Its tough to say. One thing you have going for you is that you're relatively young (when it comes to afib), and ablation seems to be more effective in younger people. I'm 39 and have had two ablations - both in the span of a year (2015). After the second procedure I'm afib free, though I do still get the occasional PAC, but to-date, no afib. I'm off all rhythm meds, and just take a small dose of metoprolol and some supplements.

The success rates for ablation depend on a number of different factors - it will vary from hospital to hospital. If you do decide to go that route though, you'll want to find the best EP you can to do the surgery. More experience means better outcomes. But there are options.

As far as treating afib, there are several schools of thought - one, live with the afib and only use rate control drugs, along with anticoagulant to minimize stroke risk. Two - treat with rhythm control drugs (and you'll still probably want to keep the anticoagulant - you definitely don't want a stroke). Three - and several people on this board can speak to this approach more than I can - no rhythm or rate control drugs, instead using supplements, relaxation techniques, yoga, etc. And finally, you have ablation.

I opted for ablation because I was so symptomatic that I was unable to live a normal life. While waiting for my surgery, I took both rate and rhythm control drugs. Thankfully, I didn't have any side effects from any of them, but the side effects can be severe. Your mileage may vary.

My advice would be to investigate your options thoroughly, and try everything else before you go for the ablation. There are other things you can check into that can contribute to afib (like sleep apnea and abnormal thyroid hormone levels). Getting those things in check might cure your afib.

Now, with all that being said, I can say from experience that the surgery is a piece of cake from the end-user standpoint. There's almost no pain, and very little downtime (compared to just about every other kind of heart surgery).

If you have any other questions feel free to ask. Sorry you had to join our little group.

I second the idea of ruling out sleep apnea, if it hasn't been done already.

Probably an overnight study -- polysomnography.

Best of luck !

Sorry you had to join this club. Duder is correct. The success rate you were quoted is awfully low. Most of the top EPs who have done thousands of ablations have success rates of 80-90% with one or two ablations depending on the particular case. If you decide to go that route go with a high volume doc. Someone like Dr. Natalie in Austin, TX or some of the guys at Cleveland clinic. Always ask what their complication rate is.

Rhythm control drugs are optional and are really at the discretion of the patient for their own comfort. At this point I'm guessing that you don't know if you would be in afib all the time without rhythm control. A lot of people self convert after hours, days, depending, and the frequency of episodes varies from person to person. It can be a few times a year, a few times a week or even permanent. Some people live very comfortably in permanent afib as long as their rate is well controlled.

I am guessing that you are getting your info from a cardiologist. You should have an electrophysiologist (EP) if you don't already. I will try to find my list of very experienced EP who do a high volume of ablations and post it for you.

Rate control and anti coagulation are a must. Eliquis is the blood thinner recommended by Dr. Natale. He says it is as safe as taking a baby aspirin.

New studies show that losing 10% of your body weight significantly reduces afib burden and reverses heart remodeling.

Decisions, decisions, decisions! Please remember what may or may not have helped one of us, may not or may help you. Every a-fib is different and every decision is a personal one and no decision is wrong.

Many people who still are, or used to be on this site, had an ablation some after very few a-fib episodes others after years of a-fib and never saw an a-fib episode again after their ablation. Others here have never had an ablation and are quite happy with their decision. Some are strictly con ablations while others couldnt be more pro. I would venture to say that a good majority of those who have had an ablation and were pleased with the results have since left Daily Strength and moved on to other pastures. Most have also reported that the ablation itself is no problem, BUT things can and do happen,(Im not saying this to scare you but to make you aware) cardiac tamponade to name one.

If you are thinking about an ablation, finding a specialist (EP) is always a good idea. Thats what they do. Ask about the odds for YOUR situation to help you decide. If you still arent sure, get a second opinion.

With your history of a PE and now a-fib, I can imagine that anticoagulation will remain in your future. What is better and what is worse in anticoagulants? As far as I can see they are all about the same; they all slow the clotting time (by stopping different factors in the clotting cascade). One is as safe as the other and they all have their good and not so good sides.

Hope this helps.
Carpe diem,
Across the pond (atp)

Ren,
This is definitely a big decision. As ATP noted, some get an ablation right away. I was in that group. I had two afib episodes before I approached an EP about surgery. I was in what you might call the "full blown psycho" group..you know, "OMG! This is going to KILL me!" And having NEVER taken drugs in my life, the metoprolol and flec combo left me barely able to get off the couch...and not in a "good" way, like "Oh, look, an Andy Hardy marathon on TCM!" I was miserable mentally and physically, and after some research, decided on the ablation route rather quickly. I was lucky enough to get one of the "superstar" EPs, my hero Hugh Calkins at Johns Hopkins. I would definitely recommend a top ranked EP...after all, the guy will be holding your life in the palm of his hands...that still amazes me. I still have PACs 4 years later, and never went back to having the physical stamina I did pre-afib, but overall, I am THRILLED with the results. But we recently had a post from someone who treated their afib naturopathically, and hasn't had an afib episode in over a year, so perhaps lifestyle changes would do it for you. Such a tough decision, I don't envy you, but do consider all of the options. In my case, I also wanted to finish up my military career, and that is tough enough WITHOUT afib, so I opted to have the ablation. Best of luck in your decision.

Bill

Well I might as well put in my 2 cents. After 40 years of afib, which got progressively worse, the DVT, Pulmonary embolisms, the and the stroke ...I had ablation #1. That worked for a few months, then I became progressively worse again. I was having major episodes weekly, minor episodes daily. I was miserable (the wife may say I just miserable period). Anyhow, I had ablation #2 6/7 weeks ago, and I feel great. I should have pursued this more aggressively years ago.

I've been on Eliquis since the stroke and will be on it for life. The ablation doesn't necessarily reduce the stroke risk, as I understand it. I have never taken even one dose of a rhythm control drug, but was on a beta blocker for 5 years, which wasn't good for me since I have a slow heart rate.

Good luck!

Here is a list of high volume EPs. There are probably some not on the list that should be like Paul's EP, but at least this is a place to begin.

http://www.af-ideas.com/Dr%20List.htm

Wow guys, thanks for all the advice, info and suggestions! Some really good ideas. Apart from working on loosing a few pounds, I'm also practising mindfulness (is part of a post graduate university course I'm doing - so timing on that was good)
After the PE and now AFib, I think I'm stuck on the blood thinners, either way, as apparently being a woman gives you an extra Chad point! Xarelto seems easier than the Warfarin (Coumadin) as I had to have weekly blood draws because my INR wouldn't settle.

my thyroid is ok, but a good idea to check out sleep apnea, . Great idea to talk to the EP. I'm in Ireland, so apparently there is just one guy doing ablations in my home city Cork, and both my cardiologist and GP have recommended him - certainly will query the 60% rate the cardio quoted! And maybe it's a good idea to check out alternatives, perhaps someone in Dublin might be better..
.
Really do appreciate the advice. After the PEs, physically I was very sick but I still felt ok emotionally, I just felt like I was truly lucky to be alive. This time other than fatigue I'm not bad physically but I am finding it harder emtionally . Best way to describe it is that I feel really flat - normally I'm upbeat, glass half full. Now it's like I don't even care. I'm thinking it's the drugs, so that's why I am really considering the ablation.

I hope you all keep well! Let's take each day as it comes and be grateful. Take care

Is this the EP in Cork?

Maheshwar Pauriah, BM, BMBS, BS, MB, CCDS, CEPS-AC

Phone: 00353021600

I know that some Canadians travel to Bordeaux for ablations and pay around $20,000 to avoid their medical system. This doc is on the list I posted. Just wanted to put this out there in case this would be a consideration for you.

Thanks pacytep, wasn't aware of that EP, was told of a Dr Gaby. Worth checking out!

Panicker, thanks, food for thought. My health insurance covers me here and I would really struggle to get that sort of money. However it has made me wonder if as I am an EU citizen would I be covered in another European country!?

Thank you both

Rengirl,
Yeah, don't listen to the cardiologist. When I mentioned ablation to mine, he said "I have sent three people for an ablation, and one of them is now dead...how do you like those odds?" Obviously NOT a big fan of ablation...did some research on my own, and found that while there can always be complications, the death rate has fallen considerably in the past few years. Dunno what the rate is now, but a few years back they said there was only a 1 in 1000 chance of serious complications...not that THAT is a good ratio, but it isn't one out of three! I was also going to mention Bordeaux, but Panicker beat me to it. You can get an ablation AND see a beautiful city!

Bill

Thanks Bill. Have a good weekend!

1 in 1000 is the death rate (2009 article).

http://content.onlinejacc.org/article.aspx?articleid=1139684#tab1

The complication rate is as follows (2013):

"The overall complication rate was 6.29% in patients undergoing AF ablation. There was a significant association between operator and hospital volume and adverse outcomes. This suggests a need for future research into identifying the safety measures in AF ablations and instituting appropriate interventions to improve overall AF ablation outcomes."

http://circ.ahajournals.org/content/128/19/2104.abstract

I've seen articles that say 4.5% is the complication rate. See below.

http://www.medscape.com/viewarticle/752625

IDK Guys,

Personally, I got two ablations so far and got no issues and I considered them both successes (1 flutter in 2011 and 1 afib in 2016). I guess it comes down on how can one cope with the sickness (or condition). Pacyetep has no symptoms and his afib seems to be under control. In his place, not getting an ablation would be a no brainer to me, but since I am very symptomatic, to me getting an ablation was the no brainer. I think when people have enough, when they are sick and tired of being unwell, when they are just fed up and discouraged.....these odds of complication starts to matter less and less and less.

That was my case anyways. My Cardio told me there was a risk, my GP even told me he had patients that went for three ablations and never got better....I didn't care anymore about odds I just went for it and I have been so much better since.

There are millions of people in life that take risks for money, thrill, health and don't give it a second though. I may not jump in parachutes or ride a mountain bike beside cliffs or rock clime to get a rush and I may not work in a high risk job or handle explosives for more money. But with the odds I read recently, I will get an ablation without any hesitations to feel better and have my life back for a while longer.

Your symptoms will dictate whether or not you accept the risks.

Scooby