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Heart Disease (Expert Forum)
Focal Point Ablation - Now or later?
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Focal Point Ablation - Now or later?
by Kymom, Oct 03, 2002 12:00AM
My 16 yr old son was diag.with LAF about a 1 1/2 year ago. He has been treated with meds during this time. He started on Norpace and now on Sotalol. They are thinking of Flecinide as the next med. He hasn't had any side effects other than being tired. In the past year, he has had 5 episodes. The first few converted on his own within 24 hours and the last few he was cardioverted.
I have read alot about Focal Point Ablation and our docs explained the procedure to me as well. They have given us the choice which way to procede. Meds or Ablation? For the most part, I like everything I have read about this procedure. It's encouraging that this can be cured. With all the good that I have read, I also see that these procedures are being improved every day, which makes me wonder how much more improved this thing can be in a years time. I also know that long term effects aren't known yet and that's quite concerning to me because we are dealing with a 16 year old and not a 60 year old.
My thoughts are to buy time with meds as long as he responds well and with little side effects while this procedure is being refined. Things I have read makes me believe that all the EP's are not in agreement in the best way to do this procedure, that's why there seems to be a few different variations. It also seems that the docs who are doing this, say go for it and the one's who are not, are more cautious. Correct thinking?
Given the info that I have given you and my thoughts, what are your thoughts on doing this procedure on a 16 yr old? Is there validation in waiting for improvement?
I have read alot about Focal Point Ablation and our docs explained the procedure to me as well. They have given us the choice which way to procede. Meds or Ablation? For the most part, I like everything I have read about this procedure. It's encouraging that this can be cured. With all the good that I have read, I also see that these procedures are being improved every day, which makes me wonder how much more improved this thing can be in a years time. I also know that long term effects aren't known yet and that's quite concerning to me because we are dealing with a 16 year old and not a 60 year old.
My thoughts are to buy time with meds as long as he responds well and with little side effects while this procedure is being refined. Things I have read makes me believe that all the EP's are not in agreement in the best way to do this procedure, that's why there seems to be a few different variations. It also seems that the docs who are doing this, say go for it and the one's who are not, are more cautious. Correct thinking?
Given the info that I have given you and my thoughts, what are your thoughts on doing this procedure on a 16 yr old? Is there validation in waiting for improvement?
Doctor's Answer
by CCF-M.D.-RCJ, Oct 03, 2002 12:00AM
Kymom,
Sorry to hear of your ordeal. Whenever I offer a treatment to a patient, I ask myself what it is that I hope to accomplish, alleviate, or relieve. Then, I weigh the risk of the therapy with the potential benefit from the treatment.
If your son indeed has lone afib -- afib in the setting of a normal heart -- then his long term prognosis is quite good and probably equivalent to someone without afib, especially given his young age. It is therefore very unlikely that any therapy will help him avoid mortality or morbidity from the afib. He will potentially benefit from any therapy only by the reduced incidence of going into afib and the inconvenience of requiring urgent cardioversion
You correctly and importantly point out that the long term results of afib ablation are not known. There is a definite, non-trivial incidence of complications, including stroke and pulmonary vein stenosis, that are not benign. We have a saying in medicine: "If you go to a barber, eventually you'll get a haircut". The point is that doctors who do procedures are often the ones who recommend them. You have to take these recommendations with a grain of salt.
I would recommend that you seek a second (or third or fourth) opinion from a reputable adult cardiologist at a major medical center before proceeding with anything.
Hope that helps.
Sorry to hear of your ordeal. Whenever I offer a treatment to a patient, I ask myself what it is that I hope to accomplish, alleviate, or relieve. Then, I weigh the risk of the therapy with the potential benefit from the treatment.
If your son indeed has lone afib -- afib in the setting of a normal heart -- then his long term prognosis is quite good and probably equivalent to someone without afib, especially given his young age. It is therefore very unlikely that any therapy will help him avoid mortality or morbidity from the afib. He will potentially benefit from any therapy only by the reduced incidence of going into afib and the inconvenience of requiring urgent cardioversion
You correctly and importantly point out that the long term results of afib ablation are not known. There is a definite, non-trivial incidence of complications, including stroke and pulmonary vein stenosis, that are not benign. We have a saying in medicine: "If you go to a barber, eventually you'll get a haircut". The point is that doctors who do procedures are often the ones who recommend them. You have to take these recommendations with a grain of salt.
I would recommend that you seek a second (or third or fourth) opinion from a reputable adult cardiologist at a major medical center before proceeding with anything.
Hope that helps.
