atrial fibrillation and cardio-ablation

[superman727]

I am a 64yr old ex-athlete originally from England but now living in Australia where my health scheme status is public patient. I have been treated for atrial fibrillation for the past 9 years but for the first 6 years I was in denial and carried on life much as before with lessening A/F free intervals and deteriorating  symptoms whilst sporadically (& therefore ineffectively) taking digoxin per my G.P.  Symptoms progressed and I was referred to a Cardiologist and put on sotalol for 3yrs. Still experiencing periods of 'chaotic chaos' of up to 16 hours and so subseqently referred to an Electrocardiologist who has put me on coumadin & scheduled me for a cardio-ablation in May '08. As I understand it, a catheter will be passed up through a R/leg vein to a R/upper chamber then it will pierce through the septum to the L/upper chamber where nerve sites around four vein portals will be heat-cauterized.  70-80% chance of success. (1% chance of death - although my Dr. has zero scorein this area).
A recent development is that my heart (normal resting pulse 48-50) has dropped beats maybe 1-2 before I become aware of it and then maybe 2-3 more before an adrenalin rush resets sinus rhythm (not always first time). Whilst the 'stop' is occurring I almost lose consciousness with sight closing in. It is rather frightening. Now. without there being any A/F, I am experiencing the heart-stop sequence.
It perplexes me that I don't really know how serious my condition is?  Even now, I prefer to believe (but with failing conviction) that I can think and plan my way out of this, cure myself with will power as it were, amend further my already healthy diet by reducing quantities, get more rest, do more maneagable exercise, get more sleep.  I am not stupid so why do I think in this way and present, in my core self, as such an unwilling patient?


This discussion is related to EKG machine interperation vs human interperation.

[dss27]

I just happened upon this thread and given the dates I'm not sure if you've taken any further steps to resolve your a-fib. I first experienced such symptoms around age 20 but every time I broached the subject with a health care professional it was dismissed as PACs or some other benign condition. I was a competitive endurance athlete (mountain bike racing) until my late 30s and have always had reasonably good stamina. Although the a-fib would present paroxysmally over the years it was never a problem and never affected me adversely, so I noted it when it occurred but took no action.

A few years ago (age 49), I had a hospital stay during which the a-fib presented and it was recommended I consult a cardiologist.  That led to further monitoring which revealed a-fib/flutter and up to 6-second flatlines! This prompted a consult with an EP which led to two cardioablations over the next year (the second to "clean up"--once isn't always enough).  Bottom line:  I'm now in normal sinus almost all of the time (everyone experiences occasional minor arrythmias) without benefit of medication, so I'd recommend the procedure (check out your EP thoroughly) to anyone who doesn’t want to be tethered to a pacemaker or be hampered by warfarin, anti-arrthymics, or  beta-blockers!

[skypirate]

I am delighted for you. Thanks for the encouragement

[skypirate]

Tks your March13th encouragement and I apologise, that it has taken me a month to respond. Your result sounds extremely satisfactory and I am very happy for you. You have enacted the atypical no-nonsense approach of a  rugged self- reliant outdoors type. But we are all different. I have always tried to rely on myself in a different way i.e. I believe that I can heal myself, if only I can obtain the information necessary to understand why I have become unwell in the first place. Basically that's where I'm still at. Trying to learn what I can and 'talking to' and 'listening to my body', so that it will spontaneously make the necessary amendments. Putting myself and my comfort, both physical and mental, first wherever and whenever I can. If I can stay one step ahead of a stroke or a heart attack, then I believe I will make it. You know what it's like - you only improve your running performances by believing that you can. Thanks again for taking the trouble to reply to me and stay well buddy!
                                                  

[gillyr]

by gillyr 70 years old
suffered afib for 6 years .
6 monthly episodes worsening to 17 hours day every second day.
usual drugs amiodarone etc. ( helped for a period ) but i will not take this drug again.
pulmonary vein ablation performed May 2005 in Perth
incredible result
Have had 3 minor episodes for a short period and my golf handicap
has gone from 29 to 18
My hero is Rukshen Weerisarooya (electrocard.)
  

[Sweetwaterguy]

I am also age 64.    15 months ago I had a successful ablation for atrial fibrillation.  I am  very active, much of that comes from living in the mountains of Wyoming and enjoying a vigorous outdoor lifestyle.  Two years ago I was at a high altitude wilderness lake when my hart began to fibrillate.  I had to walk two hours over rough terrain, ride my atv five miles over even rougher terrain to my truck, and drive 25 miles home.  I did not see the doctor, and my heart converted back to normal in my sleep that evening.  I found that sotolal did manage my a fib, but another episode even with the sotolol finally got my attention.  I decided that it was worth more to me to take the risk of ablation and be free of a fib than to try to continue to manage it with medication.   I had a low tolerance for the uncertainty of knowing that the a fib was likely to return at a most inopportune time.  
   When I was laying in a hospital bed being prepped for the procedure I thought to myself, "Oh ****  now what have I gotten myself into."   The anxiety changed to relief when I woke from anethesia, and I have never looked back.    With the exception of a statin drug and daily aspirin, I am free of medication.  I am looking forward to summer when I can hike into my favorite high mountain lakes--a 10-12 mile round trip hike.  
   I understand the trepidation and the uncertainty.  But having "been there and done that,"  I would give an hearty recommendation to go for it.  

[superman727]

Dear Julie,
   Thankyou very much for your sound advice.  I will follow your yellow brick road.  Would you please accept the temporary position (very short term & no stipend) of honorary 'Catcher in the Rye' ?
   Best wishes,  Dudley. ( A quaint name for Superman , isn't it?)

[superman727]

Tks for your interest and comments. I do not know the developmental history of cardio-oblation as a treatment option for A/F. I can however advise that my cardio-electrologist was keen to establish that I was suffering from A/F and not atrial flutter and asked me to scource ECG print-outs from my local hospital. I provided to him by post (we have a tyrrany of distance in rural Australia)  A/F traces from three particular episodes which had really got my attention due to extended duration, chest pain and shortness of breath - and I'd taken myself off to hospital - and as far as I know, he's happy with those.
   Also,as regards second opinions, there won't be any because my Dr. is the one and only - but in any event I was more than happy with his attention and explanations and am confident, he would do a good job.
    My dilemma is that my whole psychology of self-reliance is compromised by these circumstances. I'm just not 'going quietly' at a personal level. Hence my looking into the web for possible escape routes. (I have a good pair of running shoes at the ready!)
   As always, whenever I look into anything to do with health issues I realize how lucky I have been for most of my life and if I died tomorrow, I could hardly complain.
   Whilst the sands of time run out as my INR readings are stabilized, I intend to look into the psychological healing methods of an USSR emigrant to your country now returned home to Russia. Nicolai somebody or other (can't tell you who until I get back on the browser). Thanks again for your interest and support.  

[Brnvc]

No, I think the range is probably right for you and related to your life-long low rate. So my comments probably don't apply to you. The ablation is a safe procedure but be prepared to be told it needs to be redone. You should go over to www.afibbers.org and talk to the folks there. They will tell you EVERYTHING you need to know. It also sounds like you're researched your doc and that's good too. It must be cured though if it's worsening and the ablation is the right way to go. There are also foods, supplements and triggers you should learn about. The afibber forum is the place to go. Hope this helps. - Julia

P.S. If you're experiencing these blackouts (syncope and pre-syncope) you should consider an ICD or pacer. Please talk to you EP about getting one!

[superman727]

Tks your knowledge & interest (also that you appreciated irony of my 2nd choice nickname!).
My resting pulse was always slow: 60bpm as a child and down to 42bpm on waking when I was strongly into middle-distance running.  I've hardly run since A/F and not at all over the past two years due to knee problems, so that's why I think it has climbed back up to between 48- 50 now.
Do you see that what might be called normal for me range as a complication now that A/F seems pretty well set in and would I feel any better at say 60 bpm?

[Brnvc]

You heart rate is awfully low. It seems the bradycardia, which would tend to worsen, is causing the stops. The ablation statistics are accurate but usually not on the first pass for afib. A second procedure is often required even with the best doctors. It sounds to me like you're going to need a pacemaker or ICD. If your heart was paced to 60 bpm you'd feel like a true superman again! Don't let your bp run that low. It will make you feel like an invalid...Hope this helps.

[larrye]

It's been a few years since I looked into this, but I was under the impression that Ablation was primarily attempted only for Atrial Flutter because of limited success rates with Atril Fib. Perhaps that has changed, but it might be a good idea to get a 2nd opinion. Also, do some research on the web on atrial fibrillation treatment options. I'm not a doctor.