Ablation for Afib

Thx for your reply. EP said 20% likely that Keytruda caused his Afibs and flutters. He had ablations, then Cardioversion, then Amoiderone rate medication. Still having Afibs. Now also having thyroid issues.

He’s been on Keytruda every 3 weeks for 1 year, and has remained cancer free. I understand that Oncolgist doesn’t want him to die from cancer by doing the full protocol, but need to consider impact on other organs, esp heart. We cannot seem to get Onc and EP to discuss.

That's why I have a cardio onc. My regular oncologist is quite conservative. He said we'd discuss keytruda next week. I think he means to skip it. I already missed one due to colitis so I really want this one. He and I will most likely go along with the cardio-onc. And I'm also cancer free and hope to stay that way. 2 more keytrudas; the last one should be 8/5. Good luck with the decision. Does he have a cardio oncologist? They specialize in these problems and they're not unusual. My afib resulted from radiation for breast cancer in 1999.

Congrats on being on the other side of a PFA, being cancer free and almost done with Keytruda.

I was just at a talk from a cardiology team tonight and the lady next to me told me her AFib started after radiation for breast cancer. My afib started on day 5 of taking Kisqali but that was also 3 weeks after 37 radiation treatments for breast cancer so now I’m thinking the radiation may have played a part as well. I spoke to the cardio-surgeon speaking and described my pattern. He said my afib is now considered persistent not paroxysmal. I’m not going to stop Kisqali but I doubt it would make a difference in my afib at this point. Time to call my cardiologist, give in and talk to an EP. My AFib is not only scary and progressing, it’s seriously impacting my quality of life due to frequency.

That's why I had my ablation. Quality of life. I'm a tennis player who couldn't play tennis and a walker who could walk outside.
So far the worst part of the pfa is the 3 hours lying flat. Also ther stubble from shaving. You really should consider it. You also might want to discuss getting a Watchman at the same time. I wish I had.

My concern with the watchman is the limitations on MRIs. I have two kinds of cancer and I need to be able to have MRIs.

I understand. I get pet-ct and only mri of brain so I dont think it would be a problem for me. But I do recommend the ablation. If this worked, it's really worth a sore back.

A good EP will block the signals for the AF, and if you can't really have a Watchman implanted, the next best thing is to take either a full dose or a half-dose of a DOAC with your experts' studied opinion in mind. The Watchman prevents nearly 90% of the risk of a stroke if you also have AF. So does a DOAC. So, to me, the choice would be simple: get the AF stopped ASAP so that your heart doesn't continue its remodeling and progression to worse problems associated with long-term AF. From there, you shrug and pop one or two DOACs each day until you can't.

Thank you for your reply. I know it seems silly to those of you who moved right to treatment but fear has kept me from taking action. I have a long medical history and have had some complication or mishap with every procedure I’ve ever had and some really severe and rare adverse reactions to so many meds that I don’t feel any choice is safe for me. I’m afraid of the DOACs and have a rare hereditary neuropathy that makes my nerves damage easily so the ablation worries me too. It has felt like a damned if I do and damned if I don’t situation. But my last afib episode was 60 hours instead of the usual 30 so I feel that’s too much time for a large clot to form. It also just wipes me out. I’m afraid it’s time to have to take that treatment risk. I also held off on treatment because I thought the cancer would get me first but that battle has been going better than expected and I’m still here so…

I sincerely feel for you. My wife is a 'basket case' who defies all study and who suffers greatly each day. She takes at least ten medicines routinely each day and is still beset with arthritis, irritable bowel, GERD, abdominal cramps, and a great deal of anxiety both from these intractable disorders and due to childhood trauma. I can only imagine what it is like to face uncertainty, dread, and the strong desire for self-preservation at the same time, and always in conflict with the day's realities. Fortunately, and if I could encourage you to try one ablation, we're only dealing with an electrical pathway that shouldn't be there. The ablation blocks that signal from entering the left atrium and causing that vessel to contract. From then on, only the SA node does that job...which is what nature intended in the first place. If the ablation is successful, you can forget that problem, perhaps for the rest of your life. As it is, though, the risk of stroke is about 6 times what it would otherwise be whenever you enter AF. It can be for a single hour or for days, the stroke can still happen due to poorly circulating blood in the left atrial appendage.
Lastly, I wouldn't dream of assigning 'silly' to anything about you. Your life is a constant struggle, and you're trying to find the safest and least 'costly' way through it. I applaud you for sticking to it, despite the effort and duress you have had to endure.

Thanks for your encouragement gloaming. I have learned a lot from your posts. You’re a wealth of information and I understand all the risks from both action and inaction. Sorry about your wife’s challenges. I have no doubt you’re a great patient advocate for her.

I love to be informed so I can make informed decisions but it’s also a battle with some doctors to explain my complicated medical history and adverse reactions. Some acknowledge there are people who are outliers and others take the cookie cutter approach no matter what you say. Frustrating.

I’m tired of the AFib and worry so I’m ready to take action but have a couple lung tumors that need to be ablated soon as well so I haven’t figured out the timing of each yet but I’ll at least try the blood thinner for now. Thanks for all your input.