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Ablation or Tikosyn?
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Ablation or Tikosyn?

I'm 50, and have had atrial fib for 9 years.  I've tried several meds, but to be honest all of them left me feeling fatigued.  Heart rate was also very low when on meds, about 42 - 48 bpm resting and down to 28 - 30 at low point during sleep.  Anyway, I went to my Cardiologist who said I was a good candidate for ablation.  After meeting with another doc, and asking some very good questions, I thought, I decided to go in the hospital for three days and get on Tikosyn, and put off ablation until a later date.  The thing is, after reading all the info related to Tikosyn, ablation sounds like a pretty good alternative.  While my episodes are annoying, they do not significantly interfere with my daily life, but if I am to have the ablation procedure, I don't want to wait too long until the success rate is lower because of a more advanced state of AF.  I guess I'm looking for any advice I can get either way.  My wife, understandably, is every bit as worried about the procedure as I am.  I'm currently scheduled for the Tikosyn procedure on November 22 and whichever procedure I decide to have, I'll be having it at Baptist Heart in Little Rock, AR.  Thanks in advance for all the comments and advice.
Tags: Tikosyn, Ablation, atrial fib, Baptist Heart, Little Rock AR
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25 Comments Post a Comment
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Avatar_n_tn
What is Tikoysn?  thanks!
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Avatar_n_tn
From what the Dr tells me it's an anti-arrhythmic med.
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Avatar_n_tn
anti-arrhythmic drugs are BADDDDD! I just read an artice that they cause irreversable damge and are toxic and should be avoided at all cost!!!! ablation is the way to go if thats what its come to!
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Avatar_f_tn
I have VTach and have been on Amiodarone twice now since April 07.  This anti-arrhythmic drug is very very good at treating what I have, but long term there are many problems.  I just had a ablation on Monday so I can go off of the drug.  My cardiologist says I am too young (I'm 51) to be on the meds long-term and I agree.  She found three areas that she ablated, but we will have to wait until the Amio is out my system to see if there are any more.

The most important thing is to trust your cardiologist.  And I understand that Atrial ablations are pretty successful - more than for VT's.

I'm also wondering about your heartrate - that seems awfully low.  I have an ICD and am paced at 80.

Hope this helps.

Angel
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Avatar_n_tn
I had afib for 6 years.  Failed three meds because they didn't keep me in rythmn.  Tikosyn didn't work.  Had an ablation 4 years ago.  It worked.  Procedure is very low risk done under good hands.  Go to a very good center.  As to whether an ablation will work depends upon the source of the AFIB.  But I wish I would have demanded it right of way.  I wasted a great deal of time, money, and frustration on meds.

Check with your insurance.  My ablation cost 55,000.  I had it at Mayo.  Very thorough, but very spendy.  Thankfully I only had to pay 3500!

Brother recently had ablation for flutter.  Took three tries, but it worked.
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Avatar_n_tn
how did the Ticosyn work out?
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Avatar_m_tn
I just had my ablation for a-fib on Monday 8-17-2009, and after the ablation the doctor put me on Tykosin. I was in a-fib a day after the procedure, and had one more instance of a-fib after I got home, haven't had any more a-fib since. He told me that he was putting me on the Tykosin to keep my heart in rhythm while my heart healed. Don't know how long I will be on Tykosin but pretty sure it's not a permanent thing. If you have any questions about my ablation experience please feel free to ask, I will answer the best that I can.
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Avatar_n_tn
My father had ablation first, but  aryth. againso now is in hospital to get onto Tykosyn.  The ablation did not work very well for him the first time, but I don't understand why they can't just keep doing ablations.  What does your doctor say about Tykosynvs. ablation?
Thanks.
J
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Avatar_n_tn
one more question---what is so bad about aryth. drugs?

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966351_tn?1282075514
I suppose it depends on the anti-arrhythmic medication.  Some used are beta blockers, as I understand it.  (I was on Sotalol, which I was told is a beta blocker, and it actually increased my AF episodes in severity and frequency! I was on bisoprolol as well, and fared no better.)

I had been on amiodarone -- short term -- 3-1/2 yrs ago, while awaiting an aortic valve replacement, and it worked well; I had no AF episodes after "loading up" for a few weeks.  But AF continued after the valve was replaced (docs said the AF was not connected to the aortic stenosis, and that has proven to be true),

AF had not been very frequent after the valve surgery, until this past May (2009).  It suddenly, literally overnight, started occurring every few days (sometimes lasting for days!), and would often leave me exhausted from the severity, as well as the anxiety, fear, etc.  (Yes, I am on warfarin, and have been for years.)  No meds have worked, even the re-usage of Amiodarone this past autumn -- only used for 2 months, when I went back to the US for Thanksgiving; I had hoped it would keep me AF-free, but it did not.

Bottom line is:
Amiodarone, which often works to stop AF (did for me a few yrs ago, doesn't now) is toxic.  It can hurt/damage the kidneys, liver, and/or lungs -- did I leave any of the affected organs out in my list here?
Long term usage apparently damages some or all of these organs, which is why it is not recommended (prescribed) for long-term use.  Even at my age -- just turned 58 in December -- I am too "young" to be on it. A moot point in my case, as it no longer does the job.

I am now looking at ablation -- well, "looking" is not the right word. I am on the waiting list now and should be scheduled soon.  In truth, I am scared of ablation, which may sound odd as I went through open-heart surgery, and ablation is not nearly as intrusive, let alone recuperation time-intensive... so I understand

I cannot imagine the healing/pain/recuperation period being equal, let alone worse, than the valve replacement. (God willing, as some might say,)  And if the post-operative pain could be controlled, so can the post-ablation, no?

Anyone been through both (yet)?  

Thoughts, anyone?

With Hopes for Health, Peace, and Happiness -- for All of Us!
Debb, now living in the UK
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966351_tn?1282075514
By the way -- I have heard of some folks having a 2nd ablation. Never heard of a 3rd, as I recall, but no idea if that is an option in some cases.

According to statistics I have read, the first ablation has about an 80% effective rarte; the 2nd one jumps up to 95% or so.  I imagine it depends if the exactly correct spots were located and "hit" the first time around.

Perhaps it, once again, boils down to the hospital and doctor where the ablation(s) is/are performed.  Are the doctors experienced, how many of these do they a year, is it a common procedure at the hospital, one the doctor does frequently, etc?

Has you dad asked these questions of the doctor(s) there?

Again, wishing you (and everyone) all the best,
Debb
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612551_tn?1247839157
I have read on the community board of many people who have had as many as 3, maybe more ablations.  I'm not recalling for what condition, some surely were for problems other than AFib.  I do understand the probability of success improves - suppose that is because there are fewer "sites" suspect, or in need of ablation... just a guess.

I'd say try to find a doctor that does several a week, not several a year.  When I had heart surgery I looked for a surgeon who does them every day.  I had valve surgery and the subject surgeon also does bypass, a bit more than 50% of the cases.  But he is was in surgery several days each week, and did at least a couple (don't remember the exact statistics) of "valve jobs" a week.  I'm also try to find a doctor who is under 60 but still has years of experience.

Wishing all the best for the new year,
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966351_tn?1282075514
I agree, Jerry -- a VERY experienced doc is the way to go. And I agree with the experienced but still under 60 concept as well.  Not sure why I feel that way, as I am no spring chicken myself.  :)

A big AF website, based in London, recommends finding a specialist (for ablation) where the hospital does at least 300 ablations a year, and a doctor that does at least 150 or more per year.  Fortunately, the electrocardiologist I am seeing is one of 3 on that specialist team (2 of whom attend each procedure), and they perform over 300 a year at that hospital.  God willing, I am in good hands.  (My valve replacement surgeon specialises also... 80% of his work is valves,)

I am curious, regarding ablations -- have many people had 2 or more?  I have not often heard of anyone having so many, to be honest.  But several I know personally have had great success first try, not necessitating additional procedures.

And Once again, Happy New Year to All!
Debb
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Avatar_m_tn
I was on amiodorone for 5 years and started turning purple. Had to get off it and have had 2 ablations since. 1 april 2009 and the second Oct. 2009. Recovery from the ablations was very simple, in fact I walked out of the hospital on the second day. Since then I had 4 cardioversions and am holding my own the last 2 weeks. That was my 20th cardioversion, and the person in the room beside me had his 4th ablation and 40th cardioversion. I understand there is a new form of amiodirone out there that does not turn you purple. does amyone know about this new drug???
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Avatar_f_tn
My husband needs a defibulator. Anyone out there that has one?
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Avatar_m_tn
In Feb. of '09 I was diagnosed with AF.  My Dr. said AF is more common in people with mitral valve problems like mine.  My regurgitiation at that time was not to the point for repair or replacement.  I was put on warfarin which did not make me a happy camper.  In March, I went to Emory University to have a TEE to check my valve.  It had deteriorated to the point that surgery was called for.  In the meantime, I was still in persistent AF.

During surgery, it was discovered that my valve was beyond repair and it was replaced with a pig valve.  While the surgeon was in there, he repaired a hole that never closed after birth, removed an apendage that serves no purpose (it is where blood pools and forms clots) and did a Maze proceedure to eliminate my AF. By the way, they did not saw my sternum open, but went in between two ribs above my right nipple.

I was in sinus rhythm for only a day or two.  In January of '10, my cardiologist did an electrocardioversion.  It lasted for one day.  He then put me on Soltolol for about 6 weeks and tried another ECV.  This time I was in SR for 2 days.  He took me off of Soltolot and put me on Flecanaide (spelling?) and did another ECV after 2 weeks.  This time I lasted in SR for 1 week.  

He consulted with one of the electrophysiologists at Emory and they decided to give Tikosyn a try.  When I awoke in the hospital on the 2nd day of a 4 day stay, a nurse said that I had been in SR since 3AM.  

After going home, I would go into AF  about once every 10-18 days for about 18 hours.  It would then go back to SR.   Then I would last about 6 weeks and only go out of rhythm for about 4-6 hours.   Now, I have been in SR for at least 4 months.  I can't believe how much better I feel.  My Dr. said the heart likes to beat in rhythm and the longer it stays that way, the more likely it is to stay.  I am now 63 and feel better than I did when I was 50.  I guess I'm one of the lucky ones where Tikosyn works!
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Avatar_m_tn
I have been on Tikosyn since December. No side effects. NSR excepting when I tempt aFib by either consuming trigger foods like caffeine, MSG, salt OR when I let my magnesium or potassium drop.  I try to keep my potassium level in the 4.7 - 4.9 range using low sodium V8 or Mott's Garden Cocktail (loaded with the stuff) and sprinkling Potasssium into my food (1tspn=1gram).  Thus far, asides from a few gentle reminders of who is in charge I have been in NSR.  I am not a candidate for ablation as my left atrium is 60mm. and they want to see it under 50mm. hopefully.  And the plan is to remain in NSR and see if it will shrink.  Fingers crossed.  If your kidneys are healthy I would consider TIKOSYN.  If you have a very high level of confidence in your electrophysiologist and you are a PRIME candidate for ablation, however, I would not waste time.
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Avatar_m_tn
I had a heart ablation because I would have episodes where my heart rate would jump to 238 bpm. I had it done in 2005, and have had no complications. I was in and out the same day, about 5 hours. Here's the thing though, there are three different places where the extra electrical pathway can be, and accordingly, how well the procedure will hold. Fortunately for me, I had the easiest one to get to, and am doing great. This first happened in 1992, I was 24, so I opted to take Atenolol, instead of the Surgery. I got used to the meds, and finally had the surgery. I would recommend just doing the surgery and get it over with. No pain or other complications in recovery. It's great !!
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Avatar_m_tn
I've had AF for more than 10 years. I tried many mediactions but none of them worked very well. Tikosyn is the best among all. My AF was intermittend. 5 days SR - 5 days AF. I've had ablation on Sep 6th 2012 worked very well. AF free since. After the ablation My Dr. discontinued Tikosyn but then I was back to AF 5days/5days SR/AF. Placed back on Tikosyn 500mg twice a day again and didn't have an AF episode since. Every once in a while It tries to come back to no avail.
I'll be glad to help if you have any questions.    
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Avatar_m_tn
I'm a 38 yr old male with no previous health problems.  Afib started about 3 months ago.  Both Flecanide and Rythmol worked briefly but then afib returned.  I had one episode of 300 bpm during exercise.  After that episode the doctor became much more agressive in treatment.  Doctor will start me on Tikosyn next week with hospital stay.  We will see how it works.  Ablation would be the next option.  I'm conflicted because I don't want to take the meds for the rest of my life but I'm also concerned about someone intentionally burning a scar on the inside of my heart.

I'm interested to hear about the experiences of others'.
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Avatar_m_tn
I'm 60, had my second ablation 2 years ago and it progressively lost its effectiveness over the past 6 months or so.  Episodes of a-fib and a-flutter occur only with strenuous exercise of the stop-and-go nature, i.e basketball versus jogging a steady pace for 3 or 4 miles.  Anyone have symptoms caused like this and what did you do?
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Avatar_m_tn
I'm 60, had my second ablation 2 years ago and it progressively lost its effectiveness over the past 6 months or so.  Episodes of a-fib and a-flutter occur only with strenuous exercise of the stop-and-go nature, i.e basketball versus jogging a steady pace for 3 or 4 miles.  Anyone have symptoms caused like this and what did you do?
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Avatar_m_tn
I am a 59 year old female.  I've had 4 ablations, the first in Sept., 2011 for a-fib, and 3 of which were in a 2 month span - Jan, 2013 and Feb., 2013.  My last ablation was done at Loyola in Chicago.  That doctor took care of my atrial flutter.  But I still have an a-fib that seems to be hard to obliterate.  My doctor told me this week that I have 2 options left for me as doing even 10 ablations probably wouldn't take care of it permanently.  It's either Tikosyn or a pacemaker.  I know I won't do well on the Tikosyn as I have uncontrolled asthma, and it will kick me into a bad asthma attack as I had while trying Flecainide.  At this point I am so ready to have a pacemaker.  My life with a-fib is miserable.  I cannot exert myself, exercise, clean, etc,.  I have tried all the usual meds, gone through the ablations, and now have been told by a doctor who does ablations every day, that even he probably won't be able to fix this type of a-fib brought by exertion.  I am constantly working during the episodes to bring my heartbeat down to normal and that's no way to live.  I don't even dare go out and do anything anymore and mostly stay home, as it's embarrassing to constantly bear down to bring the heart rate back down in front of people.  I just want my life back.  And then there's my husband who also had a-fib for 10 years.  He had 1 ablation and hasn't had an episode since.  I guess it depends on where the problem is .  Good luck to you.  You'll have to decide which course of action is best for you, or whether you want to just try to liver with it.  I just can't handle it anymore.  I want to enjoy life with my 11 grandkids.
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Avatar_m_tn
Exactly my symptoms. Stop and go exercise, especially if I had some alcohol the day prior...how is it going now?
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Avatar_f_tn
Hi.  I am a 46 year old woman who has suffered from Atrial flutter for going on 8 months.  I had open heart surgery in my 20s for a missing atrial wall.  I have had 3 episodes this year.  The first An EP came in and did an ablation.  No meds.  I was out of the hospital within a couple of days.  Probably would have been sooner but they were worried about how long I'd been in flutter.  The second time was approximately 1 month later and I was clocked at over 300 with my flutter.  Same EP did the ablation but could see 3 other flutters he was unable to "catch" to ablate... so i went on Sotalol AF.  Felt horrible.  Low pulse rate.. Low blood pressure.  3 months later I could feel.it coming on after stress and was hospitalized a 3rd time.   No ablation this time.  The EP explained with so much scar tissue already present it didn't make any sense.  He suggested a pacemaker and Tikosyn.  I was surprised he jumped to implanting a pacemaker so quickly but he is aggressive and seems extremely well educated alrhough, very , very young.  His older associate has told me of a friend that has had 6 ablations.  I think an ablation is a low to no risk viable option for some people.  You would be foolish not to try something as simple and non invasive.  In my opinion only.  
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