Ablation for A-Fib.

[surgblumm]

My wife recently went into A-Fib and was placed on a B-Blocker and Flecanide. She converted to NSR after four days and will occasionaly go back into A-Fib. she has  two cardiologists, one near home and one in Manhattan, affiliated with Mount Sinai and Lenox Hill. The NYC doc sent her to an EP after she wore a moonitor for two weeks and suggested that she should have an ablation. Seems early, but I cannot say I did cardiology for the past ten years. If she has ablation should it be "cold "" and be secluded to the PV? I think AV Node ablation is far more complicated and would only trust places like the Cleveland Clinic. Any suggestion?

[UGoLong]

My wife recently went into A-Fib and was placed on a B-Blocker and Flecanide. She converted to NSR after four days and will occasionaly go back into A-Fib. she has  two cardiologists, one near home and one in Manhattan, affiliated with Mount Sinai and Lenox Hill. The NYC doc sent her to an EP after she wore a moonitor for two weeks and suggested that she should have an ablation. Seems early, but I cannot say I did cardiology for the past ten years. If she has ablation should it be "cold "" and be secluded to the PV? I think AV Node ablation is far more complicated and would only trust places like the Cleveland Clinic. Any suggestion?

I’m assuming things were done to look for other underlying causes, like hyperthyroid, sleep apnea, or electrolyte imbalances?

If you eventually do an ablation, I’d pick a center that does it all the time. Hopefully she won’t need an AV ablation and have to become pacer-dependent.

Good luck!


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[ventana]

make sure to go to a center that does a LOT of them and has a CT team as back up

Also search around, my MIL went to cleveland clinic and they just about killer her..... kept NPO for 5 days while constantly rescheduling cardiac procedures, keeping her on her regular dose diuretics and not doing daily weights..... ARF and hepatorenal syndrome took years off her life....   

 

So be her advocate wherever she is!  push, ask questions, demand answers - be the PAI patient if need be

[surgblumm]

Thank the both of you for your response. She was negative for thyroid disease, electrolyte imbalance and sleep apnea. The comment about Cleveland Clinic is appreciated as the institution is as good as the EP. Both places that I have suggested in NYC do volume.

[SedRate]

9 hours ago, surgblumm said:

My wife recently went into A-Fib and was placed on a B-Blocker and Flecanide. She converted to NSR after four days and will occasionaly go back into A-Fib. she has  two cardiologists, one near home and one in Manhattan, affiliated with Mount Sinai and Lenox Hill. The NYC doc sent her to an EP after she wore a moonitor for two weeks and suggested that she should have an ablation. Seems early, but I cannot say I did cardiology for the past ten years. If she has ablation should it be "cold "" and be secluded to the PV? I think AV Node ablation is far more complicated and would only trust places like the Cleveland Clinic. Any suggestion?

Be mindful that if you see an EP, you just might get an ablation recommendation similarly to if you see a surgeon, you just might get a surgical recommendation. Haha. But all kidding aside, feel free to get a second opinion if you feel it's necessary. Perhaps follow up with them again and express your concern about timing. Good luck.

[Reality Check 2]

My husband had an a-flutter right sided ablation at 45 and the left sided fib ablation a year later. He is now 58 and doing fine. Our local EP cardiologist who is also a personal friend did both of them.

He had the ablations after failing 4 meds and being highly symptomatic with difficult rate control. Heart valves are fine.

He remains on rythmol and xarelto now - symptomatic fib about 3 times a year and one night run on a 2 day monitor. Echo is awesome and blood pressure normalized. 

Statistics said ablation 65% successful but I would say his is about 90% or more. No regrets.

He has had both knees replaced in past year - he was a defensive linesman football player thru college.... both his knees and afib are related to his size and football. 

I have few reservations about ablation when done by an experienced EP. 

Many blessings to you and your wife.

[surgblumm]

Thank you so much, Reality Check

[bike mike]

What is her AF burden? If it is very low I think jumping to an ablation is a bit overkill. If she has a significant AF burden and is symptomatic then move forward with ablation with someone you trust. 

[surgblumm]

Thank you so much, Reality Check

[surgblumm]

Her HR is 64 with the B blocker but she has occasional dizziness and feels the flutter. I have been on A Fin for ten years and have a HR of 50-54 and am on Eliquis. Never symptomatic and TEE revealed a clot in right apical appendage. Repeat studies X 5 demonstrate no change and I assume it is calcified. I have not recently asked if I am a candidate for Watchman procedure. Sometimes , I feel like you, why be too aggressive except for the stroke rate of A-Fib.