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Ablation appropriate after just one prolonged a fib episode?
I had a two month a fib episode starting with severe flu and ending in cardioversion last August. My cardiologist referred me to an electrophysicist who promptly told me I needed an ablation as soon as possible. This rather shocked me as I was not expecting that recommendation. Prior to this summer my afib episodes lasted at most a day and that happened only every 4 or 5 months. I thought ablations were for more frequent afib. I've only been diagnosed for a couple of years. Is this the usual course of action? I'm finding that communication with my large cardiology group is lacking.
retiredlcsw, November 2, 2019 6:50pm EST
I had an ablation done after only about 5 episodes of short duration over a period of several months. Went to the ER each time and most of the episodes resolved by themselves in a little over an hour. The EP that I was referred to advised that the sooner an ablation was done, the better the chance for success as there are less pathways to burn out. Well in my case it was the best advise he could have given me. The procedure went smoothly without a hitch and I have been a fib free since April 2017. I am off blood thinners, only take Diltiazem XR, and my anxiety level has been greatly reduced. Should this ever return. I would do it again without hesitation. Hope this helps with making your decision. Best of luck to you.
Raisala, November 2, 2019 7:16pm EST
I, too, had an ablation after only a few episodes. It was Feb. I'm still on blood thinners and Diltiazem. I've had only a few episodes but that is why I can't come off the blood thinners. I'm learning the triggers. One is eating heavy or late. I try for my largest meal to be before 4pm. Actually, the less I eat, the better I am. Haven't lost a pound though. LOL.
Thumper2, November 3, 2019 6:06am EST
Snick449, I'll give the same advice as RetiredCSW and Raisala and your EP, regarding getting an ablation. I wish I'd had that advice -- I had few symptoms for some years, but my heart was re-modeling itself negatively,until having ablations and cardioversions did me no good at all. Ablations are not major surgery -- they are a "procedure," involving 1 or 2 days in the hospital.
MellanieSAF, November 3, 2019 11:59am EST
A two-month episode of afib is rather long, doing structural and electrical remodeling to your heart all that time, so it is understandable that your EP suggested an ablation, especially since it required a cardioversion to convert you. You had at least 60 days of afib - that is a lot.
rfedd, November 3, 2019 11:34pm EST
I saw my EP last week gave me the outline of the procedure and told me to go home and think it over. Since my first major episode in may I have one about every 10 to 12 days. He tells me that the success rate is about 50/50. No guarantees. I keep a good history on my phone of each event by date, using my Kardia. He didn't even look at it. Maybe find a different doc?
Thumper2, November 4, 2019 7:16am EST
rfedd, perhaps you could ask your EP some more questions, such as, (1) what is his opinion on Kardia data, and why wasn't he interested in looking at yours? (2) How many ablations does he do annually, and (3) what is his success rate? Responses to these questions may tell you if you might look for another EP, but you should ask that person the same questions.
In addition, have you been tested for sleep apnea? Untreated sleep apnea will lower the chances of success of an ablation.
Keep us posted! All the best, Thumper2 (Judy)
rfedd, November 4, 2019 3:50pm EST
Since my cardiologist and the EP have adjoining offices, I sent all the information to him for review. The EP has done hundreds. He just said he could not guarantee a result. They tried to test me for sleep apnea, but could not get a good result. Too many other things going on that wake me too frequently.
Thumper2, November 5, 2019 9:03am EST
Ron, I wish I had some good advice on testing for sleep apnea, but I have never been satisfied with either the tests (3) or the professionals interpreting them. One simple thing you might try is one of those finger things that registers how much oxygen is in your blood -- there is a type you can "rent" which will record all night long, as you wear it on your finger. If the numbers stay in the upper 90s, you at least will know that! I'll leave it to others to discuss whether or not this means anything about sleep apnea.
MellanieSAF, November 5, 2019 10:39am EST
If you don't have good results from a lab sleep study, you could ask your doctor if a home sleep study would work.
rfedd, November 5, 2019 4:59pm EST
Thanks for all the feedback. The sleep apnea test was a home study. Unfortunately with the prostate cancer issues I was awakened about every two hours. As far as oxygen levels I am always in the high nineties.