Ablation without a blood thinner.

Posted , 4 users are following.

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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13 Replies

  • Posted

    Derek

    Warfarin is a drug to take when you are at home and not under the immediate care of a cardiologist.  

    I am sure, that when you are undergoing an ablation, they will have you perfused with anti clotting med. such as heparin, and there would be no way that you would suffer from a clot - and if you did they would be there to unplug it immediately.

    Personally, I would have faith in the system and the experience of the doc performing the ablation and I would go for it.

    Afterwards, when you get home, you'll be on warfarin on something similar, and they will probably not release you until they are certain that the blood thinner you are on is fully functional.

    If anything, I would recommend that after the ablation, you make certain that they are sure you are adequately set up with sufficient blood thinner in your system.

    All should go well.

    Frank

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  • Posted

    this doctor B makes me feel insecure and I would hold off for another opinion. But that's just me.
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  • Posted

    Hi Derek

    My consultant would only perform my ablation when my INR reached 2.5 and had been at this range for a few weeks, he stated that the thinner my blood when performing the ablation the better.

    You need to feel confident and have as much information as possible before making your decision.

    Best  wishes

     

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    • Posted

      With each of the two cardioversions I had my INR had to be over 3.0  and then there were no scars on the heart to break off and cause blood clots as with an ablation.
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  • Posted

    He went from 'perhaps not' to 'Do it' over the weekend and did not call me back later today.
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  • Posted

    My Cardiologist told me that one way to get rid of AF if all else fails & another ablation is perhaps too risky,they can fit a "pacemaker" which takes over & contols the hear beat, he went onto to explain, when they fit one of these they uncouple the natural wiring thats supposed to control the heart beats,so then you are AF free.

    Derek, because of your overaul condition which seems far worse than mine i would think very very carefully before having an Ablation, epscially if they offer the "point to Point" ablation, this almost killed me.

    you may have alraedy seen my post, if not take a look >>

    https://patient.info/forums/discuss/atrial-fibrillation-455839

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    • Posted

      Yes, I had read of you bad experience and a similar one in another converstation.

      If they 'uncouple' the the natural wiring that must involve some type of ablation.

      I'm probably also a lot older than you, the '76' was five years ago but yesterday I was suddenly younger when my GP referred to me in a referral to someone as 'This 41 year old chap'

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    • Posted

      I did not realiose at first which Derek i was replying to.

      Quote: If they 'uncouple' the the natural wirieg that must involve some type of ablation. 

      No they dont ablate they just cut the connection to the heart , to do this and fit the pacemaket takers 15 to 20 minutes....

      But my cardiologist went onto to say that this procedure was used for  older patients , so it would be more suitable for you than me, i am still a springer in comparison.

      good luck !!!!!!!!!!!!!!11

       

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    • Posted

      Derek,

      i dont which could be potential the more fatal, the wrong pacemaker or a botched abaltion.

      The pacemaker that my Dr S mentioned was the one that takes over the complete & overaul heart beat. He told me that the natural pacemaker we have is obviously affected by AF, so to get rid of that connection & replace it with an artificial pacemaker would in turn get rid of the AF ..& i guess he means get rid of the "Lone AF" that i have.

      its definatley worth speaking to man about it, & even getting a 2nd or even a 3rd opinion if need be.

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    • Posted

      When i ask my consultant Dr S, if there was an alternative to all the medication to control the AF, he just said yes fitting a pacemaker, when i asked what the procedure was he explained the same as i have explained in my previous post, but he went onto to say it was usualy what they would do for older people, but he did not rule it out for me, so iguess if i showed more interest in that as an alternative to drugs, then i am sure i could have done.

      he did not say anything about any particular pacemaker, although i am sure they are some that are different to other,ie, there is one i know of that has a defribulator built in to it.

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