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Too Late for Ablation?
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Too Late for Ablation?

My husband has been in permanent A Fib for almost two years now and is on Warfarin treatment. He is more or less asymptomatic in that he can carry on as usual.   I have just developed this condition which is paroxysmal for me. It makes me feel faint and cold.  I have learned that we do have some willing specialists who perform ablations in our area and would be prepared to discuss this with me when all tests are complete.  Naturally my husband is asking why he was never offered this procedure but he was not in this country at the onset.  Would it be worth asking about this for him (he hates the Warfarin program, as do I) or has his condition been there for too long permanently, or maybe his age (76).  Just wondering.....
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Hi JoKelly!
Catheter ablation in permanent AFib dose not yeild good results, probably 20%.  But catheter ablation for your paroxysmal AFib will yeild better results.  There are lots of people here that have had good outcomes with catheter ablation.  But may still need meds.  Your husbands best success would be surgical ablation. There is a afibbers forum on yahoo that is helpful in learning about others experience with surgical ablation.  I know that Pete0629 recently had one done in Sept.  He posts here on MedHelp.  Other helpful research sites are stopafib.com and www.ohioafib.com. These were helpful to me anyway.  
Are you still here in the states???  Have you or your husband had an EP study??
Keep researching options - there are plenty out there - even for permanent Afibbers.
Bona Fortunum!
Angel
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I am just tossing into the mix here JoKelly for another opinion...i am unsure of where the stats are at 20% but that is not correct i believe...that may be an issue w patients w. underlying issues beside the permanent a fib however according to International cardiology and surgery for researchers and health professionals they state that 76% is an average for pts. in permanent a fib.........journal of medicine in Sweden rates the success rate at 73%.....United States Library of Medicine rates it at 75%......the list goes on and on and on JoKelly...i would do my homework and research totally on this one...my main concern that has not been discussed here is that your husband is at an advanced age and a surgical ablation could definately cause adverse effects to his health.....as Angel said Pete0629 had posted on the surgical ablation and he is a month out and his recovery has been very tought and he is a much younger man and i would take your husbands age into consideration.  A surgical ablation is completely different that a catheter ablation...it is much more invasive...the recovery time is longer and tougher.....when Angel says that the two sites were helpful to her bear in mind she has never had an ablation or gone thru one...i have.....to say that your husbands best success would be surgical is amazing to me w/out her knowing your husbands complete medical history and i think could be dangerous.....just do your homework JoKelly and heed the advise of the doctor that you know and trust....and i agree warfarin is a tough pill so swallow excuse the pun.......and no there is no time line for ablations especially catheter ablations since they are non invasive....trust your doc JoKelly......if you don't get a second opinion from one in your area....
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Sorry i wanted to say that the success rates of catheter ablation success rates are those numbers i posted to you in the above post......not surgical.....
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Personally, I think 76% success rate stinks!  Esp for paroxysmal afib.  But permanent afib is a different ball of wax. But I have higher and more optimistic expectations - that's the mother and athlete in me. 76 years old is NOT "advanced age".... I have relatives, friends and fellow triathletes that would not appreciate that statement.  True everyone has a subjective medical history - but all our concerns are valid and all opinions are of interest. That's why we all post here.
A randomized clinical trial presented at national conference in May called the "CABANA" trial (US) compared medication vs cath ablation as first line therapy with success rates BELOW 40% on paroxysmal and persistant afib (NOT permanent). Ranomized clinical studies in medical publications are the best indicators of success held as Gold Standards.  But what's most important when reading clinical studies is to understand How they are measureing success! and what are the limitations of the study.  Infact - a lot of studies can bend results to meet their intended expectations.  TRUE - I do not have afib myself (that I know of atleast) - but I do have relatives and friends who suffer(ed) everyday with it. We help eachother. It seems to me that Afib treatment has come a long way - but still has a long way to go.  I hope others respond to your post JoKelly - because this site has been VERY helpful to many people.  I pray you get the answers you are looking for. Best of luck on your journey!
Cheers
Angel
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As said, medical history and treatment is very personal.  Your best advice is to discuss probabilities of successful AFib treatments with a board certified medical specialist before you reach any conclusions - you may benefit from a second medical opinion as well.  

All you get on this community is personal experience, not medical advice.  While I try to share my personal experience I also "chip in" from what I have reading and learned from friends, neighbors, and family when I see a post that is going without responses.  I always couch my replies with a full disclosure as to personal experience or as I understand something for others.  All information here should be taken as such and is of the greatest value when it is from someone who can directly relate to your question and concern through personal experience, not through something they saw or heard or read.

As for AFib, I have considerable experience, and in fact have direct experience in the pre-ablation group.  My permanent AFib is mostly asymptomatic but I do have to take medications to lower my HR and to protect against clot formation.  I handle these medications reasonably well, only minor side effects and monthly blood tests.  My advice from both my Cardiologist and the consulting EP was not to go for an ablation, seems much as is the case for your husband.  As for internal surgery, I've already gone through that, I had an open heart surgical mini-maze procedure done while I was undergoing mitral valve repair about 3 years ago.  It did not stop my AFib, but the valve repair is holding up well.

As for recommendations for specific doctors I'd suggest that is useful only if the recommendation comes from someone you know, it is not a function of the Heart Rhythm Community.  An exception in my mind would be a recommendation to consult with a recognized organization such as the Cleveland Clinic.  Even there, I'd think it better to steer away from more detailed contact advice.   Medical doctors at the Cleveland Clinic have supported on-line chats with members of this and other MedHelp Communities, so those doctors are already known to the community.  

I hope you find information on this Community helpful, and that you are able to make use of it to better understand and interact with your personal medical doctors, doctors who have all your test results and have personally examined you.

Jerry
Co-Leader Heart Rhythm Community.
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Well said Jerry!!!  
You are a bright star in this forum and your perspective is much appreciated :)
Cheers
Angel
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Hi you may have mis read my post....the 76% success rate is for permanent atrial fib not parox.  As those of us who have gone thru the parox and persistant or sustained atrial fib know the success rate in most cases is much higher and many times well into the 90%  percentile of success rates.   Taking a personal affront at the mention of advanced age at 76 when someone is in their 40's is amazing to me especially if you look at what the average lifespan of a human is....i am definately NOT here to argue w. anyone....nor will i....this community as i understand it is based upon our personal experiences with our heart issues and to be there for one another when each and every one of us faces issues with our hearts and or family members hearts...this is not the expert forum by any stretch of the imagination....we walk thru the emotions of pre procedures and are there all the way thru the post procedures.  That is how i made it through my procedure emotionally 4 years ago with many members of this community supporting me and am simply paying it forward.  I guess the thing i am symied about at this point Angel001 is that you have no heart issues, you have not from what i have seen posted said anything about worry or wanting advice for members of your family or friends, altho you seem to propogate surgical ablations to our members when you say "All of OUR concerns are valid" sorry i have to question that one...again with no heart issues or obvious concerns of family or friends or at least you have never posted that i question the motives here...especially when you work for a heart clinic as you have posted...when you have directly given the name of a specific doctor you work with...i question that.....when you are referring people directly to that same clinic and doc you work with...it does not make for a level playing field for any of us...and i am a patient...this is all i will say about this ...i have been on this site for years now and it literally saved my life....within a VERY short period of time since you have logged onto the site the facility where you work has profited very well from one of our members to the tune of over 100,000 dollars i am sure....everyone is welcome to any of the Medhelp sites obviously however you may want to read the first paragraph of the "Welcome" message and take it under consideration.  I am sure i will catch hades with this post but my concern is for myself and fellow community members.....again we are not an expert site just a support group.......I am not going to jump into the mix with anyone who cannot relate to what is happening within our own bodies because its simple...you just do not understand it as you have never gone thru it physically and even as i type this i can feel my heart doing the "dance" as i type this because simply put  your original motives scare me for all of us.....and in ending surgical ablations and the recovery of them is very very difficult...regardless of the diagnosis....its simple reading...Petes experience from beginning to ? vs. those of us who have had catheter ablations and returned to work 4 days later or even a week later there is a world of difference there...i am done responding and posting on this subject Angel 001.....i just wanted to let you know i am very protective of this site.......again it saved my life can you say the same?  Done
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Thank you all for your advice which is so helpful for both of us.  Of course, we are no spring chickens, being 68 and 76 respectively, but he is more active than me and has just finished an extension to our home!  But the message loud and clear from your contributions is to tackle our consultants on this issue and take their best advice.  We lived in Cyprus at the onset of my husband's A-Fib which was definitely not the best place to be medically, so I feel he didn't get the chance I will get to have intervention in the condition.   I think the attitude here in UK is if you don't ask, you don't get!  However, I was formerly hesitant to encourage him to even ask...I am waiting on my turn for a Holter monitor to see the degree of AF in my own case.  Yes, there is a lot of pill taking in this household...
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I considered the mini-maze procedure when I visited with Dr Mitruka at Eisenhower Med Center in Palm Springs.  The thing that deterred me from the procedure was that I would have to have each lung, one at a time, deflated during the procedure.  That scared me.  That visit was in Feb. '08 but I'm assuming that is still part of the procedure,  I only mention this because of your husband's age and I don't recall this point being addressed  before.  I just had the catheter ablation 3 wks ago but I did have the paroxsysmal type of a-fib, not the permanent.  Like Cindy said, be sure and do your homework and and find a good EP.  I actually came across a list of Dr's who do catheter ablations on people who have permanent a-fib. if you are interested. My Dr was Andre Natale and he is on that list,....he actually pioneered the catheter ablation procedure.
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