Later this month, I will be getting an ablation. How did I get here? After 3 years of afib episodes, feeling lousy, spending a fortune on Eliquis, trying supplements, breathing, meditation, losing weight, searching for causes, I gave in. My doctors (general, cardio, and EP) think it comes down to aging and it will get worse. They think that in 5 years I'll be too old for a successful ablation (I'm near 80 now). So, at least this gives me the chance of getting on top of this condition. Maybe. I don't know, though. I always hope that my most recent episode will be my last. I note that none of the afibs last more than 4 or 5 hours. So they go away. I was told my stroke risk is minimal on Eliquis. The ablation procedure gives me the creeps. I mean, to go from the right atrium to the left atrium they have to punch a hole in your heart. That sounds extreme, doesn't it? It's a gamble, there's possible complications, it might not work anyway, etc. But I have been sold on the hope that at least I'm doing something that could have a positive outcome. Can someone give me some reassurance that I'm headed in the right direction? Or not?
Thanks,
Mel-O

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The ablation procedure gives me the creeps. I mean, to go from the right atrium to the left atrium

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they have to punch a hole in your heart. That sounds extreme, doesn't it? It's a gamble, there's possible complications, it might not work anyway, etc. But I have been sold on the hope that at least I'm doing something that could have a positive outcome. Can someone give me some reassurance that I'm headed in the right direction? Or not?

When we first hear what is actually done during an ablation, it does usually give most of us pause. But if you have a top notch EP who has done thousands of ablations the risks are minimal. Punching a tiny hole in the atrium is really routine—I have had it done 3 times for various cardiac procedures including an ablation. It heals in a few months and doesn’t cause problems. Many of us took antiarrythmics for years and only finally got relief finally through an ablation—wondering why we didn’t choose to have one earlier. It is extremely unlikely that your next episode will be your last!

But again the most important predictor of a successful ablation is who does it and it is important to choose carefully.

Thanks, Daisy, it was reassuring to read your message. My GP and my cardiologist recommend this EP doctor highly, he is very experienced, and we seemed to vibe together OK. So, I will be having the ablation later in March. It is scary, though.

MelO
I am in the same situation as you only 10 years younger at 70. I to have doubts but will be having an Ablation this spring/summer.
Nothing has worked for me and I am dead tired of the medications I am sure all will be well!

I couldn't wait to get on that operating table. I was giddy with excitement, even though I felt like hell in the weeks leading up to it due to increasing episodes of AF. For me, drugs and all the other palliatives and 'remedies' were flying in the face of all the research telling anyone who wants an honest appraisal of AF that it is a progressive disorder. It will almost certainly get worse for most sufferers. And, when it gets worse, it's more intractable and much harder to treat, no matter if surgery or yet more medications. About all that's left in the end is amiodarone or an ablation of the AV Node and you get a pacemaker. So, surgery....or surgery....pick your poison.

I was inside the unfortunate few, comparatively, whose first ablation doesn't work. Even though my EP challenged my heart before they wheeled me back out to the recovery room, and it didn't move into AF when he did that, within a week out of hospital I was back in an ER and placed on amiodarone because they couldn't get my heart to stop AF or get the rate down.

Seven months later, the same EP took another shot at me, and happily I am now one year and two weeks with no AF. I can't begin to tell you how grateful, and eased, am I for being out of AF for this long and enjoying my life once again.

Mel-O, you will be in careful hands, hands that have the equivalent of two PhDs, treating you. Plus all those wonderful operatory staff who do this several times each day, and have done so for years now. Even if you have natural trepidation, when you awaken and find your heart in steady sinus rhythm, you'll thank the gods for your experience and for the science that supports it.

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Mel-O
Thanks, Daisy, it was reassuring to read your message. My GP and my cardiologist recommend this EP doctor highly, he is very experienced, and we seemed to vibe together OK. So, I will be having the ablation later in March. It is scary, though.

Yes, it certainly can be scary going into the EP lab. Don’t hesitate to ask specific questions from members here about what you will encounter. Also don’t hesitate to ask your EP specific questions like what is his plan for the ablation: just pulmonary veins or will he do mapping looking for other sources. Will he do a “challenge” with a drug to see if he can provoke an arrhythmia, how many ablations has he done, will he use collagen plugs in the groin punctures to limit the time you will have to lie flat to 2 hours, will you stay overnight, will he prescribe an antiarrythmic during the blanking period after your ablation ? The more you know the fewer surprises!

I went this last week without any symptoms whatsoever. I felt great! So, I thought, maybe I have turned a corner, and afib is over. No operation for me. Wrong. Today I feel like s***t. My chest is thumping like 40 cups of espresso, I'm seeing flashes, getting a head rush when I stand up, and I'm weak. So glad I'm retired, I could never work like this. Whatever my reservations and fears, I'm forging ahead with the ablation. I will just have to swallow my feelings and act like a grownup.

Your story is very encouraging. Especially the part where the first one didn't work, but the second one did. That took courage but also faith that it would work out. And also the part where you review the alternatives to having ablation now. I appreciate your candor. You know what I'm going through. Thank you!

Good points, all! I will certainly ask those questions. I am rather naive. They call it a 'procedure', but it sounds much more like an 'operation' to me!

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gloaming
I couldn't wait to get on that operating table. .

Me too. No anxiety, I had 4 and told them to put me under and rock and roll.

There are other risks than an ablation. Getting hit by a bus is one. I got lost yesterday at night. I didn’t realize I was lost until I was heading for the mountains. I got off the bus in the wrong town, pitch dark, and told to cross this busy highway. There was no other way. I used my iPhone as a flashlight to see. Pitch dark middle of nowhere and civilization. I had to carefully cross the island divider and four lanes of wizzing traffic hoping someone saw me while walking to find a bus stop. One of my top ten scariest moments.

An ablation is a piece of cake. Nothing to it but some hematoma by the incision site.

wow! that kind of scare can put you right into PTSD mode! that story brings us right back to the proper perspective. it's like a bad dream only worse because it's real.

Hope it works for you first time Mel-O! Ablations do work but what i don't understand is why no researcher (are they even looking) can't explain paroxysmal AF. After all, something triggers AF and something else stops it again.
As a fellow sufferer i wonder if there is even a will (incentive?) to find out basic cause(s)

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Joe
Hope it works for you first time Mel-O! Ablations do work but what i don't understand is why no researcher (are they even looking) can't explain paroxysmal AF. After all, something triggers AF and something else stops it again.
As a fellow sufferer i wonder if there is even a will (incentive?) to find out basic cause(s)

Like all medical systems they are profit driven, I'm not sure there is any incentive to find a cause because there is lots of money to be made prescribing meds and preforming procedures. That's my gut feeling I would hope I am wrong. The EP who will be doing my ablation seems to really strive for a good out come so there is that.

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calvin
Like all medical systems they are profit driven, I'm not sure there is any incentive to find a cause because there is lots of money to be made prescribing meds and preforming procedures. That's my gut feeling I would hope I am wrong.

I think you are wrong. The doctors and centers that make money off procedures aren't the ones who are going to find the cause. That's way beyond their abilities and scope of practice. All they can do is use the tools they have to try to alleviate patients' problems, and I think they do so earnestly. They're good people doing the best they can.

The people who are going to discover the cause of afib and a treatment for it are working in labs and you've never heard their names and probably never will. They're also not rich and never will be. At least, not until one or more of them discovers the cause, and then you might hear their name(s) because they'll be earning a Nobel Prize in medicine.

If you want to know who the bad guys are in the US medical world, look beyond the people providing care. They're not the bad guys.

There are only a few sources of funding for research.
Drug companies? Haha look at the struggles taking Eliquis generic.
The Feds (NIH, FDA, etc)? Politics influences the flow of funds - there's no AF lobby.
Philanthropists? Yes, they get to name an institute or medical center, but no interest until a billionare gets AF!
Pure research? It doesn't exist in the real world.
Medical staff? They are too busy doing what they do.

It's true. Funding research is always a struggle because there are far more medical problems in the world than there is money.

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Edited 1 time(s). Last edit at 03/01/2024 08:55PM by calvin.

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Mel-O
There are only a few sources of funding for research.
Drug companies? Haha look at the struggles taking Eliquis generic.
The Feds (NIH, FDA, etc)? Politics influences the flow of funds - there's no AF lobby.
Philanthropists? Yes, they get to name an institute or medical center, but no interest until a billionare gets AF!
Pure research? It doesn't exist in the real world.
Medical staff? They are too busy doing what they do.

Google the Afib trials directed for expensive race horses suffering from afib. We are not worth the cost of a racehorse. It’s enough to get your hoofs in a twist reading all the money spent on horses.
Here are some:
[www.vet.cornell.edu]
[www.ncbi.nlm.nih.gov]
[pubmed.ncbi.nlm.nih.gov]
[vetmed.illinois.edu]

One thing I learned, horses suffering from AF have less risk for strokes. Also to ecv shock a horse, it has to be done internally by using a catheter. The procedure takes 4 hours costing $3500-4000. Like humans, it’s a crapshoot of the ECV remaining successful.



Edited 1 time(s). Last edit at 03/01/2024 05:59PM by susan.d.

Mel: Ablations are now becoming first line treatments. Age itself is no longer a limiting factor in ablations. They have been successfully done on people over 90 y/o.

I had my second one by Dr. Natale when I was 83. For the first ablation when I was 70 I was very hesitant and apprehensive. It went like the textbooks say it shoud and I was out of the hospital in less than 24 hours. The main after surgery, (prodecure), worry being healing in the blood vessels where they needed to puncture to get the catheters inserted. 6 hours of lying in place when you feel like doing things is seemed like a long time.

When the sysmptoms started coming back after 10 or so years I immediately got in line for another ablation, which went about the same as the first one, the main exception that I was much more calm all the way through on the second one.

If I get 10 good years out of this one, too, I'll get in line to do it again if the symptoms show up yet again. The difference in life quality before and after is well worth going ahead sooner rather than later.

Gordon

Someone funded the PFA studies, and the RF studies before that, plus the cryo-ablation. The field is in a state of flux all the time, as are most medical fields. There is not just riches, but prestige, in finding something that will have an historical impact on people's lives. These people are driven, and I'm not talking about the researchers, I mean the practitioners. They WANT TO be part of a cadre of highly skilled, highly esteemed, and highly ambitious people who are at the top of the food chain, which is where medical practitioners are. Not all are that way, some just enjoy the practice. It's the same in the Air Force; some have ambition and drive, and they will seek and achieve promotions and other forms of advancement and the compensation that comes with it. Others just like to fly jets...and they make no bones about it when they discuss their annual performance evaluations with their bosses. Just let me fly...m'kay? A full bull (colonel) or a general officer doesn't fly, or hardly ever. They leave that behind and want to lead, to direct, to put their ideas into practice, etc.

While my own EP is extremely busy, he is also active in the Canadian Cardiac Association, and until recently was on the board certifying cardiologists and EPs. I can't find any verifiable evidence that he is involved in research, but my impression from talking with many in the medical field is that they often are. They're PhDs in science, after all, and they like the forms of thinking and of discovery that are associated with that kind of a career.

You can take this to the bank. I'm an industrial/organizational psychologist with 30 years in leadership and management, program direction, and research. I also taught leadership theory, motivation theory, and ethics at a university. Thinking about what motivates high achievers has been my life.

Yes, the tech of ablation is truly awesome! A lot of work, brain power, money, time, trial, and error went into what we have today, no question about it. Yet it still seems primitive, doesn't it?