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Where to go?

Heart Rhythm Conditions | Last Active: Aug 9, 2025 | Replies (24)

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Profile picture for sjm46 @sjm46

I hear you; while I have the A-fib in control, I do take a lot of meds--some prescribed and some OTC. Unlike you, I can't stand the feeling of being out of atrial rhythm; it just makes me so uncomfortable and annoyed. I have been told that many folks really don't feel bothered by the arrhythmia, so if it is constant, there really isn't much you can do to change that. I am holding out for an ablation at this point since the small dose of anti-arrhythmia drug I am trying has been working so far, but if it fails then I am in for plan B. The other thing that makes my situation tolerable is that my insurance company pays for most of my meds; some folks are just paying a lot for Eliquis alone. These med costs can be a real drag on someone's budget. Take good care!

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Replies to "I hear you; while I have the A-fib in control, I do take a lot of..."

One thing to consider is that, the longer you put off an ablation, the more difficult it is for the electrophysiologist to successfully block all the spurious signals. The reason is that the heart is now electrically disordered, but it continues to evolve in this process, always 'improving' itself in how to ensure it gets more and more incorrect signaling. That is to say, it continues to develop new foci or reentrants for the signals, and you'll need more and more drugs to beat it back. By the time your EP can get to you, you're very advanced and may even find that drugs no longer work at all. So, for two reasons, you should get an ablation as early, and as soon, as possible. They are: a. that your case becomes more difficult the longer you put off the procedure, and b. the heart continually remodels itself when in AF, and that means atrial enlargement, ventricular enlargement if the AF compromises the mitral valve, and eventual heart failure if it goes on for years.
So, you apparently are still in the paroxysmal stage of the disorder. That's great! It means that a simple PVI (pulmonary vein isolation) should suffice for you. But the longer you go, the more complicated and difficult it becomes, and by then you'll have twice the medication in you that you have now.
So, my message is mainly that, while things are good now, and you may have solid reasons for not wanting an ablation just yet, mind letting your heart advance itself to the point where you have more breakthrough episodes of ectopy, need more or new drugs, and you get more and more remodeling going on due to the heart's insistence that it wants to beat irregularly. Early is better when it comes to the electrically disordered heart. Ablation is now the 'gold standard' of treatment for AF.