Thank you for your input @nevets
I promise I don’t take this lightly or think anything about it is simple. I’ve experienced too many mishaps to believe anything is simple or guaranteed. I had an isolated AFib episode 10 years ago and then 4.5 years ago it moved to 1-2 times a month for 12 hours year 1. Year 2 18 hours. Years 3 & 4 2-4 times a month for 30 hours and the last couple months once a week with the most recent episode 60 hours. I’ve tried just avoiding all identified food and exercise triggers which are lots (my PCP told me good luck with that plan). I’ve educated myself thru reading, watching videos, attending talks, reading stories here and have thus far declined meds and procedures.
I have an appointment with my cardiologist on July 2nd for the first time in 3 years. I thought my last episode would never end. This time I’ll agree to meet with the EP. I don’t want my afib to progress to permanent and it’s ruining at least 2 days a week now. I’ve had several retinal TIAs in the past 2 years. My retinal specialist is freaked out I’m not on blood thinners. I tried dronedarone (Multaq) 10 years ago for 3 days and felt like I was actively having a heart attack the whole time. I’m convinced I would have died from that med had I continued. Scariest med ever for me. He then prescribed flecainide and eliquis but I was too fearful to try either at that point.
When my brother went on blood thinners after heart surgery it took 6 months, lots of falls and injuries from passing out, and 7 ER visits before they figured out he had internal bleeding from a tumor which was stage 3 esophageal cancer. So I have plenty of risk questions for my cardiologist, EP, oncologists and neurologist regarding AFib treatment risks. I also don’t do well with anesthesia and so many stories of failed and repeated ablations are very scary. I’ve taken gloaming’s message about selecting the right EP to heart. I also know the more complex the case the more likely it may take additional ablations. Aside from the MRI issue with the watchman, I’m allergic to aspirin and all NSAIDs so that’s another contraindication. I sure hope I can safely tolerate the blood thinner.
I do feel like I’m between a rock and a hard place due to personal risk factors, but I’m very informed. I guess I’ve been in the analysis paralysis stage for 4 years. I’m trying to be extra cautious, not throw caution to the wind.
3 years ago I asked my cardiologist to stop trying to scare me into compliance. I fully understood the risks and options. I’m not sure he understood all my unique concerns. I told him, because of your constant scare tactic approach telling me your worst patient outcomes from those that refused meds, every night before bed I put out 2 bowls of kibble and two bowls of water for my dogs in case it takes a while for someone to discover I’m dead. He apologized for making me feel that way.
Your comments here lead me to believe you may either be reluctant to seek risky AFib treatment yourself or perhaps you already had a bad experience with treatment. Are either of those the case?
Hi Zebra
I am not anti-treatment (but I hate taking meds) and have a lot of respect for medical technology and healthcare providers, though I don't alway agree with them. I have /had paroxysmal Afib and opted for pulsed field ablation in January. My cardiologist is very conservative and treated my Afib with beta blockers (metoprolol) and anticoagulants (Xarelto) for about two years. Once PFA became available, he backed my decision to have the ablation. So far so good post ablation...no Afib episodes but occasional ectopic heartbeats that unnerve me a little bit. I hope I can get off the meds once I reach the 6 month milestone. We shall see.
My opinion about PFA, like all medical technology breakthroughs, is that it will evolve and improve as it matures. I'm guessing that ten years from now, even five, PFA (possibly with the help of AI) will be much better than it is currently, with success rates above 75-80%. And who knows, perhaps it will be eclipsed by something newer and better? In the meanwhile, it's the best tool we have right now.