ablation or cardioversion

Question

I had a my cardiac ablation about 5 years ago. Everything great till about 6 months ago. Believe too much exercise and lack of liquid fluids to blame. + coffee consumption before going to gym. 59 years old.Don' smoke or drink. 10 LBS over good weight. 6'2 205.
4 months ago had a cardio version . Since then have needed two more and then a left artery (upper chamber) ablation to cure my heart flutter. Now back in Afib. But heart rate well controlled 75rpm. blood pressure 101/60.
Question believe I should try 1 more cardio version and if that doesn't work do the lower heart chamber ablation.
Wife thinks I should just have ablation. What would you recommend. I have ample insurance for either procedure or both.

This discussion is related to Ablation vs. Medication.

DeltaDawn23 · Answer

I agree, if you could regain nsr via electro cardioversion, I would choose that first, and sooner rather than later.  That being said, if you are considering ablation now or in the future, you might want to check out my previous posts regarding the (relatively) new FIRM ablation invented by Dr. Narayan in San Diego and available now at 11 centers around the country.  There is a CONFIRM trial and a PRECISE trial that spells out their findings.  You can also find info on stopafib.org.  Good luck.  Let us know how it works out.

Jerry_NJ · Answer

I assume you are talking about the electro-cardioversion.  If so, I'd go for the electro if my doctor believed it may work.  It is a very low risk procedure, an ablation has considerably higher risk of complications.

In my experience electrocardioversion will require ongoing drugs and anticoagulant.  I have never undergone an ablation but believe if successful it is likely that will get one off of drugs.

As your experience suggests, AFib is difficult to "cure", I think all fixes are temporary, some just last longer than others.  If you live long enouugh AFib will come back.

I was able to maintain good NSR with electrocardioversion and medications until the age of 67j when my atrium enlargement put and end to that and I underwent open heart surgery to repair the mitral valve.  But I am stuck with the enlarged atrium and AFib.