To Ablate AV Note or Not Need Help

Hi all. I'm am a member of many years but have not been on here for quite a while. I am taking Flecainide and Digoxin. to control A Fib. After having a mechanical conversion 3 times in April and May I was referred to an E.P. to discuss AV node ablation. I saw him today and he has srongly advised me that these medications are very dangerous and will end up killing me. He is advising me to discontinue these meds and have the above procedure. I am presently in normal sinus rhythm but if I have the procedure he says I will be in permanent A Fib., though he says I will not feel it. I am 72 years old and do have many symptoms from the medications including feeling drained, fatigued, dizy spells etc but I have a vey positive outlook on life, push the symptoms aside and get on with it the best I can. I m having a very difficult time working through this decision and would appreciate some thoughts from people who have had this procedure and what if any improvements it has made.
Thank you in advanc.
Nuka

5 Comments

A-fib

by Roys - 2013-10-09 02:10:01

Why not have a PVI ablation, you would have a %70 chance of a cure. Also have you tried Sotalol for your AF, an AV node ablation is the last resort. I would try everything else before having that procedure. Get another opinion. I had AF for 10 years, but am now free of it. Look up a-fib.com by Steve Ryan that website has the best info for A-fib.
Cheers Roy

What about....

by PacerRep - 2013-10-09 02:10:18

An A-fib ablation? Did he discuss this option with you?

A -fib ablation

by ceejay - 2013-10-09 03:10:02

I am new to this site--glad to have found it. I also was wondering about an A -fib ablation. I had one three years ago; though have not been A -fib free. Take flecainide. Get A-fib every once in a while for short durations compared to very often for long durations before the ablation. Also had PM implanted at time of ablation --should have had it years ago but denied the need.

As for flecainide, been on it for about 16 of my 19 years of having A -fib. As long as dosage isn't too high, I have no problems at all. As for digoxin, I was once prescribed that. I will never take that again!

As for the doc saying no feeling that you are in A -fib after the ablation, I would think you will still feel the fatigue and lack of energy. Strange to me that the doc would recommend such a thing. What about increased chance of stroke, etc.

PVI

by golden_snitch - 2013-10-09 03:10:30

Hi!

I agree with the others: Have an afib ablation, a so called pulmonary vein isolation (PVI), first, before you have your AV-node ablated. And actually, I'd not only have one PVI, if the first one doesn't do the trick; success rates of PVIs are much higher with a second or even third procedure. Also, success rates are higher as long as your afib is not permanent. In case the ablations do not work, you can still go for the AV-node ablation. But it should really be the last resort.

Regarding the drugs: Those prescribed for afib are the best known, best studied antiarrhythmic drugs that are available, except for Multaq. But Flecainide, Propafenone, Amiodarone, Sotalol have been on the market for many, many years. Yes, they can have serious side effects, but with a good follow-up they are usually safe. I think there is no need for panicmongering, especially not telling you that those drugs will kill you one day.

If you consider a catheter ablation, make sure you end up with an experienced EP. I'd probably not ask the one who has suggested the AV-node ablation and who told you that the drugs will kill you, just doesn't sound very competent to me. Catheter ablations for Afib are a bit tricky, and should only be performed by experienced hands. You can search for specialists on the Heart Rhythm Society's website:
http://www.hrsonline.org/Find-a-Specialist#axzz2hCfBX0kv

Good luck!

Inga

Mini-maze

by ebfox - 2013-10-09 09:10:09

Nuka,

Another option is mini-maze surgery. It is more invasive than catheter ablation, however it has a better success rate for people with permanent afib.

A good strategy would be to try the catheter ablation first, if that is not successful go for the mini-maze. The AV node ablation is the last resort.

I totally agree with Inga about finding an experienced EP. You want a guy who has done at least 500 procedures; there are guys like Dr. Natale who have done thousands. You great increase your chance of success by using an experienced EP.

Check out a website called Stopafib.org for lots of good information about how to attack afib-

Good luck,

EB

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