Thoughts on Ablation and Down the Road Watchman

Afib is tricky

by Theknotguy - 2023-02-15 20:01:59

It's really hard to predict how you will be affected by your afib.  Each person is different and the afib situations are  unique to you and your body.  

Mine was controlled by medications.  I went from being knocked down for three days at a time to being bothered by it but still leading a "normal" life.  Now I'm at a situation where the afib messages aren't being sent to the other parts of the heart so I feel ok most of the time.  Occasionally I'll get into a stressful situation and know I've got afib going on but otherwise I'm ok. 

My wife had to have a couple of surgical ablations.  The first lasted several years.  The second lasted a couple of years. After that she went into 100% afib and they had to kill the AV node, then implant a pacemaker to run the heart.  My AV node degraded so I'm at the same situation as my spouse.  Hers was medically induced, mine was biological.  

It may take your cardiologist/EP several times to find the right combination that works for you.  Main thing to remember that if you go back to the 1960's there was almost no treatment for afib and you just had to live or die with it.  Going back ten years they still didn't know as much about it as they do now and new discoveries are being made every day.  So hang in there.

We live in a mickey-d world where you walk in, order something, and it shows up almost when you finish ordering. Unfortunately medical science isn't that good yet.  So you may have to live with your situation for a while as they figure out what is unique to you.  Keep a positive attitude and as I said before, hang in there.

I do hope they can help you quickly.
 

Afib? Ablation?

by AgentX86 - 2023-02-16 01:07:14

You didn't say how symptomatic you are but you say that your ICD detected it, which implies that you didn't.  If you're asymptomatic, there is no reason for an ablation unless it's so infrequenty (paroxymal) that your cardiologist is afraid of it getting worse.  The probability of success of an ablation goes down dramatically the longer you wait. Afib isn't going to do much to you.  Control the heart rate (under 100bpm) and anticoagulant and Afib is nothing but a nuisance (where "nuisance" can be seeing a cardiologist more frequently to "I'll go crazy if I can't end this crap").

I highly suggest that you find an electrophysiologist. A cardiologist is out of his league about now. I wouldn't be talking to any cardiologist about ablations or a Watchman.  You need to find an EP and if you do go for an ablation, find the absolute best ablationist you can find.  You need one who does at least a hundred per year and has done at least a thousand, lifetime.  It's important.

A Watchman isn't the end-all.  It may or may not be effective and even if it is, it might not be enough. I have an LAA clip (Watchman on steriods) but it doesn't help.  I still have to be on anticoagulation because I'm in permanent Aflutter.  Your really need a specialist's specialist here.

Thoughts about Ablation & Watchman

by Jimmoore163 - 2023-02-16 06:22:31

Thanks to you all who took the time to respond.  Most of my contact at this point is with my EP.   AgentX86, your comments were right on target.  What I've read states the same thing about ablation, experince matters.  I've been what I would call asymptomatic.  Frankly I was asymptomatic right up to implant.  Back in October of 2022 apparently I failed a nuclear stress test miserably.  Subsequent angiogram was clean but echocardiogram showed and EF of 15-20. It's only been five weeks since the implant all things considered I feel good.  I won't be making any decisions until after the 3 month, possibly 6 month mark.  Once again thanks so much for the feedback and the words of encouragement.

Thoughts about Ablation only since I am on anticoagulant Edoxaban

by Gemita - 2023-02-16 06:59:02

Firstly, welcome Jim.  Two other points.  Perhaps they want to consider treating your AF when your Ejection Fraction (EF) recovers, to avoid any inappropriate shocks from your defibrillator because AF is apparently capable of triggering this when it occurs at a rapid ventricular response rate.  Secondly, treating AF if it occurs frequently will help prevent further deterioration in your EF and your cardiomyopathy, for which I see you have a CRT-D device.  I hope though your EF picks up from the 15-20% range with your CRT alone without any further intervention.

I tend to believe the less I do with my AF the better for me personally and that not all AF sufferers will have a form of AF that will progress, even though it usually does (if we cannot control it).  Yes I totally agree, rate control and anticoagulation are the two most important treatments.  My doctors will only recommend an ablation when my symptoms cannot be controlled by meds and lifestyle.  However, should you choose the ablation route, it is certainly supposed to be more effective than medication in treating AF (I was quoted around 45% success rate for medication and up to 75%+ or more with one or two ablations).  But of course no treatment is 100% effective against AF although medium term respite with both medication and an ablation can often be achieved.

I hope you do very well with your CRT and that you stay safe

Ablation

by StephenG HCM - ICD/Pacemaker Patient - 2023-02-18 09:19:09

i have had two ablations in an effort to stop my persistant Afib - unfortunately they didnt last as after a few days i went back into afib.                                                                                            I would still try though as everyone is different....good luck!