AV ablation and pacemaker?

Posted , 7 users are following.

Hi have paroxysmal Af, I've had 3 ablations and still get frequent attacks Take Flecc twice a day 100mg and if have attack take a third. AF is frequent and can be long

so two to three times a week and last one (longest ever) was 36 hours before back to nsr Saw cardiologist yesterday and am trying one 2.5mg bisoprolol (which I last took years ago) and Flecc 50g twice a day. Trial for 3 months. If no change my next option is amiodarone but having read of side effects not too keen.

Third option is to see if EP prepared to do 4th ablation (he felt no more he could do after 3rd) SO

should I consider the Ablation and pacemaker! Read that it does not stop AF but I would not be aware of the symptoms. Any thoughts gratefully received

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10 Replies

  • Posted

    Hi Shirley. I too have AF (had a session a couple of days ago), but not as frequent or horrible as yours. Have you been following discussions on the AF Forum (AF Association on Health Unlocked)? If not, then I recommend you have a look at that.

    It is frequently said there that all treatment for AF is only to improve quality of life (QoL). On that basis, then for you, pace and ablate sounds like the best option. Yes, AF will still be present, but it would relieve your symptoms. The contra-indications revolve around how old you are, as permanent AF with no symptoms might have a long term effect on the heart muscle and cause other problems after very many years. For us oldies (I'm 70!) that's not so much of a concern. I don't have enough years left anyway to worry about my heart getting over muscular etc.

    I'm not a doctor, and should not be saying any of this, you really need to have this discussion with your EP. If he is not willing to do another ablation, (some people have had 6!) then maybe it's time to ask to see a different EP? Is your EP at one of the well recommended cardiac centres? There is a list of EPs available at the AF Association site, together with a way to research their past records etc. It would be worth travelling elsewhere to get a second opinion, at least. Your GP should be able to arrange that.

    I'm so sorry to hear that you have this mongrel disease, I'm on a waiting list for my first ablation, at Blackpool Victoria, and so far can trust my EP. NHS response is SO slow, but then AF will not kill you, only the side effects do that, and the drugs don't help.

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    • Posted

      Thank you! I am 71 so feel the same as you regarding long term damage! Had af approx 9 years. My EP is based at QE Birmingham. Go back to local hospital cardiologist in 3 months time so will be better able to assess staying on the new biso and flec or going invasive! Good luck to you x

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    • Posted

      AFib is a serious diagnosis.

      While this condition isn’t fatal in itself, it can lead to potentially life-threatening complications. Two of the most common complications of AFib are stroke and heart failure, both of which can be fatal if not managed quickly and effectively.

      According to the American Heart Association, people with AFib are about five times more likely to experience a stroke than the average person. When blood isn’t circulating through your body properly, blood clots are more likely to form. These clots can travel to your brain, become lodged in narrow blood vessels, and cause a stroke.

      Another complication of AFib: heart failure

      Heart failure occurs when your heart is unable to pump blood efficiently. If you have AFib, your heart may not be able to pump blood forcefully or efficiently enough to push it to where it needs to go. That’s why you’re more likely to develop heart failure if you have AFib.

      So when someone makes an off hand comment like AF wont kill you , procede with caution.

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  • Edited

    i am seeing an EP to learn about a pacemaker in combo with destroying the electrical system in your heart. you never have afib again! i dont know much about it. but you could explore it with your EP . i have had Afib for 17 years. amiodarone made me feel like the walking dead. i took it for six weeks before quitting. i was then Afib free for six months. strong stuff, but i would never go on it again. good luck.

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    • Posted

      Having the procedure doesn't stop afib. You need to read up on AV node Ablation.

      This procedure will control the heart rhythm but the multiple short circuits in the atria will still be present.

      You will simply no longer be aware of them, although some people still are.

      Thus, the procedure does not cure the condition. It only treats the symptoms.

      YOU WILL STILL NEED WARFARIN or another blood thinner.

      You will be dependent on the pacemaker.

      The procedure cannot be reversed.

      Some people do well after the procedure, others regret having it.

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    • Posted

      You are absolutely right. I should have said the same, and I apologize. I chose not to have it,, and am on diltiazam and flecainide.. I reduced the dose, and it is working well. I am also on blood thinner Lixiana Thanks for your input.

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    • Posted

      Am an 85 year old male with PAF for 17 years. Was offered an ablation but declined for risk at my age and did not like the success rate. Also my PAF was coincident with my taking BP meds and have always thought this was significant, unfortunately I need BP meds. Have 15/20 episodes a year lasting for 36/48 hours which self-terminate (so far) but leave me totally washed-out. Have been on Bisoprolol for AF, Indapamide for BP and Warfarin. Have never been offered any other med so interested in you experience . When you say it's working well, how well in terms of number and duration?

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    • Edited

      ello Marco. I sympathize with your experience as I know how debilitating AF can be. I was having 24 hour episodes every 10 days or so, The drugs I am on do make me fatigued,but it is worth it. I have not had a single episode of AF since starting Flecainide 9 months ago. My EP says it is imperitive to have a heart rate drug as well, like diltiazam ordigoxin. But I am not a doctor. Find an Electrophysiologist and learn what you can. I am on Lixiana, a once a day blood thinner, one of the novel oral anticoagulants (NOACs) that do not need monthly blood test monitoring. Good luck, and stay well.

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  • Posted

    Hello Shirley: I discussed the options with my EP, and here is what I learned.

    (I am 85 years old. My A-fib in the past few months has been nearly once a week. It leaves me wasted. Average 24 hours, BPM 130+). I was referred to an electrophysioligist. We tried a low dose of Diltiazam and Flecainade and I got A-fib three times in one week, although at a lower heart rate. Now we are trying Diltiazam alone, to see if I can tolerate it and if it will do me some good. It controls the heart rate, but not the heart rythmn.

    My new EP talked about using a pace-maker, along with destroying the electrical system. That way you would be entirely dependant on the pacemaker, but would never have A-fib again! This is a last resort remedy, and I would rather not go that route, but I thought you might be interested in learning about it. He also told me that they do not do cardio ablation over the age of 80, and think twice about it after 75.

    Anyway, I am still on this earth at my age, so cannot complain, and am grateful for excellent medical care here in Canada. - Moira

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    • Posted

      Thank you Moira. I have been on 2.5mg Bisoprolol and 50mg flec since 10th December and only had one attack so keeping fingers crosssed. The most simple option seems to do good for me at mo. Just had an attack this am but very less harsh so will see how I go over next couple of months. Good luck to you and Merry Christmas too!

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