Afib burden

Hi,

finally, after procrastinating for a long time, I have an ablation appointment in the end of May after having had afib for about 15 years. Over the time my afib burden increased, yet it is still below 1%.

Is this a low rate? What is considered to be a relatively high rate? What was your burden when you decided to get an ablation?

Thanks and best regards

Dirk

My burden was having to go in for cardioversions every month. I had my ablation in Dec. 2012, after having 10 cardioversions that year.

Hi Dirk,

Good to hear you have a set a date now. The issue of burden is kind of like with radiation burden, while yes it's certainly preferable to have relatively few episodes spread out over time, and have those episodes be mostly shorter duration episodes, after a long number of years even on not an extensive amount of activity, there typically is a cumulative impact in the form of gradual remodeling and, as you noted previously the increased frequency of episodes, to a degree, in recent months is indicative of that progressive process.

15 years is a long time to have AFIB, event with a modest frequency. I know from our communication by PM that it has increasingly concerned you and you seem to have paired up with a skilled ablationist in Germany. You've also given the supplemental protocols a good effort for good period of time as well and that effort may well have helped to some degree in keeping the lid on the kettle more than would otherwise have been the case for a longer period of time.

Now, though, seems to be the right time for you to take this next step and add this big tool in your battle with AFIB to really reduce the burden significantly more, and hopefully reducing AFIB in your life to nil.

Best wishes Dirk, just relax now and go with the flow.
Shannon



Edited 1 time(s). Last edit at 04/28/2014 11:31AM by Shannon.

Dirk,

I've not yet signed up for an ablation, but I can give you my history & thought processes.

My first 4 months, my af burden was ~58%, including a 2 1/2 month episode of 100%
The next year was (20 +1+. 5) /(365*24) = 0.24%
The next 6 years was about 1 hr /year or 0.01%
Then the "bad" year of 28 hours, including 8 in one week = 0.3%. The 8 hours in one week is 4.7%
The last year, I'm back to 1 hour in 1 year or 0.01%

When it was 4.7%, I was ready to make an appointment. Now that I'm back 1 hour in a year, no desire. I also don't see anything that would create an episode at this point.

I think the trend is what is important. When I went to 8 hours in one week, that was a bad sign. If I'd not been able to turn that around, I'd have been signing up right away.

George



Edited 2 time(s). Last edit at 04/28/2014 04:34PM by GeorgeN.

One thing to keep in mind with George's case is that he fundamentally seems to have been an endurance exercise-based Afibber primarily. In other words my sense is that his is a classic case of lone AFIB that I think tends to be more amenable toward nutritional dietary/exercise modifying modalities to successful minimize the beast.

George is also very dedicated and focused on following whatever steps he finds that might hold some promise which has worked out very well for him over the years. Just keep in mind that those with mixed AFIB with various other cardiovascular co-factors may not have quite the success George and some others have had, so its important to understand your situation and not drag out the conservative approach too long in the face of continued breakthroughs and also to understand and accept your natural mind set and tendencies regarding how totally dedicated to any long term management process you are realistically likely to remain over time?

Being honest with oneself in this regard is also important and wise so as to be realistic about what you are likely cut out for and are willing and ready to follow carefully and fully.

George has played his cards with great skill, just understand that not everyone has been dealt the same kind of AFIB hand.

Cheers!
Shannon



Edited 1 time(s). Last edit at 04/28/2014 06:05PM by Shannon.

Thanks for your advice which I appreciate very much.

I am definitely going to have this ablation on May 28th and won't back up. Decision is being made.

Just one question: How Important ist the problem of PV stenosis with a straightforward PVI nowadays? As far as I know it has been more of an issue in the first years of ablation practice since then ablation within the veins was part of the protocol or happened by mistake. Today stenosis is very rare with experienced ablationists. Is this correct?

Thanks again.

Dirk

Shannon,

I totally concur.

Also, from what I've learned here, at such time as I do go for an ablation, my 2 1/2 month episode makes mine a "complicated" case. This means I would be well served to choose one of the very top ablationists, such as Natale or the Bordeaux team.

George

Hi Dirk,

You say your Afib burden is less than 1% per year. Can you explain that further.
From GeorgeN's post I gather that's only 10 hours a year.
That is not a lot and may be cured by taking additional supplements like ginger and curcumin, have you tried these?
I had some success with ginger last year, reducing my Afib burden from three events a month to about five a year.
Last December I started taking curcumin and ginger and have been Afib free since.
I also don't see anything that would create an episode at this point. 

Colin



Edited 1 time(s). Last edit at 04/28/2014 04:16PM by colindo.

Hi Colin,

There are 365x24=8760 hours/year. So 1% is about 88 hours.

George

Thanks George,

I read your post as 1 hour a year = 0.01% and therefore 0.1% would be 10 hours.

Colin

Must be Metric system.

bump