Is it worth the risks? Sounds like you do not have any symptons and it has little affect on your lifestyle. I don't know what drugs they have you on but you did not mention any side effects. Ablation could make it worse. I would wait for medical advancements but remember that's just my opinion based on little information.

Every EP I have talked to (as my dr or 2nd, 3rd, or 4th opinion) said NO SYMPTOMS = NO ABLATION . They will do one if you insist. They say getting off anticoagulants is not a good reason
a you will probably have to stay on them.

I haven't had a quivering in my chest since 4th grade when Lynda J. walked by... oh, those were the days.

petey

Ray,
I am very much in favor of tackling the afib issue early on....but you don't have symptoms? I cannot believe that anyone would tell you to go for an ablation until you are riding in that ambulance to the emergency room (as so many of us have done). If you are good at online research, you will find many advances are expected in the next 5 years to deal with afib. If you are not good at online research, this website is a good soure of information. I had my surgery very early on in the process, but I didn't even consider it until the symptoms were debilitating. It is a tough decision to make...gets many opinions, and trust your gut! Good luck!

Bill

Having no symptoms doesn't necessarily mean you should just let it progress to persistent or permanent AFIB and possibly cause more fibrosis which leads to a higher stroke risk? What happens if you have to stop anticoagulation for major surgery for a week or 2 or even for routine procedures like colonoscopies or erosive esophogatis which I had and told to stop all blood thinners for a month before my AFIB ? While getting off the blood thinners your risk of stroke increases not to mention that blood thinners only reduce your risk of stroke from anywhere from 65%-82%. So there no guarantee there either even though its small.

When I was first diagnosed, I was encouraged to have an ablation. I did not know enough about AF (wish I had discovered this site early on) and put it off. My episodes were long, almost a day, sometime longer, I always self converted and never spent time in the ER. 2 years later I did have a stroke and that was the push for me to have an ablation. It took 2 ablations but the second was successful (so far). They never say cured, but it sure is nice not have AF.

That's my story, but as you will learn from this site, everyone's story and AF is different. Collect as much information as you can and make the best decision for you. Take care, Joan

Joan,
I took had a stoke and my CHADS score was ZERO.2months earlier my blood work was excellent too even my cardiac CRP was low at .99. But the weekend before my stroke I was in and out of AFIB for about 4 days and this is where the danger lies if you have to stop blood thinners for a few days or weeks. So saying this is a benign condition because you get no symptoms is not true especially if remodeling is occurring and the LAA is enlarging increasing stroke risk.

Ray, my story is much like Joan's. In many cases it takes either unbearable symptoms or an event like a stroke or TIA to motivate a patient to consider ablation. There are some that just want Afib gone and are willing to ablate sooner than later. It sounds like you are tolerating your Afib well an you're taking the precaution of anticoagulation. You have to decide if invasive intervention at this stage is necessary in helping you cope both mentally and physically with the condition. I tolerated symptoms and sleep deprivation for 17 years and eventually paid a considerable price with a TIA but I was not taking an anticoagulant, only aspirin. My first and only ablation at this point has proven successful, however I don't consider myself Afib-free. After so many years it engrains itself pretty well in your mind and I'm fully aware that another ablation may be in my future. It's a treatment not a sure fix.

Was my ablation worth it? To me it was because my condition was worsening and inaction on my part felt irresponsible. I had complete confidence in my EP, the man is an incredible and very compassionate physician with a top-notch team. That made my decision SO much easier.

I'm happy to hear that you're not struggling like I was so maybe you can buy some time safely, but as mentioned there are no guarantees - like anything in life. If you do decide to have the surgery do your homework and find the best EP/surgeon and facility that you can to have it done. There's nothing automated about an ablation, the experience/knowledge and skill of the doctor should be your top priority if or when the time comes.

Steve

Hi Ray: My thinking is the benefit of the procedure must outweight the potential risks. As a person who suffered a serious complication with second ablation, my best advice is to recommend that you weigh all the benefits against the risks. Ablation is a very personal decision. I do not regret my attempts at successful ablations but am more cautious in my decision making now. A third ablation was recommended to me, however, I have decided the benefits would not outweigh the risks at this time in my life. I would have to be suffering alot more than I am now to entertain the idea of a 3rd ablation. For now, I feel well managed on rate control and pradaxa. If my quality of life began to decline, I would definitely re-visit having a 3rd procedure. Good luck with your decision.

Hi Ray,

I would recommend getting a second opinion. Using the tool at http://www.hrsonline.org/ you can find an ep in your area.

opsyn

My EP never pushed me into the ablation, which I saw as a good sign on his part. When I did an EPS Study a few years ago and he diagnosed me with the AFIB, he gave me a prescription and told me to see him in a few months. It wasn't until the last few times I saw him and said that I'm at the end and don't have much fight left in me after having dealt with this for ten years, that he started bringing up the ablation. Petey's right. My EP agreed to do it because I'm so symptomatic, otherwise I think he would have discouraged me if I wasn't. If I wasn't so symptomatic, I probaly would have waited as they keep coming out with better procedures. I was not in AFIB full time though. One thing I've learned is no two Afibbers are alike.

Thank you so so much , i apreciate every one of you to write this .yes i do feel fine and keep going with my regular life including a 45 min treadmill a day at 3 miles per hour .

i am just scared that i might loose whatever i have now .i will get a 2nd opinion on this .

thanks

ray

Mchale: Disd you have an ablation? I don't anyone is saying afib is benign... what we are saying is that stroke risk still exists after ablation and that recent presentations at the Boston 2013 Symposium indicated fibrosis is more genetic and progresses with or without ablation... and if you are ablated alot of places/spots, the atria don't contract as well and this can cause blood pooling and stroke. In general, EPs will only say ablation is very successful at symptom reduction. This subject has been debated on stop-afib forums and yahoo afib support and I know you are on those support groups. I pay attention to detail and no-one will say that not taking anticoagulants is a reason to get ablation... it is to stop symptoms, function better, and hopefully stop electrical remodeling...

petey

Pete,
I've been on all the Forums for about 4 years and the consensus is basically a successful ablation leads to being off all drugs including anticoagulants. There's a whole bunch of posters who are now drug free. Being that I had a stroke my window of opportunity has passed me by sad to say I waited too long. What I mean by being benign is there's a window of opportunity to be "cured"
This is a typical post from someone who had a successful ablation and there's tons of posters like this:

http://forum.stopafib.org/index.php?showtopic=2058

As for the recent info of fibrosis continuing even after ablation that is yet to be fully accepted or proven I believe.?
The 4 EP's I saw didn't say cure per say but for someone for paroxysmal afib like me there is a 80-90% chance of success in stopping any sustained afib and getting off all meds. In any event a fairly successful ablation greatly reduces stroke risk.
As for compromised pumping action that happens in the LAA where Natale has been ablating persistent and permanent cases and the blood velocity out of the appendage is compromised. A few posters now have to stay on life long anti-coagulation because of this. There is a TEE that test this velocity. Most PVI do not compromise left atrial pumping velocity.

http://content.onlinejacc.org/article.aspx?articleid=1127925

To let AFIB turn long term persistent or permanent is just not good when you can have a great chance of "success"

http://forum.stopafib.org/index.php?showtopic=1945

McHale: Ablation DOES lower stroke risk, but doesn't eliminate it. The only ones that get off anticoagulants are those with low stroke risk to begin with based on CHA2DS2Vasc score. Certainly I don't go by what I read on forums regarding stopping anticoagulants after ablation because none of the doctors come up with the same conclusion. Look at the variation in the use of aspirin. I have to tell you, the biggest thing I learned regarding ablation from reading all the forums for over 2 years is: ablation is no walk in the park, it is an aggressive treatment, complications exist and two died on the forums, recovery is rough, small centers that are inexperienced are risky, recurrences occur frequently, repeats are most often necessary, and late occurences pop up with very successful ablations at 5-7 years... also with some maze procedures. I have surmised that many doctors don't keep up on the latest consensus statements. I could stop taking anticoagulants and there is a 65% chance I will never have a stroke in my lifetime... but that doesn't make that treatment plan right. The reality is that having afib is like picking the joker in a deck of cards... once you get it, it will always be a concern no matter what treatment plan you pursue. Silent afib after ablation coupled with high recurrence ratews and the need for multiple ablations makes the decision more cloudy. The more ablations, the more liklihood of left atrial contractibility. In that situation, you can be in NSR and still have a stroke because of pooling of blood from compromised pumping ability. That involves the left atrium, not the left atrial appendage (LAA) as you referred to. The only thing they believe eliminates 95% of stroke risk is REMOVAL of the LAA. That is a statement Mellanie True Hills has on her website. Concerning fibrosis, there is a relation (no cause and effect proven either way)betweeen fibrosis and afib, but no definitive answers. There is even evidence that its progression is the same for paroxysmal and persistent/permanent afib. Other factors regarding ablation and afib (besides afib recurrence rates after ablation, silent afib increase after ablation, lower than reported ablation success rates)involves what the best centers like Cleveland Clinic say is that success is measured by reduction in symptoms and reduction in burden (frequency and length of afib occurences). They also report that short duration of afib occurences does not eliminate the need for anticoagulation. Another consideration is your age when considering ablation, both because of success rates and quality of life issues. When you take all these things into account, I do not have a warm feeling that ablation would give me the confidence I need that ablation would eliminate or change my need for anticoagulation substantially. I will post some relevant websites and excerpts. petey