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← Return to PF ablation after one symptomatic Afib episode?
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PF ablation after one symptomatic Afib episode?
Heart Rhythm Conditions | Last Active: Sep 2 5:43pm | Replies (28)Comment receiving replies
Cardiologists are not a homogenous group. Hence you (like myself) are not on other meds while others have an aggressive treatment plan with more meds including Amiodarone which was developed to be used only for V-tach. Some consider it a bad choice for geriatric patients. I worked in a very large university based medical center for 20 years. Although I had very little if any contact with cardiologists I found working in the hospital based setting that there was a lot of politics in medicine and within specialties. Some specialties were worse than others.
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@harbeywj as I wrote, the first cardiologist, 10 years ago, wanted to put me on anticoagulants and I declined. It's not like I just said no; we discussed it and he agreed to wait. He did prescribe diltiazem as needed (low bp was a concern) and then went to digoxin, which I did not take and told him so.
The next episode, for which I was hospitalized, brought a cardiologist telling me to go home and forget it happened.
This wide divergence in advice was certainly a tip off.
The first cardiologist eventually agreed that I didn't need meds (after a few years) and said that "maybe we are overmedicating people." I have no idea. I am grateful and perhaps lucky to have avoided stroke or worsening afib so far (knock on wood, last one was April which came quicker than previous intervals).
The EP I recently saw said my CHADS2 technically means anticoagulation based on age and gender but all my other factors are negative so he didn't want to do anything but pill in a pocket. He briefly considered flecainide. I have taken diltiazem at home maybe three times. He said no ablation.
I am going to try to stay home next time, and medicate with diltizem with lots of hdyration. I have a bp cuff and if it is too low for diltiazem I will go to ER. EMT's always want me to call 911 but last time I drove myself.
After 9 years of magnesium, low sodium V-8, walking and tai chi, early dinner etc. etc. I bought "The AFib Cure: Get Off Your Medications, Take Control of Your Health, and Add Years to Your Life" by Day and Bunch. I was curious. They say that an increase in afib is not inevitable and that many (some?) can get off medications. I am not sure I trust anyone in this field but was glad to see some of my strategies affirmed.
That said, the cumulative physiology of this may actually be inevitable. I have some EKG abnormalities now when at rest and not in afib. I will go on anticoagulants when this new EP recommends them. I finally found a "just right" approach- not too aggressive and not too laissez-faire that I can trust.
My biggest concern is that ablation done early is more effective. My mother had permanent afib and I saw what that can do. The timing is just something I will rely on the MD for. As I said, he would consider my so far once annual episodes as success if he had done an ablation.
We'll see how long I go now!