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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
@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!
Replies to "@harbeywj as I wrote, the first cardiologist, 10 years ago, wanted to put me on anticoagulants..."
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The keys I think are 1. how often Afib occurs 2. are the occurrences increasing 3. how high is HR and BP. I understand your thinking and I believe you are right on with your own decisions. After my 1st ablation I had a brief 8 hour episode 11 months out and then 16 months later and then a year later and then a year later. All brief < 12 hours and all < 90BPM and good BP. Then last fall I started with every 3-6 weeks still reasonably brief < 36 hours and < 90 BPM and good BP but increasing in frequency. I have not gone to ER and always contacted my doc after I have converted. But the increase in recurrence has lead me to go for a 2nd ablation. It's been 5 1/2 years and mapping is better and surgical techniques better. Kardia has helped a lot because my episodes are brief even just running over to urgent care to capture it on an ECG was futile as I would convert before I they took a ECG. Anybody who is recurring I believe in having a Kardia. My doc recommended it and that is how I have been able to document episodes. Also when I have PACs it is easy to see them on the tracing and I know the difference. An aside about PACs my doc is a firm believer that they are too hard to have a successful ablation and so he says no. Yet I read about some who are ablated for PACs. I like my doc and that says a lot. My 45 years working western medicine has left me with a bit of cynicism -:) never mind my experiences as a health care consumer.
I've mentioned here before about my older brother 81 has used medication for controlling Afib and he goes to a large medical center in St. Louis. Biggest problem for him is when he exercises he can push it into Afib but so far converts quickly. He thought it was going to fail in a year or 2 and then get ablated. I think he is right at 5 years keeping it medicinally in sinus.