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Old 02-19-2020, 11:36 AM   #61
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My decision was completely voluntary. A friend of mine told, me after my ablation, that he had AFIB also and was on the same medication. One day it stopped working and he went into AFIB and to the hospital. Took a while to get something to work to get it back under control. Hopefully things will stay under control. My initial problem was I wasn't aware of the AFIB and only found it a a physical with an EKG. Now I'm more aware of the symptoms so I know what to watch out for.
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Old 02-19-2020, 11:48 AM   #62
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It was a relatively good outcome. I had very clear AFib a couple of times over the past 2 days (the timing looks to be after the second cup of coffee), but it self corrected and my HR never really elevated.

My CHAD2 score is still zero based on no other complications. I'm <65YO, have good cholesterol, exercise (with Yoga), and eat well (lots of nuts - 20% reduction in stroke risk from studies). This morning they measured a HR of 52 and BP of 120/80.

She feels comfortable (I agree) waiting for the full month of monitoring data. We discussed blood thinners (now on aspirin) and rhythm fixes. So like everyone here, I'm mortal with limited days ahead. I'll try to make the most of them.
That sounds remarkably like me, including the exercise and yoga.

For 3 months or more I had no caffeinated drinks and no alcohol but it made no difference.
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Old 02-19-2020, 11:49 AM   #63
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I'd like to ask you guys if the decision to have ablation surgery was a medical necessity or did you do it because you were sick and tired of taking pills and having a less than ideal heartbeat?

My AFIB is being controlled by Sotalol and I'm taking Xarelto for stroke prevention. I have an ectopic heart rhythm (faint, premature heartbeat) that is bothersome. I'm told I'm not in any danger but I don't like the palpitations I get from it.

So far, I'm OK with taking the meds because when I weigh the risk of the surgery vs. simply taking pills, the pills win out. Then there is the whole issue of selecting a surgeon. But the thought of being free of meds and not having the heart flutters is tempting.
I hated the idea of taking medications if I can in any way safely avoid such. At the time I was 48 y.o and in otherwise excellent shape with only episodes of paroxysmal A-fib. The cardiologist through consultation recommended strongly that ablation was the best course of treatment for me. Although it was tough to find a Worker's Compensation electrophysiologist to do the ablation, after months of negotiations one was found. An overnight in the hospital and I've been fine since. Just an 81 mg aspirin before bedtime but otherwise no medications.

I certainly am completely thrilled that I had the ablation done and that it was such a success for me.

Interesting note is that the doctors speculate what led to my A-fib was a lifetime of pushing myself through exercise and perhaps overtraining my heart. They said the atrium was stretched and that led to a type of short circuit situation with my conduction system.
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Old 02-19-2020, 12:12 PM   #64
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That sounds remarkably like me, including the exercise and yoga.

For 3 months or more I had no caffeinated drinks and no alcohol but it made no difference.
I've been wrestling with eliminating caffeine & alcohol, but between your comment & my rationalization my goal will be moderation.

Honestly, I asked the doctor and she did not recommend abstaining.
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Old 02-19-2020, 01:23 PM   #65
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I've been wrestling with eliminating caffeine & alcohol, but between your comment & my rationalization my goal will be moderation.

Honestly, I asked the doctor and she did not recommend abstaining.
When I got Afib they went through the list of possible causes--coronary heart disease, heart defects, high blood pressure, sleep apnea, COPD, and binge drinking. (I might have missed listing a couple other causes.) They could medically rule out everything except binge drinking. So that was the stated reason why I got Afib. However, I drank on weekends only, and it was usually 3 to 4 beers on Friday and Saturday nights and on Sunday afternoons. Twelve pack purchased on Friday, gone by Sunday night. Been doing that for 30 years.

I haven't had a beer since that day in 2015 they told me they suspected alcohol was the culprit.

My cardiologist says I can have a beer or two or a glass of wine now and again, but no way will I touch it. That wretched feeling of exhaustion and shortness of breath with Afib has turned me against alcohol entirely.
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Old 02-19-2020, 02:19 PM   #66
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Originally Posted by Tekward View Post
It was a relatively good outcome. I had very clear AFib a couple of times over the past 2 days (the timing looks to be after the second cup of coffee), but it self corrected and my HR never really elevated.

My CHAD2 score is still zero based on no other complications. I'm <65YO, have good cholesterol, exercise (with Yoga), and eat well (lots of nuts - 20% reduction in stroke risk from studies). This morning they measured a HR of 52 and BP of 120/80.

She feels comfortable (I agree) waiting for the full month of monitoring data. We discussed blood thinners (now on aspirin) and rhythm fixes. So like everyone here, I'm mortal with limited days ahead. I'll try to make the most of them.
AFib stroke has a different cause than other strokes as it's caused by the blood pooling in the left atrium when the heart is in AFib and possibly forming a clot.

The best advice I've heard is to find yourself a good cardiologist or even better an electrophysiologist. The cardiologist is the plumber and the electrophysiologist is the electrician. You have electrical issues.

Also there's a website called afibbers.org that I think is invaluable as it has a bunch of very astute and experienced contributors, with good advice on how to find a good EP for ablation if you so choose.

Welcome to the club [emoji16]
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Old 02-20-2020, 08:30 AM   #67
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As my learning continues (53% increased risk):


"“Previous studies have highlighted that nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with increased risk of atrial fibrillation (AF), the world’s commonest heart rhythm disorder, which in turn increases the risk of ischaemic stroke. In fact, in 2014, Liu and colleagues published a meta-analysis of existing studies, showing a 53% increased risk of AF with NSAIDs."


https://www.ncbi.nlm.nih.gov/pubmed/25260945
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Old 02-20-2020, 08:57 AM   #68
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Also there's a website called afibbers.org that I think is invaluable as it has a bunch of very astute and experienced contributors, with good advice on how to find a good EP for ablation if you so choose.

Welcome to the club [emoji16]
Thanks for that great website! It also referred me to a Doctor who I been watching - Dr. Gupta. But this video was new to me & very interesting.

Why I don't believe that AFib causes strokes

I teach statistics and I have said countless times, "Correlation is NOT Causation."
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Old 02-20-2020, 09:23 AM   #69
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Thanks for the link to the video. Dr Gupta practices at York, an hour down the road from us. What he says is in line with the advice and treatment I received from the electrophysiologists at James Cook University hospital which is close to where I live and is a regional heart centre.

I was not put on blood thinners when I had Afib at age 60 because my Chads2 score was 0 . (as he says in the video the Chads2 assessment does not consider AFib). I was only put on thinners 6 weeks before ablation and 3 months afterwards at age 63 because of the actual ablationprocedure.

My EP said that my Chads2 score will go to 1 when I achieve age 65 (last week!) but will not change just because I have had AFib in the past.
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Old 05-20-2021, 02:43 PM   #70
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I hated the idea of taking medications if I can in any way safely avoid such. At the time I was 48 y.o and in otherwise excellent shape with only episodes of paroxysmal A-fib. The cardiologist through consultation recommended strongly that ablation was the best course of treatment for me. Although it was tough to find a Worker's Compensation electrophysiologist to do the ablation, after months of negotiations one was found. An overnight in the hospital and I've been fine since. Just an 81 mg aspirin before bedtime but otherwise no medications.

I certainly am completely thrilled that I had the ablation done and that it was such a success for me.

Interesting note is that the doctors speculate what led to my A-fib was a lifetime of pushing myself through exercise and perhaps overtraining my heart. They said the atrium was stretched and that led to a type of short circuit situation with my conduction system.
[I know this is an old thread but it is fairly specialized and therefore I didn't want to start a new thread.]

I consulted with an electrophysiologist today. Many things were discussed including the ablation option.

He did say the jumbled up electrical signals inside the heart that cause afib can be caused by heart tissue that has been scarred by strenuous athletic activity over the years. It is kind of sadly ironic that vigorous athletic activity can lead to a heart condition like afib.

In February I wore a Zio heart monitor for two weeks. It showed I was in afib for 18% of the time (about 59 hours), however afib occurred primarily in a stretch of 6 days and mostly on 2 days within that stretch. For example, on those 2 days I was in afib for over 6 hours each day. For 7 consecutive days there was absolutely no afib.

I'm leaning toward having the ablation procedure. I don't like treating symptoms if I can (hopefully) eliminate the problem altogether. Thinking of not being a daily slave to Sotalol and Xarelto sounds liberating to me. The thing is, my cardiologist is advocating the medicine route and the electrophysiologist is touting the ablation procedure. The EP says I'm an ideal candidate, since I am paroxysmal afib and relatively young (63). He says the afib burden, or percent of time I'm in afib, will only increase from 18% as I get older. The cardiologist makes it sound like ablation is a somewhat risky procedure and the EP makes it sound routine.

I ask again, for those that got the ablation procedure, what was the turning point that clinched the decision for you?
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Old 05-20-2021, 03:11 PM   #71
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About a year ago, my DW had a cardioversion for AFib. Unfortunately, in November she had 3 attacks after having repeat cardioversion. She finally had a pacemaker implanted and an AV node ablation. That is the last resort of treatment for AFib.The main reason she had it done was to get off Amioderone, which has horrible long term side effects.

She is still on Xarelto, and the incision is still healing. She is relieved that she will not have to worry about another incident.

Update over a year later. She is doing fine with the pacemaker, and has a heart monitor by her bedside table, but not alerts, thank goodness.
I hope to have many more happy years with her.
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Old 05-20-2021, 03:13 PM   #72
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The tipping point for me going the ablation route: I had undesirable medicinal side effects from some, and others lost their efficacy.

Ablation is fairly low risk and has about an 85% success rate. Given my young age at the time i was an excellent candidate. Unfortunately for me it also has a 15% failure rate ..
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Old 05-20-2021, 03:19 PM   #73
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I monitored my instances of AFib on a spreadsheet. I always knew when I was in AFib as I felt a little dizzy and when it happened while hiking then I badly got out of breath going up steep inclines. The frequency and length of time I was in AFib increased over the 3.5 years before I had ablation surgery. My first instance was 6 weeks after age 60. I couldn’t drink more than a single unit of alcohol (one small glass of wine), or eat a very heavy meal and I stopped watching live football games that I was emotionally involved in because alcohol or stress was certain to trigger AFib episodes.

The EP was confident that I was an excellent candidate. Both he and my cardiologist in Houston, before I had returned to the UK, told me that I would be amazed how many athletes they had on their lists with AFib.

In my case the surgery was easy and I haven’t had a single instance of AFib that I am aware of in almost 3 years since the surgery. I check every day when I do my BP, and wear an Apple Watch that monitors for AFib. I can now enjoy a couple of pints, watch stressful football matches, and never worry about running out of breath when hiking. For me ablation has been wonderful.
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Old 05-20-2021, 04:26 PM   #74
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I've been on 50mg of Toprol for 15+ years now for my AFIB... Mine was getting bad enough that I could feel it happening multiple times a day and particularly when at rest.

My mail order drug insurance paid for the band name (Toprol XL) until a few years ago and said I needed to start using a generic (a lot cheaper). I tried a generic and the AFIB return in just a few days so I went back on the brand name... Now they refuse to pay for the brand name because I didn't stay on the generic long enough. My doctor has even documented the generic doesn't work for me... Seems like the drug company is practicing medicine to me. Now they won't even sell me the brand name "even" if I pay 100% of the cost. So I end up paying full price at a local pharmacy instead.


Oh, and the Toprol has done a good job controlling my BP too...
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Old 05-20-2021, 04:40 PM   #75
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...My doctor has even documented the generic doesn't work for me... Seems like the drug company is practicing medicine to me. Now they won't even sell me the brand name "even" if I pay 100% of the cost. So I end up paying full price at a local pharmacy instead.
Contacting the state insurance regulators where you live may help. Can't hurt. If that doesn't work perhaps a chat with an attorney is in order - it does no harm to find out what your options are and a nastygram on legal letterhead may get the attention of someone who has some sense. Sounds like it would be worth the expense/hassle to do at least that.

Back on topic, I had to "fail" two drug tries before Medicare would pay for the cardiac ablation. It worked first try and I've had one episode of afib since then. The ER doc said I was low on potassium and an every-other-day dose of over the counter potassium has fixed the problem.

OTOH, a longtime family friend has has seven cardiac ablations and none of them worked. However she is what the doctors call a "lousy patient" because she does not follow directions well or at all so I'd be hesitant to blame the docs or the procedure.
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Old 05-20-2021, 05:52 PM   #76
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DH had his first ablation about 6 years ago after 3 cardioversions. He was on meds prior but had some serious side effects with one. Almost 5 years to the day, his heart began racing uncontrollably. Off to the ER during Covid height, not fun. They had lots of trouble getting his Afib under control with meds and actually called his cardiologist because they wanted to do a cardioversion then and there. They were told no, get it under control with meds.

His cardiologist recommended a second ablation which he had a month later. So far so good with Afib rearing its ugly head only a couple of times. Initially we were worried that it didn't take as he had some scary heart rates. Don't recall how long, but it does take some time to see if the ablation is successful. Thank goodness for the Apple watch . If this one doesn't take, his cardiologist recommends a pacemaker.
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Old 05-20-2021, 05:58 PM   #77
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I had my A-Fib ablation procedure a little over 4 years ago at age 48. Although my resting heart rate is considerably higher post the ablation, it is still well within normal limits running 75-80 BPM. Prior to the ablation, when not having an episode of A-fib, my resting heart rate was in the high 40's. Other than that my only comment is that I have not had an episode of A-fib since having the ablation. I hope that continues.
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Old 05-20-2021, 08:43 PM   #78
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Originally Posted by Qs Laptop View Post
[I know this is an old thread but it is fairly specialized and therefore I didn't want to start a new thread.]



I consulted with an electrophysiologist today. Many things were discussed including the ablation option.



He did say the jumbled up electrical signals inside the heart that cause afib can be caused by heart tissue that has been scarred by strenuous athletic activity over the years. It is kind of sadly ironic that vigorous athletic activity can lead to a heart condition like afib.



In February I wore a Zio heart monitor for two weeks. It showed I was in afib for 18% of the time (about 59 hours), however afib occurred primarily in a stretch of 6 days and mostly on 2 days within that stretch. For example, on those 2 days I was in afib for over 6 hours each day. For 7 consecutive days there was absolutely no afib.



I'm leaning toward having the ablation procedure. I don't like treating symptoms if I can (hopefully) eliminate the problem altogether. Thinking of not being a daily slave to Sotalol and Xarelto sounds liberating to me. The thing is, my cardiologist is advocating the medicine route and the electrophysiologist is touting the ablation procedure. The EP says I'm an ideal candidate, since I am paroxysmal afib and relatively young (63). He says the afib burden, or percent of time I'm in afib, will only increase from 18% as I get older. The cardiologist makes it sound like ablation is a somewhat risky procedure and the EP makes it sound routine.



I ask again, for those that got the ablation procedure, what was the turning point that clinched the decision for you?


Well, I’ve had two ablations and am doing well after the procedures. The operation was not a big deal to me.

I do have a couple questions for you though.

Did your EP assure you that you wouldn’t need drugs after the procedure? I know everyone is different but I am still a slave, as you say, to Xarleto, flecenide & diltiazem.

Did he tell you it was 85% effective after just one ablation? My EP told me it was 85% effective generally after two or possibly three procedures.

I’m not trying to be argumentative. Just some things you should look into. I am definitely not trying to say you shouldn’t get the procedure. It has made a great difference in my quality of life.

Good luck to you!
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Old 05-21-2021, 05:44 AM   #79
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Well, I’ve had two ablations and am doing well after the procedures. The operation was not a big deal to me.

I do have a couple questions for you though.

Did your EP assure you that you wouldn’t need drugs after the procedure? I know everyone is different but I am still a slave, as you say, to Xarleto, flecenide & diltiazem.

Did he tell you it was 85% effective after just one ablation? My EP told me it was 85% effective generally after two or possibly three procedures.

I’m not trying to be argumentative. Just some things you should look into. I am definitely not trying to say you shouldn’t get the procedure. It has made a great difference in my quality of life.

Good luck to you!
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Good questions to ask the EP.

My EP told me that there was an 85% chance of it being successful without the need for a follow-up ablation, and we would not know if it was successful until 3 years after the procedure. Got a few months to go before hitting the 3 years mark.

No drugs at all since the procedure. Long may that last
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Old 05-21-2021, 08:33 AM   #80
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Good questions to ask the EP.

My EP told me that there was an 85% chance of it being successful without the need for a follow-up ablation, and we would not know if it was successful until 3 years after the procedure. Got a few months to go before hitting the 3 years mark.

No drugs at all since the procedure. Long may that last



If it didn't come back after the last two months, you are probably golden. Hopefully you won't go through that much stress again for a long, long time.
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