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Drugs vs Ablation for Atrial Fibrillation (AF)
Heart Rhythm Conditions | Last Active: 2 hours ago | Replies (11)Comment receiving replies
This is a really excellent video which I had not seen previously. It supports everything that I have learned and believe about treatment of A-fib since I was diagnosed. My EP's APRN told me that the use of ablation (pulse field is what I insisted on) has advanced in technical efficiency in just the last few months. What this video doesn't stress enough is that when a patient is diagnosed with A-fib, the cardiologists (and mine is excellent) do not offer the options from the very beginning when a patient is in the paroxysmal stage. The first thing I got was an anti-coagulant and medication for rhythm control. Then I had to wait for 4 weeks to get a cardioversion that was only successful for rhythm control for about 5 months. Only when I did the research online did I learn about and decide that ablation was the way to go. I had to ask for, insist on, getting a really excellent EP and pulse field type ablation. I would have driven miles to get what I wanted. Fortunately I had an exceptional doctor who I think did a thorough job (not just a "cookie cutter" ablation which is what I have heard some less experienced EPs do). This is the most definitive video I have seen reaffirming that treating A-fib early is the best chance at successful treatment; I think I have a very good chance of staying in rhythm for a long time--it's been 9 months and I have had no episodes and am on a fraction of the B/P med that I was on before. This video could have also mentioned lifestyle changes, which I believe are also important. Losing a little weight (I was never overweight) with daily exercise and avoiding alcohol also helps. Thank you for posting this; I think everyone with A-fib newly diagnosed should see this. BTW: I was 78 when I was diagnosed and was worried that my age would eliminate me from being considered for an ablation, but that was not the case.
Replies to "This is a really excellent video which I had not seen previously. It supports everything that..."
@sjm46 It is unfortunate, in some ways, that cardiologists make a living from diagnosing, informing, consulting, and then prescribing for patients because referring their patients right away for an ablation cuts them off of the potential income. IOW, it isn't in their interest to send a patient of theirs out the door, pointed toward the EP's offices across the street. So, as you say, they tend to want to keep you in their offices for at least a year or two.
Call me cynical, but.......................all EPs are cardiologists before they specialize. Why go to the Middle Man?
@sjm46 Second reply to you, this time about age. My well-ripened dad, who was 95 when this happened, told an attending at our local ER that, due to his age, he was told previously, or had read, that undergoing general anesthesia was ill-advised and not normally done. BS, said the internist.
@sjm46
So you had to remain on blood thinners after abilation?
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@sjm46 ,
Good that the ablation worked for you. I was 79 when Afib presented itself as persistent. I have Apical Hypertrophic Cardiomyopathy and see a genetic cardiologist in the HCM clinic at the Mayo in Rochester. He said I had to hve been having episodes when I thought I was having palpatations (which never showed on my holter). He referred me to the Heart Rhythm Clinic and the EP I saw gave me all the options and the pros and cons. When I asked what he would recommend, he said he would start with an antiarrhythmic medication. So, I have been taking dofetilide (Tikosyn) for 3 years and worked great for 10 months and then I had occasional breakthroughs that would self convert. When they started to become more frequent, my HCM cardiologist added Jardiance to "fine tune the diastolic dysfunction" caused by the ApHcm. Now I have been afib free for a year. I realize an ablation is the best if done early and think I was headed that way when I was having episodes, but the ApHcm is an additional risk factor as I have a pouch (not quite big enough for aneurysm) on the apex of my left ventricle. So, I am hoping to avoid an ablation, but might happen in the future. Good luck and I hope you remain Afib free.