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I need some advice
January 19, 2019 06:30PM
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.
Re: I need some advice
January 19, 2019 07:07PM
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.
Re: I need some advice
January 19, 2019 07:09PM
#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
Re: I need some advice
January 20, 2019 12:54PM
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.
Re: I need some advice
January 20, 2019 06:46PM
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.
Re: I need some advice
January 20, 2019 10:26PM
It's Tikosyn, not Tekosin.

Sounds like it would be worth getting Natale's opinion at least, Tikosyn could be tried in the meantime.
Re: I need some advice
January 21, 2019 09:51AM
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.
Re: I need some advice
January 24, 2019 07:19PM
Thank you all for your helpful comments.
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