Drugs vs Ablation for Atrial Fibrillation (AF)

Posted by gloaming @gloaming, Jul 29 5:35pm

Those trying to make up their minds to get an ablation or to commence, or stay on, a regimen of anti-arrhythmic medicines might be interested in new evidence:

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

Profile picture for sjm46 @sjm46

@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.

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If it's helpful...I get Eliquis thru Canada....Pharmstore....I pay approx $50.00 a month. I get 3 months worth at a time.

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Profile picture for diane07710 @diane07710

If it's helpful...I get Eliquis thru Canada....Pharmstore....I pay approx $50.00 a month. I get 3 months worth at a time.

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@diane07710 Thank you for the information. As I said, my insurance pays for my prescription but when I looked at what they supposedly pay, it is $785 for a 90 day supply. This is what is wrong with our healthcare system in the U.S. Why can Canada get the same thing for $150? I feel so badly for those who pay out of their own pocket to stay compliant with their meds!

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Profile picture for bforester1 @bforester1

I'm 84 years old and have had a-fib for 12 years. Initially medication (diltiazem) was key to maintaining normal sinus rhythm. But after a few years I had an ablation which was effective for about 8 years. From the inception of a-fib I took the anticoagulant, Zarelto. At 81 years of age I had a GI bleed. I had to stop the anticoagulant and had a watchman placed. The difficulty that my cardiologist and I struggled with was the rapid heart rate. Between diltiazem, metoprolol and another I could maintain NSR for indeterminant lengths of time. The rapid heart rate always returned, anywhere from 5-80% of the time. Last week metoprolol was increased again which means I have to monitor my blood pressure closely. My heart rate is now between 110-130 about 60% of the time. When it drops to 85 I pray that it stays, but it never does. So on Thursday, September 3rd I am going to have a procedure, AV Node ablation. I am so worried and angry because this a-fib is so prevalent and defies a cure or solution. I think about what this ablation means. It will keep the atrium separate from the ventricles - no communication between the two chambers of the heart!!! I'm very frightened, but have been assured that it is the only way to go with a heart rate so high for most of the time.

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@bforester1
I have a similar history to you, although I do not have a Watchman, as I am taking Xarelto without problems (so far, anyway!). Tomorrow you will have your AV Node Ablation. I had one last year. As gloaming indicated, you will have to have a Pacemaker. You stated that you understand that communication between the atrium and ventricles is severed (I generally use the term that they "burned the bridge"). Consequently, the pacemaker is needed to keep the heart beating at a 'normal' rate. I resisted for a long time (I told my EP that he wanted me to turn off all the electricity in the house and rely on the generator!). I watched several videos about AV Node Ablation. Here is one that you might find helpful: https://www.youtube.com/watch

Now - a year after the AV Node Ablation, I am grateful that I had it. Unfortunately, my atria are back in AFIB (and my cardiologist says that they will be for the rest of my life). However, it is not an issue for me. My heart beats fine; do be aware that you probably will have to have your pacemaker "tweaked" a few times, so that it works for YOU the way it should. I wish you all the best! Please report back after your procedure.

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Profile picture for bettycll @bettycll

@bforester1
I have a similar history to you, although I do not have a Watchman, as I am taking Xarelto without problems (so far, anyway!). Tomorrow you will have your AV Node Ablation. I had one last year. As gloaming indicated, you will have to have a Pacemaker. You stated that you understand that communication between the atrium and ventricles is severed (I generally use the term that they "burned the bridge"). Consequently, the pacemaker is needed to keep the heart beating at a 'normal' rate. I resisted for a long time (I told my EP that he wanted me to turn off all the electricity in the house and rely on the generator!). I watched several videos about AV Node Ablation. Here is one that you might find helpful: https://www.youtube.com/watch

Now - a year after the AV Node Ablation, I am grateful that I had it. Unfortunately, my atria are back in AFIB (and my cardiologist says that they will be for the rest of my life). However, it is not an issue for me. My heart beats fine; do be aware that you probably will have to have your pacemaker "tweaked" a few times, so that it works for YOU the way it should. I wish you all the best! Please report back after your procedure.

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@bettycll - To @bforester1: I also found this video helpful:

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Profile picture for ekiss @ekiss

I have AFib and taking Eliquis. Does anyone knows if Eliquis have side effects other than possible bleeding? I have been trying to research it but can't find a straight answer.

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@ekiss are you taking other meds for your AFib as well? I am new to Afib, taking 5mg Eliquis and Diltiazem at night. I think the Diltiazem makes me tired and a bit dizzy at times. I am seeing my EP next week for a 3 month check up to see if I want to continue drugs, do an ablation or ween off the diltiazem first and see if I truly have Afib.

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I had an AFIB ablation @ Duke U. hospital over a year ago. Everything went well until a few days ago when I experienced an all-night occurrence of rapid heart rate. I didn't sleep well but shook it off the next day and went on with the day as usual. Yesterday I woke up with the same experience I took my BP with my home cuff and it showed 157/ 77 and a pulse rate of 95 and indicated an irregular heartbeat. I took my vital info again after about 15 minutes and theBP had gone to 95/70, and my pulse went to 122. Another irregular heartbeat was indicated. I drove myself to an ER about 70 miles away where they did an exam with an ekg which indicated an A-flutter. A heart "shock" was suggested but I turned it down as I was told I couldn't drive home, and my wife has an important medical appointment today. She doesn't drive, I have to take her. My BP is OK today but my pulse is still high. Should I schedule or inquire about ablation for the flutter soon? Or another option>

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Profile picture for bobbybailey @bobbybailey

I had an AFIB ablation @ Duke U. hospital over a year ago. Everything went well until a few days ago when I experienced an all-night occurrence of rapid heart rate. I didn't sleep well but shook it off the next day and went on with the day as usual. Yesterday I woke up with the same experience I took my BP with my home cuff and it showed 157/ 77 and a pulse rate of 95 and indicated an irregular heartbeat. I took my vital info again after about 15 minutes and theBP had gone to 95/70, and my pulse went to 122. Another irregular heartbeat was indicated. I drove myself to an ER about 70 miles away where they did an exam with an ekg which indicated an A-flutter. A heart "shock" was suggested but I turned it down as I was told I couldn't drive home, and my wife has an important medical appointment today. She doesn't drive, I have to take her. My BP is OK today but my pulse is still high. Should I schedule or inquire about ablation for the flutter soon? Or another option>

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@bobbybailey Flutter tends to stay in flutter. So my EP told me (electrophysiologist). You could 'try' a cardioversion...it might work. But it sounds to me like your heart is now electrically disordered and you may be headed for a period where you get a lot of PACs (premature atrial contractions) or AF....atrial fibrillation. They are all kissin' cousins anyway.

I admire you for doing the best for your spouse. Once her needs are met, the most urgent and important ones, you should consult with an EP and see about a catheter ablation. They usually work well for AFL. They are day surgery....in the cath lab waiting room by 0700 typically, home with a driver by about 1700 at the latest, depending on when you're wheeled into the cath lab for your procedure. There will be other patients that day.

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