Ablation for Atrial Fibrilation

Posted by rbm @rbm, May 4 2:25pm

I am a 71 year old male, diagnosed with afib a year ago, taking eliquis. 4 week recent heart monitor results showed increased afib events and cardiologist suggests ablation. Has anyone been through this procedure? If so I would appreciate you sharing your experience. Thanks.

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I hav Ablation about 8 years ago. It worked and am very happy with results. They put u out and no side effects. Well worth it. The meds I was taking before made me feel terrible. No more meds. Have it done you will be happy.

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Thank you for your response. Reading through the discussions here has been a bit unnerving. It seems like the procedure has not been successful for many and had triggered other things. I have a lot of confidence in my cardiologist/EP (trained at Cleveland Clinic). Are there “must ask” questions that I should get answers to before doing this?

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I am glad to help you with MY experience, and you'll find that much of it is shared across patients. But, we're all individuals with our own care providers, spouses, histories, interests, and fears. So, I'm afraid this will have to be your own private journey. It helps to have a loved one at your side to drive you home from the odd diagnostic where you might need sedation. An angiogram, for example, if you require or with to have sedation. I didn't, and it was a piece of cake. The worst, and this is the same for the actual ablation, is having to lie still with a heavy bag or compression on the inner thigh where the incision for the catheter is. This lasts for at least four longish hours.

The procedure, for me, was largely painless. In my case, the worst for my first ablation (they were seven months apart, and I'll get to that...) was awaking with a thoroughly parched throat. If they use a a trans-esophageal echocardiogram (TEE), it goes down your throat after you're out. It helps them to keep the burning needle away from your esophagus, and to see where the needle needs to be placed for the various burns. I believe they use an agent to keep your saliva production to a minimum (not positive about this), but it was truly miserable for about an hour after I regained consciousness. I told the anaesthetist this when he came by for my second ablation, and he seemed quite pleased to be able to improve my recovery experience....and he did! The difference was huge.
In case you've not done much reading, about 75% of index, or first, ablations succeed. That means about 25% fail. It's tricky trying to find the various foci where your unwanted beats are coming from, so most index ablations just concentrate on the 80% probability that it is the typical voltages emanating from the pulmonary vein ostia at the rear wall of the left atrium. These get zapped first, and are always included because that's where so many of the unwanted signals enter the atrium and cause ectopy. But there are other places, including inside the atrial appendage, the Vein of Marshal, and other places around the inner lining of the atrium. These have to be found, but if you're not fibrillating, and don't start while they're inside your heart, they may never find them. This means a second, or touchup, ablation after a few months. Happened to me.

Honestly, it 's mostly the disruption of routine, for me, that is the worst part of any intervention like that. Sitting around in a hallway, driving long distances, staying at a motel, eating restaurant food...I'd rather not, thanks very much. The procedure is done quickly, within 160 minutes typically, and you wake up with a stern nurse telling you not to move. And, you don't. In three hours, they'll make you eat and drink, and at four hours you get up and walk around while pushing your IV tree. If you can keep stuff down, and walk for 10 minutes, they call your second and they'll be in the hallway to take you out to the car.

This is not a sweatable procedure. For me, I couldn't wait. Honestly, I was giddy when my EP told me he would do my procedure. I knew that it was the only way to halt the unwanted symptoms and the progression to more advanced arrhythmia. Happily, the second ablation took, and I celebrated a year free of ectopy last February. It should also happen for you. Count the days, my friend. Count the days!

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My AFIB and getting off drugs story:
I had AFIB, severe left atrial regurgitation, atrial valve not opening properly, no comorbidities.
Everyone is different, but here is my experience for what it's worth. I had mitral valve repair, ablation, and LAAC at 78, two years ago. No more AFIB (it can work permanently). I exercise and eat smartly (low in calories, sugar, salt, and caffeine). When I walk, I meditate by well-wishing for others. I also visualize my RNA, DNA, and all body systems being in good order. (I love order.) I got off of Eliquis after four months by wearing a heart monitor for 30 days to be sure AFIB was gone. I had to push my cardiologist to put me on the monitor. My last vital stats while sitting were 119/68, heart rate 68. I have also now weaned myself off of 12.5mg metoprolol daily and 81mg aspirin daily. (Read recent JAMA article that said low dose aspirin causes brain bleeding over time. Now it is recommended only for stroke and heart attack victims as I understand it. I have also read that metoprolol interferes with sodium and sugar levels. Too low an amount of sugar or salt can cause dizziness as I read it.) Vitals and alertness are better than ever. Daily, I do take a magnesium glycinate supplement containing 29% of RDA. Pure Encapsulations is the best brand I have found. I have read that magnesium and moderate exercise help folks to stay out of AFIB). I had a great surgeon at WakeMed in Raleigh, Dr. Boulton, who did all of the heart stuff. That was key of course. He also supports magnesium supplements. Overall, I feel extremely fortunate.
More: After a dizzy event about 10 months ago, where many tests found absolutely no signs of anything abnormal, my cardiologist wanted me to have a loop recorder implanted (standard recommendation I guess). I said no for a host of loop recorder concerns and have been fine as wine ever since. My best research indicated that the probable cause of my dizziness was the metoprolol I took, combined with too low sodium and sugar intake that day as I had cut the lawn and also had done a full exercise regimen. Off metoprolol now as I said and doing fine 10 months later. Hope this helps. Also, everyone should read "Undoctored”: Why Health Care Has Failed You and How You Can Become Smarter Than Your Doctor." I'm not saying that doctors are all wrong or all bad, just that you likely have the time to sort things out better than they can for your particular circumstances. Lastly, be sure to read "The AFIB Cure".

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I get the feeling most of the people commenting on this site are 70 or less in age. I am 81 and last year I was diagnosed with Afib. My doctor placed me on Eliquis and referred me to an Electrophysiologist/ cardiologist. I had a TEE to make sure there were no clots. About 2 wks after the TEE and Eliquis, the EP attempted zapping my heart into normal rhythm. It worked for about 20 minutes and then back into Afib! My question is: Because I am 81, going on 82, will a cardiologist attempt an ablation? I have reached a point in my heart problem that I am strongly considering it. Donna

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@gloaming

I am glad to help you with MY experience, and you'll find that much of it is shared across patients. But, we're all individuals with our own care providers, spouses, histories, interests, and fears. So, I'm afraid this will have to be your own private journey. It helps to have a loved one at your side to drive you home from the odd diagnostic where you might need sedation. An angiogram, for example, if you require or with to have sedation. I didn't, and it was a piece of cake. The worst, and this is the same for the actual ablation, is having to lie still with a heavy bag or compression on the inner thigh where the incision for the catheter is. This lasts for at least four longish hours.

The procedure, for me, was largely painless. In my case, the worst for my first ablation (they were seven months apart, and I'll get to that...) was awaking with a thoroughly parched throat. If they use a a trans-esophageal echocardiogram (TEE), it goes down your throat after you're out. It helps them to keep the burning needle away from your esophagus, and to see where the needle needs to be placed for the various burns. I believe they use an agent to keep your saliva production to a minimum (not positive about this), but it was truly miserable for about an hour after I regained consciousness. I told the anaesthetist this when he came by for my second ablation, and he seemed quite pleased to be able to improve my recovery experience....and he did! The difference was huge.
In case you've not done much reading, about 75% of index, or first, ablations succeed. That means about 25% fail. It's tricky trying to find the various foci where your unwanted beats are coming from, so most index ablations just concentrate on the 80% probability that it is the typical voltages emanating from the pulmonary vein ostia at the rear wall of the left atrium. These get zapped first, and are always included because that's where so many of the unwanted signals enter the atrium and cause ectopy. But there are other places, including inside the atrial appendage, the Vein of Marshal, and other places around the inner lining of the atrium. These have to be found, but if you're not fibrillating, and don't start while they're inside your heart, they may never find them. This means a second, or touchup, ablation after a few months. Happened to me.

Honestly, it 's mostly the disruption of routine, for me, that is the worst part of any intervention like that. Sitting around in a hallway, driving long distances, staying at a motel, eating restaurant food...I'd rather not, thanks very much. The procedure is done quickly, within 160 minutes typically, and you wake up with a stern nurse telling you not to move. And, you don't. In three hours, they'll make you eat and drink, and at four hours you get up and walk around while pushing your IV tree. If you can keep stuff down, and walk for 10 minutes, they call your second and they'll be in the hallway to take you out to the car.

This is not a sweatable procedure. For me, I couldn't wait. Honestly, I was giddy when my EP told me he would do my procedure. I knew that it was the only way to halt the unwanted symptoms and the progression to more advanced arrhythmia. Happily, the second ablation took, and I celebrated a year free of ectopy last February. It should also happen for you. Count the days, my friend. Count the days!

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What a generous and helpful response. Thank you! Fingers crossed.

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@saganjames

My AFIB and getting off drugs story:
I had AFIB, severe left atrial regurgitation, atrial valve not opening properly, no comorbidities.
Everyone is different, but here is my experience for what it's worth. I had mitral valve repair, ablation, and LAAC at 78, two years ago. No more AFIB (it can work permanently). I exercise and eat smartly (low in calories, sugar, salt, and caffeine). When I walk, I meditate by well-wishing for others. I also visualize my RNA, DNA, and all body systems being in good order. (I love order.) I got off of Eliquis after four months by wearing a heart monitor for 30 days to be sure AFIB was gone. I had to push my cardiologist to put me on the monitor. My last vital stats while sitting were 119/68, heart rate 68. I have also now weaned myself off of 12.5mg metoprolol daily and 81mg aspirin daily. (Read recent JAMA article that said low dose aspirin causes brain bleeding over time. Now it is recommended only for stroke and heart attack victims as I understand it. I have also read that metoprolol interferes with sodium and sugar levels. Too low an amount of sugar or salt can cause dizziness as I read it.) Vitals and alertness are better than ever. Daily, I do take a magnesium glycinate supplement containing 29% of RDA. Pure Encapsulations is the best brand I have found. I have read that magnesium and moderate exercise help folks to stay out of AFIB). I had a great surgeon at WakeMed in Raleigh, Dr. Boulton, who did all of the heart stuff. That was key of course. He also supports magnesium supplements. Overall, I feel extremely fortunate.
More: After a dizzy event about 10 months ago, where many tests found absolutely no signs of anything abnormal, my cardiologist wanted me to have a loop recorder implanted (standard recommendation I guess). I said no for a host of loop recorder concerns and have been fine as wine ever since. My best research indicated that the probable cause of my dizziness was the metoprolol I took, combined with too low sodium and sugar intake that day as I had cut the lawn and also had done a full exercise regimen. Off metoprolol now as I said and doing fine 10 months later. Hope this helps. Also, everyone should read "Undoctored”: Why Health Care Has Failed You and How You Can Become Smarter Than Your Doctor." I'm not saying that doctors are all wrong or all bad, just that you likely have the time to sort things out better than they can for your particular circumstances. Lastly, be sure to read "The AFIB Cure".

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This is very encouraging and helpful. I really appreciate the reading suggestions. You helped me add to my list of questions for my doctor. Thank you for taking the time to respond!

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You are most welcome. Keep up the good work.

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We here are people of good will who are desirous of helping others to get through a rough patch. We've all been there. The great news is that there are ways to manage the condition. The goal is to keep your heart in sinus as much as possible because when it is in ectopy things begin to compound, and not in a good way. So, Sir, I am happy to make any contribution to help you to deal with this episode in your life.

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@dduwe243

I get the feeling most of the people commenting on this site are 70 or less in age. I am 81 and last year I was diagnosed with Afib. My doctor placed me on Eliquis and referred me to an Electrophysiologist/ cardiologist. I had a TEE to make sure there were no clots. About 2 wks after the TEE and Eliquis, the EP attempted zapping my heart into normal rhythm. It worked for about 20 minutes and then back into Afib! My question is: Because I am 81, going on 82, will a cardiologist attempt an ablation? I have reached a point in my heart problem that I am strongly considering it. Donna

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My father had a TAVR just this past summer. He was 93 when they did it. So, it is an arrangement between you and your consulting physician. You bargain, you present yourself in your best light, and if you're a solid candidate for an ablation or an aortic valve repair, which the TAVR is, you'll get it. If one refuses, find another. My dad was fortunate that the cardiologist doing the gate-keeping/screening for the team that did the actual repair seemed confident in my dad's general health. You're well south of that, dduwe243 (Donna), and if you can do your own banking, walk a mile, cut your own toenails (don't laugh..it's a thing!), and sound the least bit coherent during your screening, I don't see why not.

Seriously, put your best foot forward, and sell yourself. Give 'im the ol' pitch about what an upstanding senior you are, how active you are in your community, and dare to suggest you're quite irreplaceable. You'll win.

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