To ablate or not to ablate???

Fairly new to afib. Diagnosed about 2 years ago. Episodes occur mostly early morning hours and never interfere
with my daily life. Good health other than afib……... episodes occurring every other day.

Also, I am not on any type of rate control medication because I don't like taking drugs, but I am on Eliquis due to frequency of afib.
My current age is 67 with no comorbidities. (Rate goes between 130 to 150 BPM).


If I continue living like this will it eventually cause damage to my heart without taking rate control drugs?

Any advice would be greatly appreciated. Thank you

Maybe, maybe not. Daily is a lot of afib, but there's no set number that says more than X will cause heart enlargement and heart failure. How long do the episodes last? One thing's for sure: it's doing you more harm than a dose of metoprolol as-needed would. Atrial enlargement is very likely eventually, and that promotes persistence and makes ablations less likely to succeed.

Concur with Carey. Having high rates (>100) for a material amount of time can lead to cardiomyopathy.

If it were me, I'd prefer to have the rate lowered. With AF, if you're rate controlled and anticoagulated then you've really taken care of the major short term risk factors and have nothing to worry about as you consider your options going forward. You can take your time thinking over the next step.

My understanding is that a-fib can over time change the shape of your heart and, in some cases, eventually lead to heart failure if left untreated. On the other hand, many people live a long and otherwise healthy life with a-fib. So whether or not to have an ablation is a very personal decision. In my case (I'm almost 62), I had a successful ablation for atrial flutter three years ago, and I'm scheduled for another ablation for a-fib next Monday. My last ECG showed that I have had enough afib in the last couple of years to slightly enlarge my left atrium, even though I have been taking rate control drugs.

Personally, I would much rather the ablation than the drugs, although I am resolved to the fact that I will probably have to take blood thinners for the rest of my life. And even though an ablation is not a cure, in my thinking, a successful ablation will kick the can down the road a way, potentially a long way, and that's what I want. The procedure itself is not difficult to go through and recovery for most is relatively quick. The issues for some may be cost. I am fortunate to live in Canada, so I don't have to worry about that part.

I met an older fellow once when I was in Hawaii who also had a-fib. He had no desire for surgery or drugs. He told me that whenever he has an episode, he just goes to lie down for awhile. He was perfectly content with that choice. I believe that each of us has to trust our gut and go with what suits our lifestyle the best.

Good luck with whatever you choose to do :-)
Irene

~ IreneJ

I have read so many outstanding things here about Dr. Natale that I feel maybe I should book an ablation sooner rather than later just in case he is nearing retirement. That would be awful - to get to the stage of feeling like I really need something like ablation, but Dr. Natale is not available anymore! It is certainly a comfort hearing about him & knowing that is what I want to do when/if I feel I need to.

I have been in normal rhythm for six months taking Dofetilide 500 mg. BID. No apparent side affects or interactions. Other than the three days spent in the hospital and the cardioversion, I was pleased with the process. IMHO, I would prefer to take two caps a day rather than have an invasive surgical procedure. This forum is filled with stories of failed ablations. Some folks having four or more and needing the insertion of a Watchman. As you have probably discerned, afib treatment is as much art as science. The decision of meds vs. ablation can be largely a lifestyle one.
I can now resume my cycling and lifting with minor limitations.
Saying all this, while my EP is happy with my results, his PA says she would lean toward ablation for me as I am probably in the best physical condition at this point. Do it now rather than later?
Good luck.