Ablation without a blood thinner.

I have posted my story of the pacemaker here previously. I had Tachy Bradycardia with three second gaps between heart beats. I had a phone call from Doctor X on a Sunday morning at the end of May after having had a seven day ECG monitor saying that I needed a dual pacemaker fitted as a matter of some urgency and all the reasons why.

I had the same story at the pre assessment from a cardiology nurse and a young doctor but found when given my pacemaker card after the procedure that a single chamber one had been fitted. I did not see the doctor who had fitted it again but raised it twice with another consultant Doctor C during ward rounds as I was in for two days with a pneumothorax.  He did not know why and said we will see how you get on with it for six months and I will see you at outpatients.

As my heart rate was hovering on the hundred mark I expressed concern and asked about an ablation in the future. He said that he would consider it. I had by my own choice not been taking Warfarin due to joint pain each time I had taken it in the past. He persuaded me to agree to try a NOAC but as I have a history of duodenal ulcers and had been having digestive troubles again I did not start it but intended to later. Since then my heart rate has settled into 70-86 bpm and I basically only feel my irregular heart rate when on my left side in bed.

I had a future cardiology appointment with another consultant that was cancelled for early October and put out to mid-November that I could not get improved. When speaking to a cardiology secretary  I found that I was now on the lists of three cardiologists. My normal one Doctor A, the one who had fitted my pacemaker B and the one C I had spoken to about the ablation and that I was on his waiting list to have it done.

I raised my concern about the choice of pacemaker with the secretary and she said that she would send a note to Dr B about it but I did not hear from him.

On Friday morning I had a phone call offering me an ablation by doctor B this Wednesday as someone had cancelled. I explained that I had not been taking Warfarin so would not be able to accept and again pointed out that I had a single chamber one fitted. She passed the message on and doctor B  phoned me. Despite what Dr X and the pre assessment team had told me he maintained that his letter from Dr X had said single chamber pacemaker and that was also what he considered I needed. Neither I or my GP had a letter from Dr X.

I said that I felt that the ablation decision had been made off the cuff during the ward round and that I had expected some follow up before it happened. I asked if with my present heart rate and ablation was still indicated and he said perhaps not as I’m not having much in the way of symptoms and to have my mid-November cardiology appointment with Dr A and see what transpired. 

This morning I had another call from admissions saying that he had now decided to proceed with the ablation on Wednesday. I questioned doing it without being on Warfarin and she said that he had said that it would be all right. I expressed grave misgivings and she said that she would get him to call me back when he is finished in the theatre. 

By chance I had an appointment with my GP this afternoon. He said that he has never had a patient not on Warfarin to have an ablation.

Would any of you submit to an ablation without having been and continuing to be on Warfarin or a NOAC in the months after it. No mention was made of what type of ablation was to be done.

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