Susan B (19 Apr 2011)
"For John Clark"


Hi John
You'll see from my post of today the that Prof didn't know anybody in the Sacramento area but I gave a name of one at Stanford and one whom Prof Sanders knows well in Santa Monica and thinks very highly of -  (sorry I am in Australia and don't know how far that is from you).
 
The nausea and sweating are definitely part of what a lot of patients experience when they are in AF.  I hope you are on blood thinners John?  If you are persistently going into AF you should be on warfarin (in line with the INR recommendations) - since you have had cardioversions I'll assume you know what I am talking about.  Clexane sub-cut is also used routinely before and after an ablation procedure to keep the INR below or around the level of 2.  Or at the very least small dose aspirin - however I am sure your cardiologist will have organised this with you.
 
I will certainly pray for you John - I have had arrhythmias myself and whilst they are benign they are sure frightening (I have a lot of ectopic activity in my heart).  Your chances of an ablation being successful are better if you are only having episodes of AF (as in not persistently in AF), do not have sleep apnoea (which by the way you need to be checked for), are not overweight or diabetic and the episodes have only been recurring in recent times.  However I have seen many people cured completely who were in persistent AF (unbelievable some people are in persistent AF and don't even know it!!!).   Im not sure of your age but people of all ages have been completely cured by the ablation procedure.  Prof Sanders normally quotes a success rate of around 80% (can be higher or lower dependent on other factors) and one third of patients will need at least one follow up procedure.  It's a good thing to go into with the thought "it may be a course of treatment".   There is nothing to fear from the procedure - some patients have a general anaesthetic but most only have a sedative.  A catheter is threaded up (normally through the sub clavian vein) and an electrical map of the heart is created using special computerised software. Most people with AF will find the majority of trouble is coming from the pulmonary veins.    This map will often show bursts of activity in the pulmonary veins, which will then be attended to and isolated.  Sometimes more substrate of the heart is involved (often the roofline) - and this will also be ablated - they use a very fine laser and this of course can only be done by an experienced Electrophysiologist/Cardiologist.  You will need to remain on Warfarin/Clexane for a time afterwards and probably also Pantoprazole as the oesophagus can get shoved around a little (sorry that sounds a bit gruesome but it's not).  Some people who don't want an ablation or are very elderly do well on a combination of beta blocker and rate altering medications such as Metoprolol, Digoxin, Perindopril etc.
(or the newer angiotensin drugs).
 
You will be in my prayers John and perhaps you will also pray for me.  I am out of work and my lease on my house is coming up - I can no longer afford the rental and have nowhere to go - its a very distressing situation.
 
May our Lord Jesus come quickly - Amen.
Your sister in Christ,
Susan in Aussie Land.