To all who have had ablations

I would like to know how often you would go into AF before you had your ablations? I do not take meds daily, only on demand. Im on propafanone and take 300mg on the onset of an episode. I have AF about every 2-3 days and usually lasts about 2-3 hours. Have those who have had ablations waited until they were more frequent before having the procedure? And also were you on meds at the time? If you were on meds and would go off them would you of had more frequent episodes? If so how often? Sorry if this sounds confusing,I'm on a waiting list here in Canada for a PVI,which could be another year before I have it done. Just want to know if staying on the demand approach will worsen my episodes and make me chronic? Or should I go on daily dosing which I don't want to, in hopes my episodes are not as frequent. My EP says I won't go chronic yet but probably will eventually if I don't have a PVI. My AF is not too debilitating and Im very active in sports and the gym, and rarely stops me form doing things. Im vagal and usually get them when laying down on the couch watching TV or on the computer. To all those like Sammy and Newman and to all the rest of you who share your ablation stories it really helps me knowing that a cure is there for us. Thanks for the strength!

Regards Frank
V44

Frank,
I had an ablation on Aug. 12 at CCF, having waited approx. 5 months. During the 6 months prior my AF became progressively worse until I was in AF about 75-80% of the time. I tried to get in earlier, to no avail, although they did put me on a so-called 'step-up' list for which there apparently were few, if any, cancellations. I tried three different anti-arrhythmic drugs. Flec. and Rhythmol put me in flutter and Tikosyn was ineffective. I used diltiazem which slowed the heart rate considerably while in AF...making it tolerable. My advice in all this is to do whatever it takes to keep out of AF as much as possible, even if it means going from 'on-demand' to around the clock drugs. I earnestly believe that if I could have had the ablation before I became almost chronic, I would have had a much better chance for success....my opinion.

After the AF ablation I developed chronic (constant) AFlutter, which I did not have before (except when drug-induced.) I'm now waiting to have a flutter ablation, which they tell me cannot be scheduled until Dec. 1. I'm counting the days and hoping my heart is not permanently damaged by then, because my heart rate in flutter is anywhere from 120 to 180. Rate control drugs are not effective for flutter. Each cardioversion has lasted only 1-3 days.

Go as soon as you possibly can and stay in NSR as much as possible prior to going, even if it means drugs. My opinion based on my experience. Good Luck to you. Char

Char:

Sorry to hear about the flutter. I was diagnosed with permanent flutter in the fall of 1998. It was finally successfully ablated in November of 2000. Afib began within 18 hours.

But my point is that my rate was kept under 100 bpm with a combination of cardioversions, Rhythmol, Diltiazem, Lopressor, &/or Soltalol. But , of course, you've got a totally different system than I.

My prayers are with you.

njb

Char:

Do you think that women have more problems, i.e.,less sucess with ablations than men.

It just seems that in reading the stories about ablations that men seem to have better outcomes. Women have smaller veins than men (as a rule) and even when having a heart attack we fare different, our symptoms and the severity of the attacks.

I remember asking my EP once about Tikosyn and he said that women don't do as well on that drug, he wouldn't ever prescribe it for me.

Liz

Liz,

I just saw an article on WEBMD that said women were just as likely as men to have successful ablations. The point of the article was that doctors tend to suggest ablation to women less frequently than to men - and later on in the AFIB process.

Studies have also shown doctors tend to undersestimate ALL heart problems with women - assuming womem have heart attacks less frequently than men do - and usually at much older ages.

BillB
48;A;2000

Liz,

You pose an interesting question. I wonder if there are enough post-ablation statistics to compile to determine the answer yet. Bill likely points out the best answer so far i.e. that doctors don't acknowledge heart problems in women as readily. It is impossible to ignore AF though...for long. Supposedly, AF does not occur as frequently in the female population. (I'd be willing to bet that it does though.)

I wonder if anyone does well on Tikosyn. (I've never read of anyone taking it to control their AF.) It is only prescribed after a 3-day hospital stay to determine whether the QT interval is affected adversely. If I had known that before agreeing to try it, I would have declined. Even the pharmacist seriously cautioned me when filling the 3-day prescription to take home....before it was determined to be ineffective in my case. (It was discontinued by the EP before I was discharged from the hospital.) Two days later I received a 30-day supply by mail from Pfizer, which they ultimately refused to have returned, even though I did not accept the package. My insurance was, therefore, charged $300+ for the 30-day supply, even though I objected to the charge. The Tikosyn "trial," therefore, cost my insurance in the neighborhood of $4,000. The state of medical costs in general is truly a disaster. I wonder if some MD's are even aware of the extent of the economic effects.

I know Ellen who has the Yahoo Afib support group swears by Tikosyn. Quote

"I was
in permanent Afib before Dofetilide/Tikosyn - and my three day hospital stay was
a small price to pay. Next month I celebrate my three year anniversary on
Tikosyn, and except for several minor afib episodes, I am in NSR."

Fran

Char,

My Uncle had lone afib for about 15 years before he died this past August. He was my only afib buddy until I was introduced to this site.

Anyway, he had had an AV nodal ablation & a pacemaker installed(?). And he still had afib episodes periodically. He was on Tikosyn and like all the others he had tried, it too stopped working after about 1 year.

Unfortunately, I wasn't able to share all this news with him.

Your experience with Dofetilide must have been a real dissappointment, let alone costly in time & money.

My doc asked me if I wanted to try it, but my father had just passed, I was leary of side affects, & I was tired of being in the hospital so I declined. But I often wonder if I would have been better off because my condition worsened.

Oh, well.

njb

Thought I would post the conclusion of the WEB-MD article:

According to the authors, the reason for following a less aggressive approach in female referral for ablation therapy "is not completely evident," but they postulate that concerns about radiation exposure, especially in women of reproductive age, may play a role. In addition, they noted that earlier studies have shown that "symptoms of paroxysmal supraventricular tachycardia are more likely to be attributed to panic, anxiety, or stress in women than in men, thus delaying the diagnosis of supraventricular tachycardia."

This premise may be supported by the findings of the comparisons between male and female patients with and without pre-excitation on resting ECG. The authors believe that one potential explanation as to why the absence of the delta wave on ECG delayed diagnosis in women was because physicians may have first sought to rule out the possibility that the reported symptoms were of psychosomatic origin.

The authors also speculated that females may prefer not to undergo medical procedures because of safety concerns or childcare considerations; because they suffer less or are better able to tolerate incapacitation, compared with men; or because they consider themselves less important than men consider themselves.

On a larger scale, the authors note that findings of this study are consistent with other previous reports "demonstrating a less aggressive approach and a potential underuse of medical resources among female patients in different fields of cardiology and in medicine in general.

BillB