Vagal Afib, progression and ablation

Hello everyone, I'm 42 and have paroxysmal vagal afib that only comes on during sleep. Taking Flecanaide and had zero episodes since then. I read a lot about vagal afib being more unlikey to progress. Any other 100% vagal affibers in here that can confirm that or had an opposite experience? Also wondering about ablation and whether it also applies to vagal afib to rather get it sooner than later.

Thanks in advance for your insights, this is a great forum!

Not sure where you read that vagal afib is unlikely to progress, but I don't believe that's true.

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Carey
Not sure where you read that vagal afib is unlikely to progress, but I don't believe that's true.

In Hans Larsen's (founder of this site) 2003 edition of his book, "Lone Atrial Fibrillation, Towards a Cure," he writes, "There is no indication that vagal LAF involves any heart abnormality and vagal LAF rarely if ever develops into a permanent condition." (p 19 of the book, p 31 of the PDF). I agree with Carey that I don't think this is true. I've been a member here since 2004 and I've seen many vagal afibbers progress. In my personal sphere, my best friend from childhood was and is very fit and a vagal afibber. He progressed to permanent. I suggested he go to Natale and after two ablations around 8 years ago, including LAA isolation, he is doing very well at age 71. He's one of the lucky ones with an LAA isolation & does not need anticoagulation.

{edit} permanent is typically called "longstanding persistent" now.



Edited 1 time(s). Last edit at 02/28/2023 01:15PM by GeorgeN.

Yeah there are several sites claiming that it doesnt likely progress - however I have never found anyone explaining why vagal Afib would NOT progress as opposed to other Afib so I'm also somewhat doubtful.

Any literature I have read makes no distinctions between various progenitors of AF. None have even mentioned research or the possibility that any one kind, origin, or suspected progenitor, of AF might not be progressive in the way AF is typically progressive.

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andreas22
Hello everyone, I'm 42 and have paroxysmal vagal afib that only comes on during sleep. Taking Flecanaide and had zero episodes since then. I read a lot about vagal afib being more unlikey to progress. Any other 100% vagal affibers in here that can confirm that or had an opposite experience? Also wondering about ablation and whether it also applies to vagal afib to rather get it sooner than later.

Thanks in advance for your insights, this is a great forum!

Hi,
You don't say how much flecainide you're taking and for how long.
Usually, rhythm drugs become less and less effective over time. If you're fine with flecainide, I don't see the need for an ablation right now.

I'm vagal too, episodes coming at rest or while digesting. Meds (I tried a few) didn't work for me. I've had four ablations, but I've still AFib. Short episodes, vagal, self-ending without drugs. No increase in length or frequency of my episodes for nearly 5 years.
Statistically, AFib would progress, but it's only worth as statistics. Each case is different.

Hi Pompon, may I ask how old you are?

I'm very new to this "game", diagnosed last December, on Flec since two months, 100mg a day.

@Gloaming: there is quite a few literature and studies out there talking about the less likelihood of progression of vagal afib (one was quoted by GeorgN in this thread) but yeah I am also not entirely certain.

Not saying anyone is right or wrong but the book was from 2003. There has been a lot more research done and knowledge gained on Afib over the last 20 years.

Vagal Afib here—progressed slowly over 12 years until I was getting an episode every day. Failed Flecainide after being on it for many years. Successful ablation 4 months ago.

Hi andreas 22,

I'm vegal also with AFIB for the last 5 years (no medication). I'm 67 and my first year of AF was difficult with 77 episodes all converting on their own within 3 hours max. I am a long-time endurance exerciser and was training for another triathlon doing lots of HIT and drinking too much alcohol. Once I started detraining and stopping the alcohol, my heart started to get better; seven episodes the second year, four episodes the third, four the fourth, and only 2 in the last year. One converted in an hour and the second in 8 minutes. Both brought on when sailing a boat off shore with no sleep, sea sick, and dehydrated!

I know AFIB could rear it's ugly had at any time, but so far I really believe mine won't progress. Of course I'm sure others have thought that as well. The book:
"The AFib Cure: Get Off Your Medications, Take Control of Your Health, and Add Years to Your Life by J. Day" has really helped me.

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andreas22
Hi Pompon, may I ask how old you are?

I'm very new to this "game", diagnosed last December, on Flec since two months, 100mg a day.

.

I'm 65. First episode at 57. No health issues, all tests returned normal. Both my parents were afibbers, but later in their lives. I guess I'm genetically sensitive to vagal disorders, and it's likely that my way of life (bicycling and hiking) made my AFib episodes appear sooner than theirs.
You're young.
Are you an athlete ? Have you other health issues ?
Seeing a good electrophysiologist would be a good idea, but don't rush for an ablation before having had the required tests and being sure your life habits have been managed appropriately.

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Daisy
Vagal Afib here—progressed slowly over 12 years until I was getting an episode every day. Failed Flecainide after being on it for many years. Successful ablation 4 months ago.

You sound like me. Flecanaide slowly losing its power over my vagal Afib. Ablation schedule later this month. What type of ablation did you have? How did it go?

john

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Johnnyk80

Vagal Afib here—progressed slowly over 12 years until I was getting an episode every day. Failed Flecainide after being on it for many years. Successful ablation 4 months ago.

You sound like me. Flecanaide slowly losing its power over my vagal Afib. Ablation schedule later this month. What type of ablation did you have? How did it go?

john

I went to Dr. Natale and he had to do an extensive ablation including, the LAA, in order to get all the sources of Afib and Aflutter. I am 4 months post ablation and all is looking good. I will return for a TEE and probable Watchman in the next couple of months.

I have vagal afib and it most definitely progressed. From once a year to ten times a month over about a ten year span. Would it have gone to persistent? I have no idea. But it clearly got worse over time.

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keeferbdeefer
I have vagal afib and it most definitely progressed. From once a year to ten times a month over about a ten year span. Would it have gone to persistent? I have no idea. But it clearly got worse over time.

That almost exactly describes me except that it was about an 8-year period. I have no doubt it was headed toward persistence.