Heart Rhythm Community
Ablation or Cardioversion/Drugs first
About This Community:

This patient support community is for discussions relating to heart rhythm issues, arrhythmia, irregular heartbeat, implanted defibrillators, pacemakers, and tachycardia.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

Ablation or Cardioversion/Drugs first

The initial cardiologist suggested trying cardioversion before trying ablation to cure my artrial fibrilation. The surgeon seemed to think that with a 5 1/4 cm chamber that cardioversion woudln't work and my heart would just flip back into fibrilation. My question is - Is there any reason to NOT try the cardioversion and/or drugs first?  
Related Discussions
Avatar_m_tn
How long have you been in fib?  Is your atrial diameter that size due to hypertrophy from a long history of heart problems or is it just naturally large (mine is 5.7 with NO appreciable hypertrophy)?  Cardioversion COULD help.  Then again it might not.  It has the advantage of not being invasive.  I don't know about other folks but the only real negative to cardioversion (i.e. they stick two large electrodes to your chest and back and electrocute you) for me was the nice first degree burns I got from the combination of the current and the adhesive.  Yup a nice big burn on both my chest and back about 4" square.  

If cardioversion doesn't do the trick and you REALLY want to try to get out of fib, then the next step is ablation.  Unfortunately ablation is not so useful for atrial arrhythmias as it is for ventricular problems.  The odds on ablation are like this.  Initially it is about 3 to 2 in favor of ablation solving the problem.  If a single ablation doesn't fix your problem then the odds on a 2nd ablation working are dead even - a toss-up.  With an atrial diameter above 4 cm the odds in favor of fixing the problem start dropping. At an atrial diameter above 5cm the odds are significantly against ablation actually curing the A-Fib.  After that there is NO way to get out of fib unless your heart spontaneously decides to get its act together on its own.  The only way to get a regular VENTRICULAR rhythm at that point would be to ablate the AV node and pace your heart.  It works - just ask me and others here.

How irregular is your over-all rhythm?  Mine was all over the map from 30-odd to over 140 bpm.  It was described to me as irregularly irregular.  It changed from moment to moment with no discernable pattern.  Digitek and diltiazem kinda sorta kept me below 100 most of the time - kinda sorta.  

Whatever you do do not just blindly accept the word of any surgeon.  Cutters are great people but they believe in the supreme effecacy of "cryo-ferric" (cold steel) therapy.  I once had a cutter tell me that even when he didn't know exactly what was wrong the patients usually got better.  BRRRRR!  

How old are you?  What other symptoms are you having?  How much is being in fib throwing you off your game?  If the meds are keeping things more-or-less regular then you have to decide whether you want to proceed.  For me it was a no-brainer.  I was half alive.  I had to do something or crawl into a hole somewhere.  Ultimately it is your heart, your body and thus your decision and yours to live with the consequences of the decision.  

I am glad I had the AV node ablation and a pacemaker implanted.  I do not - I say again DO NOT - like being dependent on a machine to function.  But it beats the way I was living (if you couldreally call it living) before.  I'm ready to get on with my life.

Good luck.  Keep us posted.  If you want to talk privately, send me a private message.

Regards,
Bionic Bill
Blank
Post a Comment
To
Top Arrhythmias Answerers
612551_tn?1247839157
Blank
Jerry_NJ
NJ
1423357_tn?1373023915
Blank
tom_h
Central, MA
1807132_tn?1318747197
Blank
michellepetkus
Chicago, IL
1124887_tn?1313758491
Blank
is_something_wrong
Oslo, Norway
86819_tn?1378951092
Blank
Bromley
257552_tn?1404606154
Blank
Artaud
Pittsburgh, PA
MedHelp Health Answers
Recent Activity
Avatar_f_tn
Blank
kimLaura added the Heart Rhythm Tracker
9 hrs ago
Avatar_f_tn
Blank
mandy876 commented on my friends
Jul 21
Avatar_f_tn
Blank
vp_555 joined this community
Welcome them!
Jul 20
Heart Rhythm Community Resources
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank
Top Arrhythmias Answerers
612551_tn?1247839157
Blank
Jerry_NJ
NJ
1423357_tn?1373023915
Blank
tom_h
Central, MA
1807132_tn?1318747197
Blank
michellepetkus
Chicago, IL
1124887_tn?1313758491
Blank
is_something_wrong
Oslo, Norway
86819_tn?1378951092
Blank
Bromley
257552_tn?1404606154
Blank
Artaud
Pittsburgh, PA