RE: To Ablate or not to Ablate...

[Guest guest]

" Greg Dudgeon " <Kooshdaka@h...> wrote:

>

> Now here's my dilema. My local doc prescribed a low dose cocktail of

> Flecainide, Altace, Toprol XL and Warfarin since that last e-cardioversion

> last February. I have had no AFib symptoms since. I work regular hours, am

> in the gym almost everday day for weights and cardio and am enjoying a

> quality of life - and confidence - that I haven't experienced in years.

>

Hi Greg,

Here is my humble opinion. You have almost a full year without AFIB. That is

cause for

celebration! If your drugs are working that well, I would say stay the course

until you break

through the medication and start having episodes again. I had my first ablation

Sept 15,

2004 and it started me on a year-long period of getting worse before I got

better. Mind

you my AFIB was sending me to the ER twice a month because I simply did not

self-convert

anymore and I'd tried atenolol, sotolol, rhythmol with varying degrees of

success. My

ablation solved the afib problem, but gave me flutter, a new wrinkle which took

two more

ablations to finally get rid of, with many months of constant flutter at 100bpm

(150 bpm

at it's worst) despite heavy medication. I considered myself an invalid.

Fortunately I healed

up from the last ablation and went into sinus this past August, where I've been

ever since

except for a few short episodes from which I self-converted and attributed to

continuing

to heal. I don't know how long the waiting list at Cleveland is. The ablation

will always be

there as an option. Techniques will only get better the longer you can put it

off. I just think

you've had such a long run without afib, why put yourself through a procedure

that for a

lot of people is not as easy to recover from as some cardios would have you

believe, and

which could give you flutter as a complication? I would wait until your afib

returned and go

from there. I had twenty cardio-versions before I agreed to an ablation...you

have a ways

to go! Also, if you are in sinus, you may not need to be on warfarin. As long as

you get

treatment for any afib within 48 hours it is my understanding that you don't

need to be

anti-coagulated. Of course if you are planning an ablation you have to be on

warfarin for a

certain number of months before the procedure.

Anyway, all of this is just my opinion based on my own experiences of 2005. I

wouldn't

have an ablation until afib makes your life unbearable. Every situation is

different.

Best wishes to you whatever you decide.

Helena

43, afib also started at age 39

[Guest guest]

>

> After breaking through the highest doseage of Sotolol my doc would

prescribe I

> got serious and called the Cleveland Clinic. Long story short I

was seen by

> Dr. Natale and am now scheduled for an ablation by him on May 1.

>

> Now here's my dilema. My local doc prescribed a low dose cocktail

of

> Flecainide, Altace, Toprol XL and Warfarin since that last e-

cardioversion

> last February. I have had no AFib symptoms since.

Am I daft for thinking I should postpone the

> procedure which two EPs have told me is inevitable, or should I

charge on

> and have this done in spring by one of the best in the Afib-remedy

business?

>

Your situation sounds similar to mine is some respects. I started

getting afib again after 4 years without while on Amiodarone. When

the Amiodarone pooped out I was started on Flecainide, Atenolol and

Warfarin. I had no afib at all during the 5 months after I started

them and before my ablation by Dr. Natale.

My conclusion was that I didn't like the side effects of those meds

and probably sooner or later they would poop out like the Amiodarone

did, so I decided to go ahead with the ablation last November. I've

since tapered off the Flecainide and will start tapering off the

Atenolol if I continue without symptoms for a few more weeks; then

off the Warfarin a month after that if still no symptoms. I can't

wait.

The only upside I could see in waiting while making my own decision

was that there might be some breakthrough in treating the afib

either surgically or with new drugs. Both Dr. Natale and my own

cardiologists said they didn't see any breakthroughs coming and Dr.

Natale is on the forefront of surgical technologies.

Would I do the same thing today if I had it all to do over again?

Most certainly, yes.

Gordon

[Guest guest]

Hi, Greg.

I would wait a while, maybe until April, and then cancel. Why fix what isn't

broken?

And, congratulations on your NSR!

To Ablate or not to Ablate...

Folks: For those of you who have had an ablation, I would really appreciate

hearing from you. I am a 46 year old male, married and father of three. I

was initially diagnosed with AFib at age 39. Like many of our AFib

colleagues, I've had mixed results and diminishing returns with different

meds. Over the years I've blown through increasing levels of atenolol, then

sotolol. (I've had eight electocardioversions and have self converted a few

times since 2000.)

After breaking through the highest doseage of Sotolol my doc would prescribe

(this on my eldest daughter's birthday - for the second year in a row), I

got serious and called the Cleveland Clinic. Long story short I was seen by

Dr. Natale and am now scheduled for an ablation by him on May 1.

Now here's my dilema. My local doc prescribed a low dose cocktail of

Flecainide, Altace, Toprol XL and Warfarin since that last e-cardioversion

last February. I have had no AFib symptoms since. I work regular hours, am

in the gym almost everday day for weights and cardio and am enjoying a

quality of life - and confidence - that I haven't experienced in years.

I am struggling with the thought of the procedure now. It's not the ablation

in and of itself, but the unknown since things are working so well now with

the meds. I have a growing active family, a challenging job that I love, 30

employees who count on me and the pressing concerns and responsibilities of

middle age multi-taskers. Am I daft for thinking I should postpone the

procedure which two EPs have told me is inevitable, or should I charge on

and have this done in spring by one of the best in the Afib-remedy business?

Thank you in advance for sharing your wisdom. -- Greg

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