously, and forums like this one also. We all understand… but again, this can be handled, possibly quite well.
I had a Pulsed Field Ablation at the Royal Liverpool Heart and Chest Hospital (for early persistent AF) in September 2023 (so not long after the procedure was adopted in the UK) and so far it has been a success, with no known (or obvious) spells of AF.... I deliberately do not go for modern wearable tech as it would only stress me out and be counter productive, plus I am in any case on Apixaban due to my ChadsVASC score. The procedure was straightforward and I recovered well and quickly.
Hi and thank you for your useful input regarding your experience of pulsed field ablation. How long did it take to recover from this procedure and was the recovery painful ? I hope you carry on feeling well.
Thank you. Other than some minor chest discomfort and the bruising at the groin (all quite normal) I felt fine pretty much straightaway.... however, I did err on the side of caution and generally respected the usual advice (via this forum) related to the so called blanking period, although perhaps returning to exercise earlier than I should have. I am fairly active for my age, so partly my idea of nothing strenuous may not be the same as others... 🙂 I hope you get yourself sorted whatever you choose to do. 🫰
Thank you. I need to do more reading and read again all the information I have been given by so many kind people. Then seeing an EP again to discuss before making my mind up. It is quite overwhelming.
If your PFA is successful & you remain in Sinus Rhythm, you will not need or want a pacemaker. Pacemakers with AV node ablation are for permanent AFib.
Or according to my husband’s EP the pace and ablate approach is also used for highly symptomatic PAF which hasn’t been improved by one or more ablations.
Hi- I've had 3 ablations over the last 15 years. The first one was unsuccessful but the second one gave me 7 years of sinus rhythm. I am in the US and had a great electrophysiologist. I googled this new procedure and the Mayo Clinic has a good article on it. It's called Novel pulsed field ablation. I don't know how accessible it is right now, but it sounds like it will be in the future and it does sound safer. I am on Dofetilide now because my Afib is persistent. It does work for me and hopefully I can remain on it. Best of luck with whatever you decide to do. Chris
Thank you for reaching out. I live in the UK. The pulse field ablation is new therefore it might be wise to avoid this procedure at the moment and go along with a procedure that has been truly tested.
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