Everything seems to be pointing to "hitting the right spots" for ablation durability. FIRM ablation demonstrates that theory. A "cookie cutter" approach yields lower success rates and less durability. Here is more evidence:
New 3-D Technology to Treat Atrial Fibrillation
May 11, 2013 — Researchers at the Intermountain Heart Institute at Intermountain Medical Center have developed a new 3-D technology that for the first time allows cardiologists the ability to see the precise source of atrial fibrillation in the heart -- a breakthrough for a condition that affects nearly three million Americans.
Yes, good point. If I had paroxysmal AF that wasn't too frequent, I would consider delaying until this comes to the UK and becomes more mainstream.
I delayed my ablation as long as possible, but 3 years ago I was on the point of becoming persistent so I had to go for it. Fortunately I chose a good EP (Prof Schilling) who managed to sort it out.
AF becomes a lot more difficult to sort out once you're persistent/permanent, though this new method seems to work very well with these difficult patients.
Tim, that is a terrific article. Thanks for sharing. With AF becoming epidemic and this is great news of a promising new technology. YAY for all of us!
Good article, I wonder if it will be available in the UK? I will ask the EP when i get my appointment. Only just been referred to ST Thomas Hospital in London.
Interesting stuff. About four years ago I gave a talk at the Patients Day at Heart Rhythm Conference in Birmingham UK where I described my experiences. I opined that if you compared ablation procedure to aviation and likened the first RF ablations in the early 90s to the Wright Brothers at Kittyhawk, then we were about level with the First World War in terms of progress. . Later in the day one of UK's top EPs told me he thought things had plateaued so maybe I was right after all.
I'm also surprised that the expected level of AF in US is only three million. Maybe that is three million DIAGNOSED, Since the number in UK is around 1 Million diagnosed with another half million suspected out there waiting to be found then I would have thought the true numbers would be much higher in US. We have regular awareness weeks and try to encourage regular pulse checking by GPs to find the others who are at risk but it is a slow process. I think that people living longer on one hand and the number of people who train to excess (yes endurance training is suspected as being a cause of AF in younger people) accounts for some of the numbers along with just finding patients with AF at all.
Twenty years ago it was likely to have been miss diagnosed or even disregarded by many doctors.. Many patients were told AF is a benign nuisance so get on with life. It was only around 2007 that the link with stroke became fully understood so you get the feeling how new a science this really all is. We must all thank Trudie, Jo and all the AFA gang including medics Like Prof John Camm and others for all their hard work in educating doctors and politicians alike about this condition
Such good news. I can't believe that it could be in the UK in about a year!
One question brought up from the delaying ablation comments - what are the signs of movement from paroxysmal to permanent AF or flutter especially for those with few or no symptoms? Can this only be detected by ECG?
So when do we think it will be available here in the UK? I should have undergone ablation 21st of May and got the cancelled call.On the 12th of June it will a year of being in AF (had a cardio version that lasted 4 days).
I'm wondering if I should hang on until the 3D mapping is here in blighty!
The YouTube video of the 3D mapping looked a true advance in the technology any thoughts?
bigE, That's a good question... With new procedures you never know how long they will take to be available. Only Guessing but I would think it will be a while because of the way that your healthcare works. One of the good points about NHS also can be bad for those waiting on a new procedure. If you are offered a procedure, under your system, then it has been proven to have a high success rate and worth the investment. But a newer procedure Even with a high success rate may be delayed until larger case study is done to support the cost. So I guess it's anyone guess when it will be available.
As to holding off... That's another good one. For myself, not knowing when the procedure might be available and having suffered with AF for 13+ years I would probably go ahead with the ablation.
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Convergent ablation procedure 
Appointment to discuss Ablation Procedure 
Interesting new take on pared down ablations
The Ablate part of the Pace and ablate procedure
A question about ablation procedure
