Do I really need an ablation top up?

[MisterMagoo]

Settle in. Get a drink. Long post coming.Advice, opinions, anecdotes, experiences and jokes all welcome on this.

Nearly 2 years ago I had a partially successful ablation for afib and flutter at the Nottingham City hospital. Partial on 2 counts.

1. They failed to get to the flutter because of some wierd anatomy in my heart blood vessels.

2. My afib was almost totally cured. I need to take 25mg of Flecainide once a day at night, sleep well, stay hydrated and avoid drinking to 5am to keep it at bay.

Since the ablation, I have only experienced flutter when taking 25mg of Flecainide in the morning as well as the evening and then cycling up a very steep hill at the end of a long ride.

I also take Apixaban.

I now no longer experience flutter, hardly ever afib and exercise well all week, including hours on my bike at the weekends.

I have now received a redo appointment under general anaesthetic for next month and I'm wondering if I should let sleeping afib/flutter dogs lie or get them seen to once and for all - in as much as that is a reality.

What do you good people think?

[mjames1]

Why GA for flutter? I'm going to guess then that this is not typical right sided flutter but something on the left side. What success rates are they giving you?

I have a similar but different situation. PVA took care of my Afib., but still have very occasional tachycardia episodes of unknown origin. Rather than go for a fishing expedition I've decided to leave things alone forl now as long as I can prevent them with a low dose of daily diltiazem which is the case.

Jim

[MisterMagoo in reply to mjames1]

They need to do a scan to identify the best way to access the flutter and remaining afib as they couldn't get to it last time. They are assuming s complex route requiring GA.

[mjames1 in reply to MisterMagoo]

You really need to talk with the EP as to what they are expecting a result wise. Are we talking 50-50, or do they think it's going to be a slam dunk? Is this a high volume center of excellence that has done many similar procedures?

Jim

[BobD Volunteer]

There is an old saying "When the pupil is ready the teacher will appear". Only you can decide but for what it is worth, if there is abnormal formation in your heart (which no doubt is why they want GA) then it will be far from routine so you need to question likely success and balance against your current and likely quality of life. Note I am a great fan of ablation having had three for AF till 2008 since when no AF and one in 2019 for atrial tachcycardia which also worked.

[Buffafly]

If they couldn’t fix the flutter last time what has changed? I’d love your QOL! Maybe the ‘earlier the better’ mantra applies to redos but I’d question what the redo hopes to achieve before accepting.

[MisterMagoo in reply to Buffafly]

They couldn't get to it because of the blood vessel structure of my heart. That's why the GA after an MRI to ascertain the best way to access the area.

I fully appreciate how lucky I am in my current situation, hence the reticence.

[50568789]

My initial ablation for AF appeared to be working but Flutter then broke in and my EP has put me on his list for a second ablation to sort it out. It will be GA, in his words he needs the time for this procedure and what he will be doing would be too painful for normal sedation. I could easily think why bother, the Flutter is pretty unobtrusive at this stage and I'm not a glutton for punishment, but no question about it, I know I'm not 100% and if there's a chance of improvement, I'm going for it.

[30912]

A difficult one. I did let sleeping dogs lie. Wrongly in my opinion and in hindsight.

After my first ablation I was told it would have to be done again but my AF improved (strange word) such that the bouts were few and far between like once every 6 months or so and I could get on with my life. I was discharged back to my GP and a repeat ablation was never offered and I didn't push for one either. Roll forward a good number of years and the beast returned - back to square one. 10 years later I had ablation number two. Rinse and repeat - after 8 years, I'm back with similar problems.

On the basis that you haven't been forgotten about and someone knows that you need a re-do and you've been offered it, I would take it. My view is that it may help to prevent problems in the longer term.

My second ablation was under GA which I much preferred and had no issues with recovery.

Good luck with your decision.

[MisterMagoo in reply to 30912]

That's given me something to think about but not made my decision any easier!

[Vonnegut]

It’s great that you have retained your sense of humour which is the most essential aspect of dealing with our problem! As I developed chronic fatigue with the PAF following a virus, it has put an end to my active life style so guess that is how my PAF is well controlled with Flecainide, though I take far more than you do, 50mg am and 100mg late pm.