AV NODE ABLATION + PVI AND HAVE GONE BACK TO AF

As I posted before I now have returned from seeing my EP who confirmed that I am in irregular heartbeat.  He said that although I have had extensive work done on his two previous procedures he has one more he can offer me, but no more after this one.  He said it would be an extensive procedure done under a general aneasthetic and would take between 3-5hrs. He wants me to see if I can tolerate Solotol at a low dose to control these irregular beats as he told me quite straight that no matter what he did most liklely I would not stay in sinus due to my age and that I am  persistant AF.

I have agreed to do this and he has placed me on his list to see how I would get on whilst waiting.  This bears out the whole augument that AF is not at present "cureable" but can be controled to make QOL better.


4 Comments

Get a second opinion

by AgentX86 - 2019-10-09 09:18:24

What procedure is he offering now? What irregularities? PVCs? An irregular heartbeat isn't always dangerous, though they can be quite uncomfortable. Note that every antiarrhythmic drug is toxic (the more effective ones are the more toxic ones) and are rarely effective over the long term. You need a lot more information than you're giving here.

UPDATE TO FIRST POSTING.

by bilboesylvia - 2019-10-09 10:08:52

When a second opinion was mooted I neglected to say that this guy is the second opinion and he concurred with the first one who came from Birmingham and was equally experienced.

I do not have details of this coming procedure as I am awaiting his report.  I didnot ask at clinic as I would not have been able to understand the complexities of it.  He knows that I will research it before agreement fully.  The irregular beats leave me very syptomatic with breathlessness and I cannot walk further than 5 mtres, and travelling to another opinion is out of the question for me.  I am sensative to most drugs not just heart drugs, but blood pressure drugs and antibiotics.  This alone make me hard to treat.  I feel lucky that I found someone who was willing to try.  

A-Fib

by AgentX86 - 2019-10-09 22:01:13

But she said she had an AV ablation.  The ventricles won't be affected by the AF.  That's the whole point of it.  There is something very wrong with the whole thread.

THE NATURE OF AF

by Gemita - 2019-10-10 06:15:23

Dear Bilboesylvia, 

Yes, I think we all know that AF can be a real pest even though some find their own ways of stopping it.  As we get older it is more likely to worsen and cause difficult symptoms unless it is firmly controlled.  I have tried throwing everything at mine, but it only makes it worse.  Now with minimal intervention, except low dose betablocker and dual chamber pacemaker I am doing much better.  To do nothing (except control heart rate and protect against an AF related stroke with anticoagulation) is also an option for some and a good one. 

I hope you find some relief with Sotalol which has both an anti-arrhythmic and rate control action in one.  I have never taken it, but I know that some have found it helpful.

When I was considering an AV Node ablation one thing stood out and that was a remark from my EP about right ventricular pacing.   If right ventricle alone is paced this could lead to heart failure symptoms in some patients (because of a loss of synchrony between the two ventricles).  This could be helped by introducing an additional lead to the left ventricle to allow for more natural pacing.  I do not know how many leads you have Bilboesylvia but a pacemaker upgrade might be helpful but perhaps your EP has already tried this ??  There is a lot that can be done to treat AF, so dont ever give up. 

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