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1569985 tn?1328247482

Switch Hospitals for upcoming Cardioversion/Cleveland Clinic Visit

With the terrible experience I had with my recent cardioversion attempt at the smaller hospital where my ep practices, I'm wondering if I should look into going to our larger University Hospital for the cardoversion?  It would mean looking for a new ep and I'm just 2 weeks away from the scheduled cardioversion.  My ep wasn't in town when I had my recent cardioversion attempt and my case was mismanaged between the other doctors with one telling me my afib had nothing to do with my recent lung surgery, to another telling me the blood clot they found was mostly likely more tumor that was missed -- both WRONG!!!!  In addition, the one cardio was pushing for a AV node ablation and pacemaker even tho I made it clear I was not ready for that except as a last resort, and even withheld my coumadin in preparation for that procedure!  Starting to feel like I might be better off at larger hospital, even though I would be switching horses in mid-stream, so to speak.  I am 2 weeks away from existing cardioversion appt. and REALLY wanting to get this over with.  Any ideas????  Comments???

Just back from Cleveland clinic, an appointment my cardiologist here encouraged me to keep.  Met a very well known electrophysiologist and got some short term advice as to my present situation, which he will pass on to my doctor here, as well as some long term advice as to the options in dealing with my afib.  Just from what we learned today, I am inclined to go ahead with the catheter ablation he suggests.  He thinks waiting a few months from my present situation(still in afib with a blood clot) is a good idea.  It is an overnight procedure with a high record of success and low risk.  After this last month or so being so uncomfortable, I believe I am ready to seek a more permanent solution.  So after the present situation is resolved, scheduled for October 1, I think a catheter ablation is what I'll be doing in the spring.

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1569985 tn?1328247482
Advice please?
Helpful - 0
1807132 tn?1318743597
I am not so sure I have any advice but will say I have had just about every illness I went to a doctor for presumed it was cancer.  Well maybe not every but enough that it seems par for the course to some degree but with every issue I knew in my heart I didn't have it.  We all have an internal knowing that will guide us safely through life.  This is what you need to access to decide if you should change hospitals.  Do not stay at the one you are at just because it is easy stay or leave because it feels more right.  I go by the sense of calm I feel.  Even when both options are stressful one will seem just a bit quieter than the other or one will get me just a tad more agitated.  Pick the option that feels more right to you and you can't go wrong.  

As for the ablation.  That is a very big decision and personally I would get a few opinions on the matter.  Is this going to cure your afib or just allow your heart to circumvent the atria all together.  What are the pros and cons, what commitment do you have to make in regards to a pacemaker.  What are the risks if you stayed in permanent afib as opposed to getting the ablation.  If you can try to find some info on what it is like for people to deal with permanent afib.  What effects has it had on their life.  Ultimately I would do a lot of research on the subject and see as many doctors as it takes to feel like you can make the best possible choice for you.  

And one last thing that I like to do that may or may not work is ask for advice from your dreams.  Your higher self communicates to you through your dreams so I try to ask any and all questions that are brought up in my daily life and I try to pay attention to my dreams.  I keep a journal by my bed so I can write them down first thing when I wake up even if it is in the middle of the night.  It may take a little practice and persistence to have good recall and decipher them but it is well worth the effort to get your own best advice.  If you ever had any dreams you wanted a second opinion on you can always pm me.  I mainly see them as little puzzles that need to be put together but they always seem to have great nuggets of wisdom and advice.  Well anyways just a thought.

Well best of luck.  You are in my thought and prayers as you work through all of this.  (((HUGS)))
Helpful - 0
1569985 tn?1328247482
Michelle -- Thanks for your input.  As always it give me food for thought.  My ep at the smaller hospital is retiring soon and I will be looking for another, so I may look at the larger university hospital which feels more comfortable for complicated issues.  Right now I am in constant afib, a state I am not willing to endure one more minute than necessary.  I suppose the meds might be fine tuned, but I have not been given that option at present, just told to hang on until the cardioversion.  So I am hoping the clot is dissolved or calcified and a successful cardioversion happens.  It's scheduled for October 1, not sure I can arrange anything sooner at the larger hospital, but may look into it, if nothing else as a 2nd opinion.

The ablation is a pvi ablation and would not require a pacemaker.  I have studied this option for a couple of years now and was never, apparently, uncomfortable enough to decide on it. I traveled to Ohio State University to be evaluated for the FIRM ablation and now have an opinion from Cleveland Clinic.  The question I am asking myself is more meds or pvi ablation and I decided a while back when I had a bad reaction to a new anti-arrythmic med that I wasn't going to try anymore of those.  So I am down to a pvi ablation (90% success rate with 2 tries and 1% complication rate).  

This cardioversion shouldn't be such a big deal but I have felt so badly the last 5 weeks with all the side effects that I am "borrowing trouble" and worrying that the cardioversion won't be possible or won't work and I will be permanently stuck in this terrible limbo that I seem to be in.  I think I need to back up and cross each bridge as I reach it.

If all else fails, I can have the av node ablation and a permanent pacemker, something that is truly a last resort in my book.  But, at this point, going on as I am at present is not something I want to think about.

Thank you again for being my sounding board and laying things out in a logical pattern for examination.  I get so caught up in this sort of thing that it is hard to see the forest for the trees.  

Please keep me in your prayers.
Helpful - 0
1807132 tn?1318743597
Ah, I see now. I wasn't clear that there were two different ablations being offered.  I am with you to try a second pvi before the extreme step of becoming pacemaker dependent.  You are definitely in my thoughts and prayers.  Please do let us know when you have the cardioversion scheduled and I will send extra prayers your way.  
Helpful - 0
1569985 tn?1328247482
Thanks again -- I will keep your posted.
Helpful - 0
612551 tn?1450022175
COMMUNITY LEADER
Yes, I read the next (first?) ablation will be an attempt to stop the AFib and get your heart to run the heart rate on its own.

I think you need to consider going for the ablation even if the cardioversion works - as you know, as do I, electrocardioversion are always temporary, never lasted longer than 18 months for me and that was with a dose of Propafenone every 8 hours.

I am happy that I can live with AFib taking BB just to lower my heart rate (rate control) .  This isn't a great solution, but counting on my fingers I see I have been in that state for 7 years this coming November.

Sending prayers for a successful cardioversion followed by a successful ablation.
Helpful - 0
1569985 tn?1328247482
Jerry -- Cardoversion is scheduled Oct. 1 and I pray that it is successful.  Can they do a catheter ablation while you are in afib?  The meds to keep my heart rate down from the rvr have terrible side effects for me.  I am glad your meds seem to be serving you well.  

And, yes, I am convinced now that the catheter ablation is the way to go.  Patrick Tchou, ep at Cleveland Clinic says I'm a candidate and I am convinced, after this experience that I don't want to continue the drugs if there is another alternative.

Your prayers and advice are most welcome.
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