Ablation

I have an ablation scheduled for early December, and I am hoping to get some information from others who’ve had the procedure.
I’ve had paroxysmal Afib for approximately 7 years, and is now becoming more frequent. I have the option of having it done at Mayo, but they’re booking into April. My EP has performed this procedure hundreds of times and can do it sooner. Can anyone tell me if you have to be on OAC forever or can you stop if a few months after the procedure? Currently, I only use it when I have Afib. I have such side effects from it, fatigue, stomach pain, etc. I feel like I could tolerate it for a few months, but I don’t know about permanently. Also, do you have to be on a PPI long term? My EP uses general anesthesia, which I’ve had problems with before, but just wondering if anyone has any advice about tolerating it better.
I know these are a lot of questions, but I really want to get this done, and am also a bit apprehensive.
Any advice will be appreciated.

- Stopping OAC a couple of months after ablation can be done if you're afib free and your CHADs score does not require still taking it.
- Prescribing a PIP after ablation is common and well advised, but you've usually to take it for a short time.
- An OAC can give some discomfort (stomach, guts...), but I'm doubtful about tiredness.
- An EP having performed thousands of ablations is likely more experimented than another having only made some hundreds...

I've learnt that the right EP is rarely the guy next door. So, waiting a little more for a better one is usually worth it.

I dislike general anesthesia as much as anyone, but for a first ablation, it's the way to go, IMO.

Tbh I am only guessing at how many he has done, but he has been doing this for over 30 years, so it could very well be thousands. Is there any way of finding out?

Something doesn't track here. Afib ablations, as we know them, have barely been done for 20 years. If your guy has been doing them for 30 years, he must be well into his 60s at least, considering all the years for education and training. Also, what's the experience level doing them at the hospital where he does them ?

Your questions are normal for everyone and should have been gone over with you by him or his staff before now.

At minimum, a second opinion from a recognized EP surgeon should be your next step.

As others have said, the experience of your EP is the most important factor in success, and yes thousands rather than hundreds is very important. You can ask him how many he has done – it is a fair question. As far as anticoagulants, if the one you are taking is bothering you, there are other choices and it is usually possible to find one that doesn’t give you side-effects if it is deemed necessary for you to continue to take it.. Some are known to be more likely to give gastric side-effects. General anesthesia is not popular with anyone, but believe me you want to have it for an ablation! You will have an opportunity to speak with the anesthesiologist and share any special circumstances you might have. Not only do you not want to move by even a centimeter during an ablation, you don’t want to be conscious while they are doing the necessary invasive procedures. A high volume facility and an EP who has done thousands of ablations greatly increases both your chances for a successful ablation, and lowers the risk of any complications. When you think about it, you are trusting the EP to make appropriate burns on the inside of your heart and you want someone who can handle any arrhythmia he encounters.

Thanks for your reply. As I mentioned I actually don’t know how many he has done that was just me guessing, but I will try and figure that out. I asked him the 12 questions that were in this book, “The Afib cure.” When the question about how many procedures came up I said I’m sure you’ve done hundreds of these, then went in to the next question. But I will try and get a more definitive answer. I have met with another EP from Mayo, and didn’t ask him how many procedures he has performed, otherwise their answers were very similar. One difference in answers, the Mayo dr talked about if anything goes wrong they will take care of it, my other EP talked about 2x over the past however many years something went wrong and how they were able to take care of it.

I was also reading in another post someone saying they have more issues with flutter now than before, is that common? Sone one has also mentioned a pulsed ablation which is still in trials.

I am hoping to get my Afib procedure done so I can enjoy my child’s wedding next year.

Just ask him. It's a perfectly valid question and he should be able to give you at least a good estimate.