contro; afib with pace maker or oblation?

@jc76
Your situation seems quite similar to mine. I will be seeing an electrophysiologist in a few months. I have two triggers that set off my arrhythmia thus far. My Fitbit is my captain! On blood thinners. BPM resting at 55. Nightime: 42. What is the ICD? I think, as time goes on, a pacemaker might be best for me, but I'm still learning about all this. Your message shed some new light for me. Ty!

I've had a pacemaker since January 2026. Which was for Bradyacardia.
I still have afib and fllutter which I'm getting ablation/watchman in a few weeks.
Mean while I've had 20+ TIA's and gone to ER too many times. ER just looks for
serious stroke symptoms with scans and blood tests which are all negative.
I seems the day before TIA's I've been overworking somewhat.
On eliquis and metoprolol.

@d050526
ICD: Implanted Cardiac Defibrillator.

Some get ICD alone, some get pacemaker alone, and some get what they call a dual device. I have a dual device.

As I write this at 3:30 a.m. I am in VTAC. The only reason not being shocked is the Amiodarone is keeping my heart rate down below the shocking threshold.

@shamus
Hard to answer your question as not a medical professional and even if were don't have your medical and mental health history or examined you.

These questions really need to go to your (EP) electrophysiologist who is the expert to answer them.

You mentioned one or the other. I can only give you my experience on this and I have had both.
How low is your AFIB and resulting heart rate?

An ablation is done to stop the errant tissues causing the electrical signal putting you into AFIB and PACs.

A pacemaker is designed to give you ventricles a steady and pre-determined pulse rate. How low is your HR (heart rate)? Have you been told have low HR?

My pacemaker has helped with PVCs. My heart rate was down in low 50s because of medications. My EP experimented with HRs to see what rate helped reduce my PVCs. We tried 50, 60, then 70 seemed to be best to help prevent them.

I am not sure but I don't think a pacemaker paces the atrial just the ventricles. Good question for your EP and why I hesitate to write things like this as not a medical professional. But have had a ICD/pacemaker for over 21 years now, been shocked about dozen times, and have had two abalations on ventricles.

I have a few months to wait before an appointment with an electrophysiologist. The more educated I am, the better. I so appreciate your comments. Yes, I understand none of the comments are from professional physicians.
Here's what I know...Contracted Covid last December which messed up my health in many ways. Severe Gerd triggered an Afib episode. I've had three since May 5th. Resting heart rate 42-55. I stopped exercising vigorously (125 bpm and over). I try to keep my adrenaline rushes controlled. I am a performer. (125 bpm and over). Knowing these triggers have been helpful. My cardiologist told me, at this time, ablation therapy is off the table. Explained to me a Walkman if I want to go off blood thinners. The devices (pacemaker and the ICD) still need to be explored. I will be working on securing an appointment with an electrophysiologist sooner than the three month window I was given. My Fitbit and I have become best friends! Once again, many thanks for your share.

I had a LBBB/Left Bundle Branch Block in 2005, late 50s, which causes Bradycardia, AFib event in 2019 and Ablation on 2/20, stress EKG in 8/23 diagnosed “chronotropic incompetence”, which is condition where does not have ability to pump blood when body is under stress, resulted in a two lead Pacemaker, I’m now 80, satisfied with ICD, get ChatGPT, describe your condition and ask questions about your health, it will respond to you in a manner that non medical people can understand.

@d050526 Gerd and indigestion, belching due to gas (swallowed air) are among the three or four dozen known 'triggers' of AF. And AF can come on once for such triggers and never appear again in one's lifetime. Doctors know of 'holiday heart' which is when over-imbibers drink too much alcohol on a weekend binge or a party and end up in the ER needing a cardioversion....yet another example of a one-off event.

Have you had a gastroenteric evaluation to determine the cause of GERD?

Why is ablation 'off the table?' Cardiologists might disagree with an electrophysiologist's assessment, but if it were a disagreement over ablation vs. toughing-it-out, I'd soon be in the EP's offices, not the cardiologist's. So, don't give up hope that a worthy EP might feel you're very much a decent candidate for an ablation.

Hola, mi esposo tiene 50 años en febrero le hicieron un ecodoppler y le encontraton ue presentaba la valvula mitral, tricuspide, y aortica con insuficiencia leve, dilatacion del vetriculo izquierdo pero todo leve. No es hipertenso ni presenta ninguna enfermerdad cronica. Pero hace una semana ingreso a cuidados intensivos por presentar un cuadro de fibrilacion auricular y le encontraron como hallazgo la auricula izquierda dilatada.
salio de uci pero le dijeron que pude volverle a venir esta FA.
en un holter de febrero le salio el QT en 511, pero con los antecedentes le dijeron que todo era leve pero ahora le vino la FA. como debemos de proceder ante este hecho?

@mari23 He should consult an electrophysiologist. His heart is disordered, and probably 'diseased' (most men of an age have some order of atherosclerosis and valvular disfunction/wear-and-tear).

An electrophysiologist will assess him, probably with new diagnostic tests, to see if he/she can ablate your husband's heart to curb the atrial fibrillation (AF).

You say your husband is only mildly hypertensive, and this may, or may not, have resulted in the mild enlargement of his atrium. AF also tends to cause atrial enlargement over time, but this takes months, and his burden of AF would be higher than about 5% of beats in a 24 hour period....typically if it was AF that has caused the mild enlargement.

The translation does not know what FA is (is it fibrilacion atrial?).

Your husband's fibrillation seems to come and then stop? If so, he is in the earliest stage known as 'paroxysmal'. This early stage is the stage when AF is the easiest to treat. So, and electrophysiologist (EP), would want to see him sooner rather than months from now when/if your husband's heart has deteriorated further or has more intractable fibrillation due to advancement or progression.

@gloaming
Gastroenterologist set up next! Thanks! Never had issues before. On Prilosec.