Cardiac Ablation

[Regulator]

I've had atrial fibrillation for a while now (it came on after I had Covid but there is also a familial history on the female side) and it's been decided that I'm a good candidate for cardiac ablation, with a good chance if will cure the fibrillation and allow me to come off the long term meds.  The ablation is booked for 13 June at Papworth. 

Anyone else had it done?  What was your experience?

[robgul]

I've had the other treatment for AF in about 1997 - cardioversion - which didn't work (I just got two large scorch marks on my chest and back!)

I believe Basil OTP has had the ablation treatment.

Three people I know have had successful ablation treatment, one probably 25 years ago and he's still going strong with no obvious signs of AF.

[Basil]

Definitely worth it, but a permanent fix is not guaranteed. 
Had the procedure c20 years ago and it worked very well.
However, in the last 6 or 7 years AF slowly came back and I'm now more or less back where I started.
I'm sure everyone has a different experience, and I hope yours will be longer lasting.

[Feanor]

Junior the Elder had this done when he was 15, some 10 years ago now.

He had an arrhythmia issue where upon exercising, his heart rate would suddenly jump up to 200+, and stay there for an alarming time.
This was caused by some kind of electrical short-circuit in the heart, where it would go into an uncontrolled feedback loop.

They burned a short section of short-circuiting material away, and it was a 100% cure.

[readingjohn]

[I'm a long-time lurker here, but have almost never posted before]

I was diagnosed with persistent AF in 2016 IIRC. Had a cardioversion, which stopped the AF but it returned after a few days. Then had an ablation which again stopped AF but it returned again after a few weeks. Second ablation - same effect. Third ablation (Feb 2019) - AF went away again, but returned as paroxysmic rather than persistent AF, which I still have - anywhere from nothing in a day to all day, average around 20% of the time. Ablations were around a year apart from each other owing to waiting list. All were done in St Bart's in London. I'm now in my early 70s.

General notes:
- The actual procedure isn't too bad; if it got a bit painful they just increased the amout of opiates they infused into me. They used diamorphine i.e. medical-grade heroin which I found very euphoric; I can understand how folk get hooked.
- Procedure takes c.1-2 hours
- They kept me in overnight each time, just for observation
- I was distinctly weak and shaky for 2-3 days after each procedure, and for a couple of weeks had occasional mild faint/dizzy spells (not bad enought to be dangerous for driving etc.)
- After 3rd ablation I was put on Amiodarone which is an anti-arrhythmia drug with possible nasty side effects. I seemed to tolerate it well for about 16 months, then suddenly came down with very unpleaseant symptoms of over-active thyroid (had missed regular blood test because of Covid lockdowns).
- Now on Sotalol (beta-blocker) instead of Amiodarone, which I have no problems with, though I know many don't like beta-blockers. Also on blood-thinner (Apixaban).
- NICE guidance is apparently to try up to 3 ablations. Last time I saw cardiologist, early 2020, he said he'd push for one more attempt, but I've heard nothing since - I haven't chased it up as I'm not really convinced it would fix things.
- Since my last ablation I've kept a daily diary of symptoms (% of time I experience AF each day, and anything else which seems relevant). I find this useful, and so do any doctors I've spoken to. Takes about 20 seconds per day, using a spreadsheet.

I'd say it's worth giving it a go - it clearly does work well for many people. No major downsides apart from the slight risks associated with any cardiac procedure.

[L CC]

He had an arrhythmia issue where upon exercising, his heart rate would suddenly jump up to 200+, and stay there for an alarming time.

My team mate had this last year/couple of years ago. So far the ablation has cured it.

[Regulator]

Thanks for the responses.

My AF is paroxysmal (seems to be triggered when I've got an infection).  The NHS offered cardioversion - which isn't much used when your AF is paroxysmal.  Luckily, I have health insurance through work.  So I've managed to see two consultants and get a treatment plan quite quickly.

The consultant says that the fact it is paroxysmal increases the chance that the ablation will fix it... and, if I don't get anything done then it'll only get worse over time.

[chrisbainbridge]

As a doctor Regulator I am sure you will have chosen your cardiologist carefully and all will go smoothly.

However
My brother-in-law (66) had an ablation 10 days ago.  Sent home the next day. Severe chest pain. Rushed back in about a week ago.  2litres of fluid drained from chest, followed by 3-4 days of ongoing drainage.  A week in CCU.  Now on ordinary cardiology ward.

I am presuming either a response to ablation or severe LVF due to some faulty wiring.

https://academic.oup.com/europace/article/18/4/521/2467118 interestingly high incidence of Heart Failure after ablation but mainly after persistent AF rather than paroxysmal.  I hope it helps the decision making.  I can see that taking drugs for a paroxysmal event is untidy and probably not helpful

[sojournermike]

As a doctor Regulator I am sure you will have chosen your cardiologist carefully and all will go smoothly.

However
My brother-in-law (66) had an ablation 10 days ago.  Sent home the next day. Severe chest pain. Rushed back in about a week ago.  2litres of fluid drained from chest, followed by 3-4 days of ongoing drainage.  A week in CCU.  Now on ordinary cardiology ward.

I am presuming either a response to ablation or severe LVF due to some faulty wiring.

https://academic.oup.com/europace/article/18/4/521/2467118 interestingly high incidence of Heart Failure after ablation but mainly after persistent AF rather than paroxysmal.  I hope it helps the decision making.  I can see that taking drugs for a paroxysmal event is untidy and probably not helpful

I’ve only read the abstract, but that’s a staggeringly high complication rate taken at face value. Do we know if the heart failure describes is persistent or if the situation typically improves over time post procedure?

[Regulator]

As a doctor Regulator I am sure you will have chosen your cardiologist carefully and all will go smoothly.

However
My brother-in-law (66) had an ablation 10 days ago.  Sent home the next day. Severe chest pain. Rushed back in about a week ago.  2litres of fluid drained from chest, followed by 3-4 days of ongoing drainage.  A week in CCU.  Now on ordinary cardiology ward.

I am presuming either a response to ablation or severe LVF due to some faulty wiring.

https://academic.oup.com/europace/article/18/4/521/2467118 interestingly high incidence of Heart Failure after ablation but mainly after persistent AF rather than paroxysmal.  I hope it helps the decision making.  I can see that taking drugs for a paroxysmal event is untidy and probably not helpful

I'm not a doctor - my other half is.

Have yet to be seen by an NHS cardiologist (despite three AF related trips to A&E)...  My initial (private) cardiologist was Sarah Clarke.  I'm now seeing one of her colleagues at the Royal Papworth, Simon Fynn.  From what I can see both are considered experts in their field.

I know there are risks with ablation, but it's a risk I'm willing to take - particularly if it mean I can reduce/stop the long term meds.

[Regulator]

Well, I had the ablation today.  Two and half hours in theatre, most of which I don’t remember thanks to some very good sedation.

Great team of nurses and HCAs looked after me.

Jon was able to drop me to Papworth on his way to work and pick me up when he finished. 

I’ve now got the rest of the week off to recover.

[Jaded]

 

Hope all goes well.

[perpetual dan]

I hope the recovery goes well.

[Sergeant Pluck]

Hope your recovery goes smoothly and swiftly, Regulator

[andrewc]

Best wishes for a quick recovery .

[T42]

Same from me too.

[Robh]

Best wishes from me too.

[road-runner]

And from me, too.

Can you believe the last forum rides we were on together were 15-20 years ago?

[Canardly]

Al the best Reg.

[Basil]

How are you feeling today, matey?

Like road-runner, it's been many years.  At first, I thought the Reggicide ride to Ely, but thinking about it, it was probably the forum camp at Gordon Taylor's place.

[Wowbagger]

Wishing you well, Reg!

[Salvatore]

Whereas I first met Reg last month.

All the best for the recovery.

[Lightning Phil]

Good luck with recovery and hope it’s effective.

[Regulator]

Thanks all!

I’m feeling a lot better, although I do have some very spectacular bruising in my groin, which is continuing to develop (apparently it can take a week or more).  I’m not allowed to do any heavy lifting or vigorous exercise at the moment, but I have been out with the dog a few times and have a short walk (about 2.5 miles) planned for this afternoon.

[andrewc]

Please, no pictures