Ablation ageism

A friend who has been successfully ablated in Wales wrote this to me today -

quote "He also told me that the ablation is more successful on younger people and I at 52 (at that time) was nearing the top end of what he was happy to carry out the procedure on."

I'm shocked by that and obviously at 70 on the scrap heap

Welcome Joyce,

Overall its nice to have youth on your side for any medical procedure, for a host of reasons regarding overall body functions etc.

That being said .... HA, I think I've heard everything now! Rest assured Joyce that it is total HOGWASH that this EP considers afibbers above 52 to be near the end of the line for doing an ablation! What is true is that some EPs should not at all be doing these procedures and such a comment is your direct evidence you are in the presence of one such doctor.

Physically fit up to 92 year olds with not excessive levels of CVD or other co-mordbidites have completed very successful AFIB ablations with much gratitude for having been offered and going through the process for freedom from arrhythmia for the rest of whatever life they might have .. not infrequently now starting to reach 100 or more. Typically once in the 90s it will be just the very symptomatic seeking and ablation to begin with.

It can take a bit longer to fully recover energy and stamina after an ablation once you get well into your 80s but, the flip side of stopping all symptomatic AFIB is well worth it on multiple levels.

Especially with the increasing strong evidence of Silent Cerebral Ischemia (SCI) accumulation over time just from any on-going AFIB in ones life. A new study has found that AFIB tends to shrink ones brain volume as well, which ties in consistently with the finding that people with unaddressed AFIB have significantly higher odds of early onset dementia and Alzheimers as well.

A number of studies have validated that even well into ones 80s there are not any appreciable extra risk of complications , all else being equal between folks younger folks and older folks.

Ive noticed too anecdotally and have heard feedback on this fact in multiple physician AFIB conferences that a good number of younger folks in their 30s and 40s require more work over all just because so often there is a strong genetic component to their AFIB as well for them to even get AFIB to begin with at such a young age.

In any event, please run .. don't walk ... away from who ever told you such nonsense and find a real AFIB ablationist who is confident and highly experienced in ablating people of all ages within reason.

Go see Dr Sabine Ernst at London's Royal Brompton for better recommendations and review of your situation Joyce.

Take care,
Shannon

Thankyou for the positive message, Shannon. I'd already noted and looked up Sabine Ernst when you mentioned her the other day

Naturally I was hoping to find someone nearer to where I live, but not with that kind of attitude!

I'm re-reading Hans' books at the moment

Joyce, I don't know if there was ever a study looking at AF ablation and age. There was one done on patients with ventricular tachycardia. These are patients with structural heart issues such as prior heart attacks and cardiomyopathy with ICD implants, so much worse shape than AF only patients. In that study, age was not a big factor below the age of 75. The biggest factor was kidney function via blood work, as an overall indication of how healthy an individual is. These procedures are also more time consuming and complex than AF ablation. Like Shannon said, age is not a factor for you.



Edited 1 time(s). Last edit at 07/21/2016 12:36AM by researcher.

Hi researcher, there here have been a number of studies on AFIB ablation and age, including a multi-center study done under St Davids Med Center comparing outcomes and complication rates for over 80s octogenarians undergoing AF ablation versus younger aged afibbers with generaly well matched stats other than age for each comparative cohort in the study spanning several large centers if I recall.

It showed no inherent age-based limitation, at least up through the oldest group studied with similar levels of complications and overall outcomes between the octogenarians and younger groups. I don't have the time at the moment to look that up for you ... am juggling six balls as usual at the moment. Dr. Natale, I know, has done a good number of patients over age 90, though he offers it only to those above 90 who are symptomatic and otherwise in good overall health for their age with no significant co-morbidites..

Two of the folks I have followed from our site who were referred to me by others, and that were in their early 90s have had expert ablations in Austin with Dr. Natale, and both are doing well now at around ages 94 and 95 respectively, a few years after their respective ablation process was complete. You wouldn't offer an ablation to a 90+ year old if there AFIB is very well managed and/or they are truly asymptomatic, but for the spritely 90 year old who has had remarkable genes and/or who have taken very good care of themselves and whose later gold years are greatly burdened by AFIB, there is a solution.

Cheers!
Shannon



Edited 1 time(s). Last edit at 08/04/2016 07:39PM by Shannon.

Joyce... My first ablation was at age 67. Eleven years later, I had the second...at age 78 and then another, at 79.
I was reassured that people 80 and older do fine.

My personal experience is that the first two were much easier overall than #3 and that could be because 2 and 3 were 7 mos. apart and I think the anesthesia was especially difficult for me on the last one. However, the good news is that I really didn't have any severe issues other than energy and stamina and that's slowly normalizing.

Heart is in peaceful NSR.

Jackie

Keep well away from this doctor! I had mine at age 65 and have been in sinus rhythm ever since - over 13 years.

Gill

You are welcome Joyce,

And while it is very convenient to find an elite level AFIB ablationist near by ones home, it is typically a real exception to the rule when an Afibber finds themselves so lucky that they wind up in the same town or region with one. And there just isn't any such elite ablationist in Wales, Im afraid. Only a couple in all of the UK that I am aware of.

As such, the bit over 3 + hour drive or train trip to London is well worth it for your hearts sake, and spend a few days there after the procedure to be close by those first couple days after release from the overnight hospital stay post ablation before the modest and lovely trek back to Wales ( I love Brecon Beacons area )

I traveled from Amsterdam where I lived for four years from 2006 into 2010 all the way back to Austin for my index ablation with Dr Natale and it was one of the single best decisions of my life, after marrying my wonderful Magdalena.

Wales is a stones through away from London by comparison and one thing we urge everyone here is to make that one critical choice of who is going to have their hands on the catheters inside your heart during those few critical hours of your ablation, which will have the single biggest impact on the trajectory your experience with AFIB will take.

There is lots of good guidance here on this website and forum, so take to heart that central message to be very discriminating in who you choose to do an ablation within your heart.

You friend my well have had a successful outcome, though would have to hear just what defines his success and for how long and from what degree of AFIB. But even poor overall ablationist typically more often than not can do a decent job on a straight forward PVI... its just that the odds of them being able to handle any case with including Non-PV triggers which so many people do have to one degree or another, are not very good for long term success.

Stack the odds in your favor by going to London and Dr Ernst, at least for a consult and take it from there. From all reports she is very thorough and we have had a number of folks from the UK go to her with excellent results.

Be well,
Shannon



Edited 1 time(s). Last edit at 08/04/2016 07:16PM by Shannon.

Thankyou everyone for info and support. Just been checking routes to London from very west Wales.... 2 buses and 2 trains.

Not sure from websites whether I can refer myself for a consultation or whether I've got to go back to GP.... maybe best to phone on Mon.

Hi Joyce,

As I recall, you are in the Outer Hebrides. I'm sure it is a bit of a trip, but likely worth it!

Here is a search on Dr. Ernst on the forum <[www.afibbers.org]

Also, David Price got an ablation from her and this is his business website if you want to contact him about direct experience with Dr. Ernst: <[engagedlearning.co.uk]

Cheers,

George

Hi George,

Good memory or look up? LOL. Yes I was, but am now in the wild and equally beautiful Wild West of Wales
Tried to settle inland, but needed the sea/coast.

Many thanks for info will look properly later.

Hope you are doing well - remember teasing you about taurine and the best source being mouse brain - cats are wise

PS would have been 2 planes from Hebs and quicker trip!



Edited 1 time(s). Last edit at 07/22/2016 03:01PM by Joyce.

Hi Joyce,

I did remember, but verified. Likewise with glaucoma. As I recall, you have your on test machine?

Funny on the taurine. Still have a cat, but changed houses where there are no voles in the garden, much to his chagrin...

Cheers,

George

Thankyou all for all the information.

Had a very pleasant family visit this week so bit behind on thinking about anything else. Also feeling a lot better since ditching furosemide with GP agreement and perhaps a bit naughty of me but also halved the Ramipril to 1.25mg. Taking Bisoprolol as ordered and sadly the rat poison as well.

BP was going far too low [90/53 one afternoon] and making me dizzy. No wonder some of us oldies fall and break things.
I see GeorgeN functions well on quite a low BP and his memory is excellent

I looked up David's business and will email him.

Seeing the nurse tomorrow for an INR and will see if I can hasten the local cardiologist appointment I was promised 8 weeks ago!

At least OH has said he will come with me if a London trip is on the cards.

Keep well everyone and above all Keep Calm!

Not heard back from David after filling in his contact form on his website, but loads of info by looking at his posts on here and all your answers/ discussion.

I was a bit depressed about cost as I have no private insurance, but then pleased to read that the NHS paid for David, do am bearing that in mind.

Heart is quiet at the moment and I seem to be tolerating the bisoprolol, not so keen on the ramipril or the rat poison!

If things stay as they are just now I'll wait for local-ish cardiologist opinion and take 'it' from there.

Thanks again everyone.