Ablation and asymptomatic/persistent AFIB

[Mjlarson11]

I am 65 year old physically active male. I have had persistent AFIB for 10 months and the only impact to my lifestyle is the inability to cycle at the previous pace - a state I have come to terms with.

I have had two unsuccessful cardioconversions. My doctor says I have two options

1. Remain on Metoprolol and stay in AFIB the rest of my life or

2. Go on Amiodarone, get my HR controlled and then have an ablation.

I have read that AFIB increases your chance of stroke, congestive heart failure and dementia...especially if you have hypertension which I do. This info suggests I should go the ablation route but I am not sure how significant the stroke, congestive heart failure, and dementia risks really are.

I am wondering if other Asymptomatic Affibers have had ablation surgery and why?

Thank you

Mike

[MoundMan]

Underwent 2nd ablation earlier this week. Previous one 2 1/2 years ago. Have slow afib. Last shot at getting heart to sustain rhythm. Norm has been, as I now realize, over decades to be in slow afib. What heart has known. Strong symptom didn't surface til mid-60's. Definitely recommend ablation for my situation. If I return to afib, then it's a quality of life shift. Less physical activity than accustomed to. That has been basketball with men in their 30's ( I'm early 70's ) and back-packing in back-country. Guessing regular medication too. For now a fresh, sound, healthy, new beginning.

[sheffbk in reply to MoundMan]

I'm also early 70s - had some afib for last 20 years and it is now (last 5 years) continuous, 24/7 but, apart from awareness if I listen close, take pulse or am tested (once or twice a year ECG and scan) no impact on qual of life.

I have had no intervention apart from anticoag (apixaban).

My cardiologist at local highly regarded dept favoured ablation but left decision to me .. I also talked to two of the top EPs in country who said if q of life OK then not worth ablation.

I know I'm one of the lucky ones (swim, and competed in Euro masters last year) I have greatest sympathy for those with bad episodes.

My resting pulse is an irregular 35-50 bpm, 25 years ago resting was a steady 55, but is slightly better than a couple of years ago … the long beats were about twice the short, now less than twice and fewer… it's like a base of 60 with a miss every few beats.

[Mjlarson11 in reply to sheffbk]

Thanks for your reply. I am very interested in your swimming performance. My cardiologist has told me to keep my HR under 140 - but with AFIB my HR goes to 140 very quickly - even with meds. My cycling performance/output is about 55% of what it was pre-AFIB. I good go faster but I have to slow down to keep HR under 140. May I ask how you have maintained your swimming performance?

[sheffbk in reply to Mjlarson11]

Hi - many years ago, when my Afib probably started, it was signalled by jumps in HR to about 200 - felt like a sudden adrenaline rush for no reason, usually happened during recovery slow swims in interval training - I didn't feel bad, just strange, and after pausing at pool side for a minute, it cleared and I continued - no probs. I was then off swimming for about 3 years with shoulder injury - on returning I had and have more of the opposite problem - I'm a sprinter and heart rate won't go high enough - tops out at about 130. So -- not much help - each story is different. Performance not too bad -- I was middle ranking in the Euro games in my age group - kid myself it's because of the afib - but surely it's my age and lack of pool hours (on purpose - I want to keep having fun going through age groups - not burn out at my young age of 72).

Good luck with your cycling - hope you enjoy it whatever - that's the main thing.

[sheffbk in reply to sheffbk]

couple of other factors to bear in mind:

- stroke risk is probably back down to 'normal' if you take anti-coagulant.

- some say ablation should only be considered for quality of life reasons as it is not proven to extend life expectancy

- ablation is said to be less effective the older one is and the longer one has had the afib

I'm not an medical profesional/expert, but have read quite widely around this