Has anyone with a pacemaker had an ablation for AFib?

I was not present when your EP described the 'simple ablation' procedure, but it sounds to me, as uneducated as I am about medical stuff, that he means an AV node ablation. If he says that you won't be so symptomatic, I can only conclude that you'll still have the AF, and the pacemaker probably won't be able to control it, but by nuking the AV node they'll control the RVR a lot better and you won't feel breathless and so anxious. Once again, this is what I THINK he means, but really you ought to put the question to the physician.
Here is what I found, if you haven't seen it:
https://my.clevelandclinic.org/health/treatments/23013-av-node-ablation
https://a-fib.com/treatments-for-atrial-fibrillation/av-node-with-pacemaker/
If you know for a fact that your AV node was destroyed during your pacemaker implantation, then what I have offered is of no value...sorry.

Gloaming - thank you so much for the explanation. Yes, he did mention AV node ablation. He was the EP who implanted my pacemaker, so I am sure he knows whether or not it was destroyed! I very much appreciated reading the Cleveland Clinic article. I obviously meet the criteria for an AV Node Ablation. My EP is hard to get an appointment with; generally, I am shuffled to a PA or NP. However, my nephrologist intervened, and I have an appointment with him in April to discuss all options. Before I read the article you referenced, my reading indicated that an AV Node Ablation was not used much anymore - that a complex ablation was preferred. I, of course, do expect to be dependent on the pacemaker for the rest of my life. Thanks again.

I had the Watchman procedure done in January 2024 due to having AFIB for several years, and I am not able to take blood thinners due to falls. I had a cardioversion several years ago, but that only stopped the AFIB for a brief while. My AFIB symptoms have become more and more evident as of late, so a ZIO test was prescribed, with the results making me even more anxious than ever. I am now in the process of getting an AV node ablation and pacemaker implantation done. I have read things and viewed videos about this procedure, but now I am even more freaked out. I am reaching out to see if any others have gone through the scenario I have and will be doing to lessen the AFIB flutters, anxiety, lack of energy, etc., etc., etc. I am interested in the pros and cons and the experience shared with me. Thanks.

My story is a bit different. I had the ablation first(Jan 2024) which has stopped my a fib. I had an RVR - rapid ventricular response. I had a pacemaker implanted February of 2024 after wearing a Zio monitor which detected bradycardia. The pacemaker also helps with my RVR. I have had my pacemaker adjusted twice for that. I hope you find a solution to your problem.

I had an afib ablation after having a pacemaker. The pacemaker was inserted because I had Sick Sinus Syndrome. I was having pauses in my heartbeat. Currently, I am not having any long-run afib like I had before the ablation. I had tried several medications that either didn't help or caused bad side effects. I was allergic to Sotolol. My ablation was done at Mayo in Rochester. Absolutely the best decision I could have made.
Edited-I also had episodes of RVR. Scary and left me exhausted. None since my ablation.

@gram0322 may I ask how low your heart rate went? I have Afib with RVR
- that’s what they wrote in my recent hospital notes. I wore a ZIO patch recently. Will find out more in two weeks.
I am nervous because I stopped breathing when I was under anesthesia for a colonoscopy and endoscopy (together) a few years ago… woke-up after the very short procedure (probably 15-30 mins max) and was coughing and had something attached to me (breathing machine or something?) and two days later I was in the emergency room with aspirational
Pneumonia.
How long was your ablation procedure and how was the recovery? My heart rate goes as low as 48 (but generally it is 50’s and 60’s) while I sleep and then I get tachycardia when I walk. Over 100 and sometimes up to 160 if anxious. When in Afib it goes up between 125-173). Afib is not every day or week. Can go a month or two without Afib. It used to be once a year or so.
My typical Resting rate is in 50’s, but more like 60 as an average.

Many thanks - appreciate your sharing. All
If the best with your health!!

Your AF is still in the paroxysmal stage, the first stage. It comes and goes. You are symptomatic to an extent, and you can probably tell when your AF wants to start and then does start...if you're awake at the time? Your tachycardia when walking sounds like your AF might be the adrenergic kind where thinking of things that need doing, getting up and moving, all mean a bit of a stress response...so adrenalin. The metoprolol counters that...................some. More metoprolol does more, but it also puts some people into bradycardia territory when they are calm or asleep. Many, including myself (I'm not a medical professional), feel that a fit heart in a person who is at rest and who is not experiencing light-headedness or fainting, is probably just fine at an HR of even less than 50 BPM. Athletes, especially males, can go as low as 30 BPM and still function very well, even walking. So, it's a 'discussion' between the patient and their heart about what bradycardia means for the two of them. The < 60 line that doctors use is just a guideline.

It is when our AF is in the earliest stages that it is the easiest to treat and to ablate especially. So, if an ablation is in your future, don't let too much time go by. AF gets harder to control the more advanced it becomes, and yours sounds like it's working its way forward...slowly, maybe gaining speed now.

Depending on what the EP finds, an ablation might only take 90 minutes, or it might take up to 4 hours. If he/she finds several foci on several walls of your left atrium while in and ablating you, then that has to be dealt with, and that means more applications of energy which each take about 8-10 seconds. About 20-30 around each focus...so you do the math. And then there is the mapping process to find them all. Then, once done, or apparently so, they have to challenge your heart chemically to see if they can get it to act up again and reveal a place they've missed ablating. If you're good, out you go to recovery. It's all day surgery, like an endoscopy, cataract surgery, vitrectomy, etc.

Recovery is as individual as freckles. Yours might be four days and you're back driving, shopping, hiking, kayaking....even playing the violin, which you never learned to do. 😀 Others, like me on my first ablation, felt dull, no energy, and I finally needed another ablation (about 25% of all first ablations are unsuccessful, but a redo improves the changes...happened to me and I'm three years free of AF....YAY!). Some find their heart rate returns to normal inside of a few weeks, while others report it took a whole year before their heart went from 80 BPM back down to 70 or less. We're all different. It's an adventure we must all write as we do it.

Bettylcc
I'm 75 now and had a pacemaker installed for bradycardia in 2010, back when all pacemakers eliminated your ability to ever have an MRI. Developed Afib in 16 and had an ablation for it in 19 at Mayo Phoenix, done by IMO one of the best EPs in the country, Komondoor Srivathsen, AKA Dr Sri. The ablation lasted 6.5 hrs because Sri kept finding more spots to ablate. He told me he zapped a total of 72 spots, hence the reason for the longer than usual time for the procedure. The pacemaker was not an issue of any sort before, during or after the ablation. If Sri turned it off or left it on or changed it in any manner, I was never told. I assumed because it was a complete non issue to the ablation. As others have said, a pacemaker cannot control Afib and has nothing to do with it. It simply functions to prevent the heart from dropping below the programmed rate when the heart is in normal rhythm.

While I had the usual post ablation bouts of minor Afib common to every ablation patient, they went away within a week and since 19 I have not had any Afib incidents. I attribute that to Sri's determination to not quit until he felt he'd found every trigger spot. IMO the key is to work with as good of an EP as you can find who is also completely dedicated to going the extra mile to take care of what's triggering the Afib. There's a reason why 30% of first-time ablations do not stop Afib and I am convinced a big part of that 30% is a less than an almost fanatical commitment of the EP. Keep in mind that the process of finding every possible spot to ablate is a very tedious procedure which after thousands of procedures could become boring. But having a pacemaker is a non issue with regard to an ablation. And really, to me the ablation itself is a nothing burger in terms of going through it and afterward. Try open heart surgery or better yet, back surgery! Even after being out for 6.5 hrs I went home the next day and felt great with no after procedure drag.