I need some advice

I have recently converted into persistent AFIB from 5 years of Proximal AFIB while using Flecanide.
My first ablation was in 2010 at C.Clinic. My second ablation was in 2012 also at C.C. Dr. Saliba performed both. I am 83 and have had AFIB for over 20 years. I have been exhausted by almost any exertion for the last 2 years. I’m normally quite active and still working. I have a mild, stable case of IPF.

My Denver EP has recommended that pick one of 4 courses of action.

1) Lapse into permanent AFIB with rate limited by drugs
2) Get an AV node ablation
3) Get a 3rd “touch up” ablation
4) Try Tekosin

I am leaning toward a 3rd ablation in Austin under Dr. Natale. What do other subscribers suggest?

Incidentally, although my log-in shows membership for only a few years, I have been an Afibbers member for at least 12 years. I found great comfort from Afibbers before my 1st ablation, in that I became educated in making good choices regarding my condition.

Quote
peterA80
I am leaning toward a 3rd ablation in Austin under Dr. Natale. What do other subscribers suggest?

Option 1 won't get rid of the exhaustion. Option 2 might or might not, and you'll be pacemaker-dependent for life. You could try Tikosyn, but it requires a 3-day hospital stay, it's expensive, and you might not like the side effects.

Natale is the most certain route to being afib-free and getting rid of the constant exhaustion.

#3 with Natale would be my choice.

#2 would be the very last resort in my book. I would not go back to a doc who suggests it.

I understand that Dr. N has tried to recruit Wendy Tzou at UC Health. <[www.cudoctors.com] You might try a second opinion with her if you don't immediately select #3.

Good luck!

George

At what age would Dr. Natale not do a Ablation? I do realize it is very dependent on the individuals Health overall but there does come a time when surgery or this procedure becomes High Risk due to age right?

I say do the Ablation.

Yeah, advanced age is certainly a risk factor to be considered, but I'm pretty sure Natale has no firm cutoff age. There are 90-year olds out there healthier than the average 60-year old, so it's always going to be a judgement based on the individual. But would he ablate, say, a 100-year old? I don't know for sure but I think if he judged the benefits to outweigh the risks then the answer would be yes.

It's Tikosyn, not Tekosin.

Sounds like it would be worth getting Natale's opinion at least, Tikosyn could be tried in the meantime.

If possible I would opt for ablation with Dr Natale. In the interim, if the Ticosyn works to keep you in rhythm until then by all means do it.
I had my 2nd and 3rd ablations done this past year. The first was basically just a redo of my first in 2009. Just PVI done with cryo. 3rd done by Dr Natale which was a more comprehensive ablation that at this point appears to have been successful. Though I realize that a touch-up may be in order at some point.
In the time between ablations I was put on Ticosyn as the flecanide no longer worked for me. I had limited success with it but it did keep me in rhythm for periods of time.

Thank you all for your helpful comments.