PFA procedure with stroke risks

I really feel for you. This kind of decision isn’t easy, especially when you’re facing it mostly on your own. It’s good that your EP is confident and experienced with PFA, but I totally get your fear about strokes.

Are you on a blood thinner of any description? Some people manage okay in long-term AFib if their rate is controlled and they’re on anticoagulation. Others feel pretty awful and do much better after something like PFA.

There’s no easy answer here—it’s about what gives you the best quality of life and feels least unsettling. Whatever you choose, it’s valid.

I am 85 and I had a PFA 2 weeks ago. From the information that was provided to me, the probability of a stroke is very low after the procedure as long as your heart remains in NSR. If for some reason it goes back to Afib then an anticoagulant like Eliquis should prevent a possible stroke because of a blot clot. I took Eliquis and Metoprolol before the procedure and will continue on both meds for a short period of time.

For me the PFA was easy with no pain after the procedure. A very nice comfortable 2-hour nap. Not sure where you live, but I had my PFA done at the University of Colorado Health Center in Aurora, CO. Great facility with great staff. I had a CT scan done the day before, so I was at a nearby hotel for roughly 4 days.

I am 66 and had a PFA at Mayo Jacksonville last summer. It was easy and, so far, successful. I continue to be on Coumadin as afib can return but I have no regrets having gotten the ablation.

Why would they not put you on a blood thinner or is the stroke caused by the PFA?

To my knowledge, the potential for a stroke associated with Afib is due to blood clots forming in the left atrial because it does not empty correctly since it is beating out of rhythm with the ventricle. The blood clot could then flow into places in your body causing a stroke because of blockage. PFA or other ablation procedures put your heart back into sinus rhythm which then removes the potential for formation of blood clots. The continuation of Eliquis or other blood thinner is a precautionary measure in the event you go back into Afib. When my cardiologist told me this I asked: shouldn't ever person over the age of 70 be taking a blood thinner since at this age they are at a higher risk for Afib? He didn't answer.

Go for it! I'm 79 and I am willing to have an ablation tomorrow! I can't tolerate the arrhythmia episodes even though my cardiologist says it's not life threatening. I want some peace of mind!

I had asked my cardiologist the same thing. While he gave me an answer, it was so vague it might not have even qualified as an answer.

My own opinion is that any medication used to lessen clotting is another big issue as far as bleeds. I never see much published about reversal of Eliqus and similar agents. Supposedly reversal agents aren't that stocked everywhere. So for the person suffering a major bleeding event whether internal or external they seem to be in big trouble. We all mention not wanting a stroke, true but bleeding out doesn't sound like such a great alternative either. Put everyone over 70 on Eliqus and it's going to get even busier at the ER or the morgue.

There is a lot of good data now that PFA is better than being in afib. For both stroke and heart failure risk. I’m disappointed that there isn’t good data collection for post PFA complications, we really should have robust systems to quantify complications. I had an ocular migraine on day 2 and day 3 after my ablation. I’ve had 2 previous ocular migraines in my life over the course of 4 years. I think the hemolysis from the PFA could have caused it, but who knows. My experience isn’t going in any registry. . My brain is better now than pre PFA. AFIB was caused me a lot of symptoms. It’s been 39 days since my last afib, I feel so much better. My groin hurt for the first week and the anesthesia recovery was miserable. Don’t push it that first week. I was a fool.

Your description is correct, and it happened to me. A stroke within six months of being diagnosed with AFIB, so I'll be on blood thinners forever. I'm 70. But if I didn't have AFIB or any other heart condition I would not take a blood thinner. They have side effects, and I try to take as few drugs as possible, which was NONE until I got AFIB.

My husband 77 had tremendous fatigue and no appetite. He had ablations for 2 afib areas. He woke up hungry and without fatigue.

I wish you the best. Let us know how you’re doing.