ablation

[dlhirschpc]

I have been told that abalation's goal is heart rhythm management vs. illimination of the Cumadin I take. That I can anticipate being on Cumadin even after the ablation. That based upon my episodes of problems coming after taking medication dosages and overdosesages, such as Zyrtec, and with caffiene and despite the fact that although the beta blockers control those benign flutters I am told that I still need to get shocked out of AF, I will still need to be in the hospital for three days following a preliminary endoscopic view of my heart and an attempt to get the rate medication working. All of this before trying the ablation according to the standard of care? Does this sound appropriate? How risky is a medication which the manufacturer requires 6 doses in a hospital environment before a release? Also the beta blockers seem to produce some difficulty with regard to weight gain and ED issues which have exacerbated in the last few years. I am approaching 60, overweight with one stint and despite my active lifestyle I would like to be able to lose some weight with my diet of low calorie foods, I would like to be able to eat green leafy vegitables without concern of its impact on the Cummadin and would like to know that I am not running a risk of stroke which runs in my family along with the AF. Is the ablation the answer to all of that?


This discussion is related to Ablation vs. Medication.

[Waitingforablation]

I have atrial fibrillation....I will be having ablation in 2 weeks time.  I have been cardioverted (shocked) 8 times and chemically cardioverted 20 plus times....  My heart rate is from 220 and irregular....chest pain and shortness of breath and my thoat feels like I can't swallow.  I have reduced coffee and alcohol....still having afib every 2 - 5 days.  It is very disruptive.  I am taking metoprolol 200mg and rythmol 600mg and coumadin 4 mg daily.  I am off work....I have two children and I am getting very tired of AFIB.  I am praying that this surgery will get rid of my atrial fibrillation so I can get on with life and not take these horrible meds.  I am 35 and healthy otherwise.  

Sincerely,

Waitingforablation  

[ptadvoc8]

I don't have the information to address all your questions (and hope that your doctor will take the time you need to do so), but it is fairly common for patients to be on various anti-coagulant and/or anti-arrhythmic meds, for varying durations, even after a successful ablation. There are various reasons for continuing and/or changing to meds post-ablation and you really need to find out the specifics for your case from your doctor.

However, in general, the anti-coagulants are continued because AF can cause clots that can remain in the heart for some time even after the arrhythmia has abated. Ablation can also cause clots in some cases, but if AF did not exist before, these clots are usually treated with aspirin unless the docs believe there may be many clots or the patient has a history of stroke. If the AF is truly cured (as in Twinbees case!) anti-coagulants are almost always stopped eventually as long as NSR continues. If AF episodes return, then patients may be put back on anti-coagulants to treat potential clots.

The anti-arrhythmic meds are used in an attempt to promote NSR while the heart is healing after ablation treatment. In many cases of successful ablation, eventually anti-arrhythmic meds can be stopped after NSR is achieved and maintained. In some cases, where the arrhythmia improves, but is not completely cured, anti-arrhythmics may be continued indefinitely. Ablation is attempted as a cure for arrhythmia in most cases, but is also used as a treatment option that can improve, but not necessarily cure, other cases.

It sounds like there is a lot going on for you and I would definitely suggest discussing all this with your doctor at length until you feel you understand what is going on. Good luck!  

[twinbee]

"Is the ablation the answer to all of that?". It was for me! I had my ablation for a-fib and a-flutter in Januay 08. Today, I am off all meds, including coumadin. Before my ablation I did try many different meds (Rhythmol, Cardizem, Atenolol, Sotalol to name a few). My a-fib eventually "broke" thru all of them.  I also had severe symptoms with my a-fib. I found that most EP's insist on trying and then failing at least two different meds before they will do an ablation. Now that was in 08, I do not know if this has changed since then. Yes, I was on coumadin for 1year after my ablation, but I am now off it. And yes, everytime my EP put me on a new med, I did have to spend 3 days in hospital to make sure I tolerated the med. But now since my successful ablation I no longer have to worry about beta blockers, coumadin or trips to the ER. Good Luck! Wishing you well, and wishing you enough...