Ablation?

Hello everybody,  I'm a 31 year old male,  in the gym 4 days a week(bodybuilding) and i am having PAC's and afib episodes.   First one was 1 yr ago and I have had 7 afibs since.  My concern is should I have ablation done?  I've read go and bad stories.  I take no medication and do not want to take any,  I'm just too young to take meds.  If anyone has had this procedure please give me input.  The dr doing surgey is highly ranked in nation(Kirkland clinic)  Im just worried how it ablation will affect me 20 years down the road.  Is there any long term side effects.  My wife is all for it but I just can't decide.  Any input will be helpful.  Thanks

[Jerry_NJ]

Your doctor, who you characterize as an expert, is the best source of information.  You may want to do some searches on "long term affect of ablation" may be also for "..of ablation for atrial fibrillation".

At your young age a cure is far better than taking symptom only medications.  I think that is what medication basically are, in the case of heart rhythm problems medication reduce affects, they do not cure/fix the problem.

I think you should be on some anti-clot practice, maybe a simple as a low-dose aspirin a day.  Talk with your doctor about that as, in general, we are told not to take aspirin more than some very limited number of days.  I take a low dose every morning with breakfast, the food helps the stomach deal with the bad side effects that aspirin can produce.

[RVVq]

In my opinion it is better to have an ablation for a-fib early rather than late. Afib is a progressive disease, and every time your heart fibrillates for a prolonged period of time, it causes damage to your atria, making them more prone to fibrillate again (AF begets AF). However, you should first of all rule out potential AF causes, such as thyroid diseases, hypertension, electrolyte imbalances. After these causes have been ruled out, a diagnosis of lone A-fib can be made. This means that A-fib, more likely than not, was caused by a primarily dysfunction of the autonomic nervous system, or more specifically its cardiac branch. This means that your heart is technically structurally normal, however its innervation is abnormal. For example, an overgrowth or heterogeneity of nervous fibers in your pulmonary veins can cause points of focal irritation that initiate and sustain your AF. Ablation can do the trick in many people, as it not only destroys heart tissue but also damages the ANS ganglionated plexi.

There's no way to know what's going to happen to you 20 years down the road. Afib ablation was developed less than 20 years ago, and I think the longest longitudinal study done on Afib ablations followed patients for 5 years. The recurrence rate for Afib after ablation is high (I think it is around 7% per year, cumulative) . Many people (if not most) need more than 1 ablation.

Good luck and good health!

[PapaOwl]

From what I read athletes can sometimes be prone to a-fib. One of my favorite blogs for information on a-fib is  http://atrialfibrillationblog.com/ and sites is http://www.stopafib.org/what.cfm

I have been battling a-fib for just short of three years and unfortunately do not convert back to normal sinus rhythm without a cardioversion.  I have tried 4 medications, had ten electrocardioversions and two ablations, second which also failed and the only thing currently keeping me in NSR is sotalol and whenever I wean off it to see if the ablations worked I go back into a-fib.  I too did not want to be on medications the rest of my life but for now will stay on sotalol until it fails. At that point I will need to decide if another ablation is in order.  Good luck ato you. Steve

[RVVq]

The reason why current a-fib ablations (PVI) have low success rates is because pulmonary veins are not responsible for initiation and maintenance of all cases of lone - Afib. There's so great work done by Dr. Narayan is San Diego, which proves that atrial rotors play a key role in sustaining this arrhythmia. His team was able to achieve a remarkably high success rate of 84%, using a combined technique of PVI and rotor ablation, in a group of patients in whom 80% had persistent and 20 percent had paroxysmal forms of Afib. Hopefully this method will be replicated in larger clinical trials, and within the next 2-7 years become the mainstream practice, resulting in a higher success rates.

You can read more about Dr. Narayan's research here:

http://www.stopafib.org/newsitem.cfm/NEWSID/379/atrial-fibrillation-focal-rotor-catheter-ablations/Dr-Sanjiv-Narayan-video

[Kgs123]

Thanks everyone for the info!!  It's been very helpful.