Seeking advice about Paroxysmal Afib before seeing cardiologist

I think judging from the replies some of us missed the OP mentioning that he is Canadian and has limited access to other Cardio docs.
As he said and I quote "I should mention there is very little chance of finding another cardiologist."
Additionally he says the cardio is anti ablation. So he is dealing with a very difficult problem. Informing himself so he can maybe have a conversation with the doc sounds like the best he can get.

Is it possible to find an electrophysiologist in Canada? I think many of us caught the location of the OP but what else can we suggest ? I certainly hope the suggestion of an EP has not added to frustration in seeking help.

You can look up "The Watchman Procedure" on the Watchman website.
They call it a procedure throughout the site even in the URL https://www.watchman.com/en-us-hcp/about-the-procedure.html The watchman doesn't do anything to control or help reduce Afib. The purpose of the watchman is to prevent or catch clots from moving through heart/lungs and brain. Whereas Ablations and some drugs are used to control and or stop/reduce Afib.

i had the ablation done in 08. My surgeon tried to put me in afib while doing the ablation but he couldn’t. so he basically guessed. it was a success and i had prob 10 years without afib. i had two strokes 6 months apart in20 and 21. had been on eliquis until recently when i had the watchman done in this past may. off the eliquis right after the watchman was done, now i get off the clopodgril end of sept and will only continue with a baby asprin for the rest of my life. the watchman was a piece of cake. no pain at all, only one night in the hospital. i’m so glad i had it done

Hi! I hear what you are saying. The worst thing about AFIB is that it is very fatiguing as the heart is beating erratically which results in heart pump inefficiency. Unfortunately, the atrium and ventricles are not working in sync. This results in an adequate supply of oxygen getting to various body parts, resulting in fatigue.
If you are only having AFIB attacks intermittently this is better than having permanent AFIB as there are more treatment options available and the longer you have AFIB the more difficult it is to treat.

AFIB can be treated with medications. A blood thinner is usually used to decrease the chances of stroke as blood tends to pool more when the heart is beating inefficiently. Thinning the blood reduces its chances of clotting. Drugs such as Eliquis are often prescribed as many of the newer drugs have fewer adverse side effects and don't have to be monitored as carefully.
Other drugs can be used to control "rate" and "rhythm" Unfortunately, drugs usually have some adverse side effects. Drugs such as beta blockers can slow your heart to make the heart beat more efficiently. Unfortunately, some of these drugs reduce your production of adrenaline which can also make you feel fatigued.

Traditionally drugs were the first course of treatment. However, recently it has been shown that people with intermittent AFIB can best be treated with "ablation" procedures. This treatment consists of scaring the heart tissue to prevent erratic electrical impulses so the heart can return to a normal sinus rhythm. This can be done with laser (burns) or cryoblation which freezes the heart tissue to scar it.

Treatments today can be less invasive and have a relatively fast recovery time. Catheter ablation is one of the best options as small tools can be inserted into a catheter/tube and these tools can create the necessary scar tissue to prevent AFIB. There are several hospitals which specialize in this treatment and the success rate is quite high, particularly for those with paraximal AFIB. (Only occurring intermittently) See if you have any electrophysiologists in your area. Do your due diligence and check out the various options available as well the centers that specialize in this procedure. Check out the odds of having a successful treatment. It's often good to get a second opinion. The fact that you are in good shape is a big plus. Good luck and God Bless.

I have done a fair amount of research since I was diagnosed with Afib. Everything I read says that the best outcome is for paroxysmal Afib to have ablation sooner. Sooner is better.

I am waiting for PFA to be available in my area. I had a watchman 3 months ago….so, the biggest danger (blood clot and stroke) are past….now to try to get some long term relief.

Afib is progressive. Don’t wait till it becomes more frequent and longer. Sooner is better

@katiekateny the book "The Afib Cure" by Day and Brunch, two cardiologists, says that afib is not always progressive. It also discusses meds and ablations but emphasizes avoiding triggers and lifestyle changes. I have no idea if afib is progressive, myself, just mentioning that there is some difference of opinion apparently.

My own EP says that he would view my episode frequency ( once a year, once every two years, one time twice in a year) as a successful ablation and does not think I need one. Time will tell. I don't eat after 5, lie on my right side, drink low sodium V8 for potassium, take magnesium at night, and (the hardest thing) try to avoid stress.

Regarding being progressive, I had afib very severe episodes from age 14 to 21. Then quit caffeine and rarely had minor short episode until age 75. In error, was eating coffee ice cream from US and was starting again. So had to quit.

It has progressed almost like a kind of clock work with me. 10 years ago it was once, twice, maybe 3 times a year, never lasting more than 5-10 minutes. This is why no cardiologist ever saw it on the heart monitor. It shortened down to about once a month…and in the final months last year is was about every 10 days…but lasting hours. This is why it was finally caught in ekg.

I have never yet discerned any “ trigger”. No rhyme or rhythm. (Pun intended).

Since being on metoprolol and flecainide I have not had to deal with the symptoms, though I am told the electrical firing is still happening,

I cannot have the typical ablation because my esophagus is too small for the temperature gauge they must use. So, next I wait till Pulsed Field ablation is available in my area…simply no other choice.

I will add this. The studies I have read were fairly current and legitimately done…double blind with 3 year or 5 year follow up.

Pubmed is a great resource for the actual studies if you are like me and want to learn from the source.