A fib for a long time

[Guest guest]

I have had a fib attacks for about 15 years. I have been hospitalized

three times in that time. Each time I have had my heart converted to

normal sinus rhythm with medication.

The frustrating thing is that over time the ability of the drugs to

keep my heart in normal rhythm fades and I begin have occasional bouts

of a fib they usually keep getting worse until I end up in hospital

again. The first time I was placed on Acebutolol this work for five

years. The next time I was placed on sotalol this worked well for two

years then I began having short bouts of irregular heart beats this

continued for another three to four years until I ended up in emergency

again. The last time I was placed on metoprolol , cozaar and amiodarone

as well as warfarin. This worked well for another three years and at

present I am have short bouts of a fib again. The doctor is now talking

about concentrating on heart rate control and not trying for rhythm

control I don't like this as when I am in a fib I find the fluttering

in my chest very uncomfortable. I would like to know if anyone else has

a similar history and where they are in there treatment at this time.

[Guest guest]

I would disagree with most of this post.

A pacemaker is not the preferred first line treatment of afib. Either

medication, a MAZE procedure or ablation is generally preferred

for 'straight ahead' afib. The option of natural/lifestyle treat ment

is also available.

The characterization of ablation in the post is unduly negative. While

ablation has not been around long enough to be absolutely assured that

it is, indeed, permanent, I am unaware of any studies that show that it

loses efficay over time. I'd appreciate any citation that you might

have in this matter.

I agree that it may take more than one try to get it right. My first

ablation made me better, but it did not solve the problem altogether.

My second one, however seems to have done the trick. I'm now coming up

to my first month with absolutely no, zero, zilch fib incidents -- not

even the usual 'dust settling' that usually goes with an ablation in

the first few months.

Finally, I have serious doubts about choosing what, who and where to

have heart work done based on price. I don't think that a trip to

India would be high on my list of options, but your mileage may vary.

>

> Ref your af (Which I have at the moment). You could go for a catheter

ablation but this is often only partially successful and you sometimers

need more than one and even then it may not be a long term cure. I

would think that your best option would be to have a 2 lead pacemaker

fitted. But which country are you in? and can you afford it? If not I

suggest you consider flying to India to have a pacemaker fitted there

for a fraction of the cost of western country charges. You would not

end up with a rusty box of tricks but a state of the art pacemaker.

This is probably your only option for a conclusive end to your af which

in your case sounds quite bad and needs sorting asap. Af is

internationally recognised as a life threatning condition and should be

treated as such. Good luck. Let me know how you get on.

[Guest guest]

From what I have read here, pace makers don't control afib at all? I could be

wrong, but that's the jist I get from what I read here.. they control rate, and

can certainly control ventricular rhythm, but I thought they did nothing for

afib unless the AV node was killed...

As for ablations and long term success... I was recently quoted (don't ask for

the source.. it was third hand, but by someone who WOULD know.. I'm waiting for

it to come out in print) that the actual ablation success rate 5 years plus is

actually only about 40% to 50%... this, by the way, is about the same success

rate as seen in medication for afib. There was no further information on

whether the study group had one ablation, or more.. were they healthy, did they

have any other problems.. etc... you know.. all the things that make statistics

actually mean something....

And then there is the never ending questions of what is considered a success?

For me, a successful ablation at the lowest end of success would perhaps leave

me with periodic short lived spontaneously ending afib, and no daily meds. I

might even consider it a success if I still had to take Tikosyn (but not

coumadin) and had NO afib... . Anything above that would be gravy....

And another question in reference to the time frame of 5+ years, is how can

the ablation technique of 5 years ago compare to the ablation techniques of

today, and is the comparison of those who had the surgery in its infancy with

those having one today really accurate or fair? To me, probably not... I'd

like to see a statistic of 1 year, 3 year and 5 year for the same group, and

attempt to compare THAT with things happening today. That would give a more

accurate view of success (again.. needs to be defined to mean anything!).

I'm in line for an ablation.. I hope that it will be a cryoablation with the

study I'm in, but after event #5 this past Sunday night (in the past 4 months),

which required an ER trip and a zap, an RF ablation is looking might attractive

too....

Stef

Bill Manson bookman00@...> wrote:

I would disagree with most of this post.

A pacemaker is not the preferred first line treatment of afib. Either

medication, a MAZE procedure or ablation is generally preferred

for 'straight ahead' afib. The option of natural/lifestyle treat ment

is also available.

The characterization of ablation in the post is unduly negative. While

ablation has not been around long enough to be absolutely assured that

it is, indeed, permanent, I am unaware of any studies that show that it

loses efficay over time. I'd appreciate any citation that you might

have in this matter.

I agree that it may take more than one try to get it right. My first

ablation made me better, but it did not solve the problem altogether.

My second one, however seems to have done the trick. I'm now coming up

to my first month with absolutely no, zero, zilch fib incidents -- not

even the usual 'dust settling' that usually goes with an ablation in

the first few months.

Finally, I have serious doubts about choosing what, who and where to

have heart work done based on price. I don't think that a trip to

India would be high on my list of options, but your mileage may vary.

>

> Ref your af (Which I have at the moment). You could go for a catheter

ablation but this is often only partially successful and you sometimers

need more than one and even then it may not be a long term cure. I

would think that your best option would be to have a 2 lead pacemaker

fitted. But which country are you in? and can you afford it? If not I

suggest you consider flying to India to have a pacemaker fitted there

for a fraction of the cost of western country charges. You would not

end up with a rusty box of tricks but a state of the art pacemaker.

This is probably your only option for a conclusive end to your af which

in your case sounds quite bad and needs sorting asap. Af is

internationally recognised as a life threatning condition and should be

treated as such. Good luck. Let me know how you get on.

Web Page - http://www.afibsupport.com

List owner: AFIBsupport-owner

For help on how to use the group, including how to drive it via email,

send a blank email to AFIBsupport-help

Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

[Guest guest]

Well I can assure you that a pacemaker is often used to cure Afib. But you are

right they have to ablate the AV node and you become pacemaker dependant.I was

in hospital for six days just before xmas and doctor who discharged me said "

you cant go on like this (ive had 5 cardioversions) I am going to recommend to

the heart team that they consider you for a pacemaker.This was a very

experienced doctor. I took it with a pinch of salt as the health service in the

UK is collapsing and there is no money for a pacemaker and I am absolutely

certain as sure as night follows day that I will never get a pacemaker out our

health service. When I first went into permanent AF in the UK I was left in

that state for nearly two years without any anti coagulation. One appointment

after another was cancelled and the result was my heart weakened until I drifted

down into heart failure. Even then gaining admission to hospital in the UK was

difficult. I just refused to leave the hospital and got a cardioversion in 7

days but was left in a very weak condition. THe insurance did not pay up (the

usual in the UK) I lost my very well paid job and nobody wants to employ anyone

with a potential health problem in the uk because of employers liability. If you

are Tony Blair you get vip immediate treatment under our health service (he had

atrial flutter) while the rest of us are left to rot. My treatment or lack of it

under the NHS is much worse than the brief notes I have given above. On a plus

point you seem quite switched on and I like your heathy scepticism as to the

long term success of any intervension. Doctors still have very few real cures no

matter what they might wish us to beleive. One point of interest my local

hospital has started doing the maze proceedure (they have probably done about 4

of these) and a patient in the next bed had just had it done. He did not look

too good and I kept thinking about the doctor on this site who said " I would not

do that to a dog " If you are interested in just how bad things are for AF

patients in the UK I am prepared to give you more details.Going back to

ablations I think you are right in thinking the jury is still out as to the long

term effectiveness as you rightly point out it is a fairly new proceedure and

could lead to something worse later on. It is said that a very large proportion

of patients in the UK are in hospital due to the wrong or too much medication. I

have had to " self adjust my medication " on a number of occasions. I have just

reduced my sotalol to 80mg from 160 taking it every 6 hours which I find much

better as sotalol is a short acting drug. My hands were freezing up in the

middle of the night with a strange pins and needles sensation. I doo not need a

doctor to tell me what to do in these circumstances however I am aware of the

risks of cutting or stopping Sotalol quickly. Cheers

Re: Re: A fib for a long time

From what I have read here, pace makers don't control afib at all? I could be

wrong, but that's the jist I get from what I read here.. they control rate, and

can certainly control ventricular rhythm, but I thought they did nothing for

afib unless the AV node was killed...

As for ablations and long term success... I was recently quoted (don't ask

for the source.. it was third hand, but by someone who WOULD know.. I'm waiting

for it to come out in print) that the actual ablation success rate 5 years plus

is actually only about 40% to 50%... this, by the way, is about the same success

rate as seen in medication for afib. There was no further information on

whether the study group had one ablation, or more.. were they healthy, did they

have any other problems.. etc... you know.. all the things that make statistics

actually mean something....

And then there is the never ending questions of what is considered a

success? For me, a successful ablation at the lowest end of success would

perhaps leave me with periodic short lived spontaneously ending afib, and no

daily meds. I might even consider it a success if I still had to take Tikosyn

(but not coumadin) and had NO afib... . Anything above that would be gravy....

And another question in reference to the time frame of 5+ years, is how can

the ablation technique of 5 years ago compare to the ablation techniques of

today, and is the comparison of those who had the surgery in its infancy with

those having one today really accurate or fair? To me, probably not... I'd

like to see a statistic of 1 year, 3 year and 5 year for the same group, and

attempt to compare THAT with things happening today. That would give a more

accurate view of success (again.. needs to be defined to mean anything!).

I'm in line for an ablation.. I hope that it will be a cryoablation with the

study I'm in, but after event #5 this past Sunday night (in the past 4 months),

which required an ER trip and a zap, an RF ablation is looking might attractive

too....

Stef

Bill Manson bookman00@...> wrote:

I would disagree with most of this post.

A pacemaker is not the preferred first line treatment of afib. Either

medication, a MAZE procedure or ablation is generally preferred

for 'straight ahead' afib. The option of natural/lifestyle treat ment

is also available.

The characterization of ablation in the post is unduly negative. While

ablation has not been around long enough to be absolutely assured that

it is, indeed, permanent, I am unaware of any studies that show that it

loses efficay over time. I'd appreciate any citation that you might

have in this matter.

I agree that it may take more than one try to get it right. My first

ablation made me better, but it did not solve the problem altogether.

My second one, however seems to have done the trick. I'm now coming up

to my first month with absolutely no, zero, zilch fib incidents -- not

even the usual 'dust settling' that usually goes with an ablation in

the first few months.

Finally, I have serious doubts about choosing what, who and where to

have heart work done based on price. I don't think that a trip to

India would be high on my list of options, but your mileage may vary.

>

> Ref your af (Which I have at the moment). You could go for a catheter

ablation but this is often only partially successful and you sometimers

need more than one and even then it may not be a long term cure. I

would think that your best option would be to have a 2 lead pacemaker

fitted. But which country are you in? and can you afford it? If not I

suggest you consider flying to India to have a pacemaker fitted there

for a fraction of the cost of western country charges. You would not

end up with a rusty box of tricks but a state of the art pacemaker.

This is probably your only option for a conclusive end to your af which

in your case sounds quite bad and needs sorting asap. Af is

internationally recognised as a life threatning condition and should be

treated as such. Good luck. Let me know how you get on.

Web Page - http://www.afibsupport.com

List owner: AFIBsupport-owner

For help on how to use the group, including how to drive it via email,

send a blank email to AFIBsupport-help

Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.