Afib - do I just live with it?

Posted by kfox21 @kfox21, May 3, 2021

I am in permanent afib for 18 months. Because my quality of life is good (mild SOB on exertion) I am told to just live with it vs ablation. Is this a good recommendation?

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@phoenix1647

I am now (Apr 28) at the one year mark with my Watchman. I have had NO problems with the device at all. I still get some very minor AFIB episodes now and then but nothing like I had before. I did not get a stent put in as my doctor said the issue she saw in the lower part of my heart was not that bad and we decided to do a wait and see. I am very happy with my Watchman and my medical team.

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I meant to thank you too but posted instead of replying by accident. It's good to read that the Watchman is working well for you and will reassure a friend of mine likely to have one in the near future.

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@callalloo

I meant to thank you too but posted instead of replying by accident. It's good to read that the Watchman is working well for you and will reassure a friend of mine likely to have one in the near future.

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One thing we all must remember...the Watchman device does NOT prevent AFIB from happening. The device is to prevent blood clots from forming in the LAA area of the heart and nothing more. I hope your friend decides to do the WAtchamn and that it works out well. Thanks for your comments.

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@phoenix1647

One thing we all must remember...the Watchman device does NOT prevent AFIB from happening. The device is to prevent blood clots from forming in the LAA area of the heart and nothing more. I hope your friend decides to do the WAtchamn and that it works out well. Thanks for your comments.

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Oh ok I didn’t realize the Watchman did not prevent AFIB at all. It was strictly for preventing blood clots. Thank you for the information.

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I had AFIB for 18 months that after 1 year it became basically out of control in spite of taking 3 expensive medications that sapped my energy - and had CardioVersions. I spoke to my smaller town (100k pop) surgeon his success Ablation Surgery rate? 40%!! So after checking a few other Doctors out of town I went to Mayo Clinic Phoenix and had the surgery 11/20. I have not had an AFIB experience since and I am 77 years old. I only take Eliquis now because I have a history of blood clots. Just saying.

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@mercuryrose

I had AFIB for 18 months that after 1 year it became basically out of control in spite of taking 3 expensive medications that sapped my energy - and had CardioVersions. I spoke to my smaller town (100k pop) surgeon his success Ablation Surgery rate? 40%!! So after checking a few other Doctors out of town I went to Mayo Clinic Phoenix and had the surgery 11/20. I have not had an AFIB experience since and I am 77 years old. I only take Eliquis now because I have a history of blood clots. Just saying.

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I too had AFib for many years, had the ablation and no other issues. I was on Eliquis then Warfin, I had a Watchman inserted and no longer on any blood thinners. I'm 70.

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@kfox21 -- Hi there, K!

In answer to your question... maybe you can. I do!

I'm a male -- almost 74 yy... been in permanent, asymptomatic AF for the past 20 years. Unless I'm exercising, my HR stays in the 65 to 85 bpm range. My BP is on the low side as well. Blood work – including lipids, A1C, etc. – is excellent. BMI is 22.3, on Keto diet (but not super-strict), usually walk 40 minutes or so four times / week, and workout with resistance bands twice a week.

No history of DM, CHF, no previous TIA / stroke / TE, nor MI. Don't smoke / drink, and don't mess with recreational drugs (I'm not totally boring though – instead, I sing / play electric bass in my Classic Rock band).

Meds: Low-dose beta blocker (very cheap), Eliquis (expensive), and several supplements: D3, CoQ-10, magnesium, saw palmetto, and psyllium. Get check-ups twice a year with my EP.

Feel great... the irregular rhythm doesn't bother / impede me in any way! No way I'm going the ablation route.

Wouldn't push ablations on anyone who's asymptomatic, your HR is under 100 bpm, and you're on anticoagulent... as recommended by your EP. (Please research ablations well before considering this procedure... so many failures... watch out for the sales pitches and medical marketing... often it takes two OR MORE to be successful... also examine the inherent critical risks. For anyone wishing to go forward, please consult only the most qualified / most experienced EPs that can demonstrate a record of tons of successful ablations “under their belt.”)

Re: the Watchman... recent studies indicate that the seal created by procedure often leaks, over time, potentially allowing a clot to pass through. (Google: electrophysiologist Dr. John Mandrola's site).

All the best!

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Thanks… I have a tele-consult on Thursday with Dr Munger. Maybe I’ll be able to resolved conflicting advice. If my quality of life is good (which it is), is doing nothing other than meds the best approach?

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@squeaker2

I was told by 2 different cardiologists that I would be on medication for the rest of my life. The medication made me feel bad. The third cardiologist who is still my doctor and who I picked out of the phone book, recommended an ablation procedure. He referred me to a Dr. Paul Mounsey at the University of North Carolina hospital in Durham. My a-fib was intermittent and when I went into a-fib, I was so breathless that I had to go to bed. Dr. Mounsey said I was an "ideal candidate" for the procedure and.
so my ablation procedure was performed eleven years ago at UNC by Dr. Mounsey. I take no medicine for this other than an 80 mg. aspirin a day. I also take medicine for my blood pressure but that is all. I am 81 years old and have never had another problem with a-fib.

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I find it interesting that all the comments here talk about Afib sessions that do not result in going to the hospital. I have been told that I should call 911 if I have an attack. The challenge is that as soon as I think I should call 911 it quits! I have a pacemaker because my heart rate dropped below 55 and I was blacking out. My heart rate at age 16 was 72! At my last check-up of my pacemaker the technician raised the heart beat to 81. After a few weeks, I asked for it to be reduced and he refused. A few weeks ago, I had a phone call session with my cardiologist and he told me that my heartbeat wasn't 81! Fortunately, I have kept copies of my heartbeat sessions and it clearly shows that before the change it was lower and the pacemaker is set at 81 beats a minute. I am concerned that this higher rate may have a negative impact on my heart. I would like to know more about the positive and negative benefits of raising the heartbeat beyond what was my normal since my teenage years. Any information would be helpful. I am concerned that I suffering from "senior dismissal" or what you want to call it, when you are a senior and your concerns are dismissed. BTW I didn't have any blackouts until I was 80. Now I am 84! I hate mentioning my age. I used to be proud of it. Now it seems to bring negative reactions. I took a cognitive test a few years ago and I aced it. 30/30! My doctor wasn't sure he could do as well.

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You want a mechanical vs a chemical fix. Ablation works, and they're improving it all along. It may not work the first time. Failure rate is about 30%, but...BUT....it depends a lot on who is performing the procedure. Don't go to an electrophysiologist who only does three or four a week, and who is only three years out of training. You want an EP who performs 10 a week, and who has been doing it for donkey's years. The EPs with 20 years experience and who do 1000 ablations a year are the ones you want.
Always remember that you want to treat this ASAP. AFib is a progressive disorder. It always progresses, and not in a good way. So, you want to undergo ablation before it becomes persistent....get it while it's still paroxysmal in nature, the kind that comes and goes. If you put this off, you can count on having a worse and worse time of it. Lest you think I'm a blowhard, or someone who could use the work, I am a retired military officer who just had a second ablation inside of seven months. I had developed flutter, a not uncommon occurrence after an ablation. My EP found the gap in the lesions he had made last time, and when he burnt and closed the gap, my heart restored its natural rhythm immediately. He seemed pumped when he came bedside a couple of hours after I had regained consciousness and said he didn't even have to shock my heart to get it back into NSR (normal sinus rhythm). If you must fear anything about your heart and how to make it better, fear going to the wrong EP. Find a good one (forget the reviews carping about his/her bedside manner, you want an EP, not someone to hold your hand and tell you, "There-there..."). And do it tomorrow if today is too late.

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A pacemaker may be in your future---I was a-fib and just got one, after alot of dizziness.

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