Drugs vs Ablation for Atrial Fibrillation (AF)

It is a personal decision with guidance from your doctors but I am a 71 year old women who has had afib or some sort of arrhythmia (flutter, or atrial tachycardia) since 2021. I have had four ablations, the last one was the new Pulse Field approach. None of them worked. I was put on Flecanade and had terrible side effects and didn't put me back in rhythm. I was on Sotalol for a while after my second ablation and it didn't keep me in sinus and the cardiologist admitted me and tried to raise the Sotalol level and my heart paused. He took me off of it completely. My sister who is 10 years older has also lived with afib for 20 years now. They put her on Tycosin and she had Torsades and it damaged her heard to the point where she needed a pacemaker and a defribulator. My cardiologist wanted to put me on this drug and I refused. The cardiac nurses say they see a lot of people with problems from that drug. I will not go on amiodarone either. It is a drug of last resort I am told. There are terrible side effects. My cardiologist recently wanted me to take Farxiga which I refuse to do because of the side effects and this drug was intended for people with Kidney disease and who are Diabetic. They discovered it impacted the heart and now are trying to use it for people with a 45-50% ejection fraction.

All in all, I take 25mg of metoprolol twice a day and eliquis and they added losartan to help my heart - not because I have high blood pressure. I live in and out of some arrhythmia but I feel well. I am not out of breath, I am able to exercise and do everything I need to do. I travel a lot but avoid high altitudes because I do feel it if I am exerting myself. Otherwise I, likey sister, have stopped trying to achieve sinus although sometimes I am in sinus rhythm. I no longer consume any alcohol, or caffeine or gluten to do away with triggers for afib.

I don't know if this helps you, but I believe many people live in afib - my oldest brother did as does my sister and others I know. It isn't the best option but I have found my body does not respond well to the drugs which don't change the afib anyway.

Good luck to you.

@loswalt0525 I am just curious; did the ablation ever stop the A-fib completely? What did the EP say about the reoccurence and when did it start after the ablation? I had to wait almost a year after my diagnosis to get an ablation and I, like you, did not want to take the anti-arrhythmia meds due to the side effects. I did use flecainide as a "pill in the pocket" a couple of times and that worked, but as far as taking a regular dose, I elected to not do that. My A-fib episodes were more sporatic than yours sound; I would have a two to four hour episode and then nothing for several weeks. I am almost one year after ablation and have not had any A-fib and only occasional awareness of PACs which my cardiologist says is no big deal. Have you made any lifestyle changes that are working. For me, giving up all alcohol (I was having a beer occasionally before) and cutting down on caffeine has helped, I think. I also lost some weight although I was not overweight to begin with. Just wondering how you will make out; please let us know.

@sjm46
Do you take blood thinners or no

@carlwgordon Yes, I take Eliquis and have taken it from the minute I was diagnosed with A-fib. My cardiologist, who I feel is very consciencious, practically ran out of the room to get a pill for me with a glass of water after he told me what I had. I had, a one point, tried to advocate for a lower dose, but he was adamant that this was not possible. I have taken it faithfully before and since my ablation. I have no interest in a Watchman procedure; I have no significant side effects from Eliquis (although if my insurance did not pay for it, I would probably be looking for a substitute since it is very costly) so I take it as directed. I have friends who have had mild to moderate strokes and I have no desire to increase my risk. I am consigned to taking blood thinners and if I can live A-fib free, I will tolerate the med.

@sjm46
Thanks I have afib if I run I can walk on treadmill up 3.9 mph. No problem. I am adverse to taking blood thinners.it may stupid but that what have decided so far. Thanks foe answering.