2 things, if I may?

1. Is there less success with an ablation if you have been in permanent AF for years? I am due to have my second ablation soon and have read that it is more successful if your AF is new and not permanent?

2. Are we able to opt for a General rather than a Local anesthetic for the procedure? I know this would depend on health etc and also know that I am OK to be knocked out! (Had my gall bladder removed in June).

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  • Hi Froggy

    Yes as I understand it, the longer standing the AF and especially permament AF the less likelihood of success of the ablation, and this was confirmed for me at the recents Patients day by several EPs. Basically as someone who is permament like you but asymptomatic, I am simply hoping it never gets worse, because ablation is probably not going to work.

    As for the General, I think it's down to the hospital I would ring and ask in advance

    Take care

    Ian

  • i think it is harder if you have permanent AF but, from reading only, I gather it can be successful but takes longer as more areas need ablating and also possibly more repeats are needed good luck- I hope you do well.

  • Yes it is more difficult. The best success rate is with paroxysmal AF, then permanent where the permanence has been less than 6 months, then permanent > 6 months.

    If I had permanent AF I would consider a FIRM ablation, or at least when they become available in the UK, due to their success rate with permanent AF in trials.

  • Thank you for your replies, they have confirmed how I understood it. Next question then, I suppose, is - is it worth the risks involved and the continued intervention? I am symptomatic, unlike You Ian and so do need my symptoms to be alleviated somewhat :-(. I am taking Flecanaide (200 per day) and Bisoprolol (7.5 per day). I still get breathless especially on inclines, even slight ones, and am very aware of my irregular, fast heartbeat most of the time. Oh, I was also told that I had a flutter showing on my last ECG.

    I also understood that an ablation was my only route too in order to feel right again - do you that that is the case?

    Any help would be well appreciated.

    Joan

  • Hi Froggy

    Just to go against the grain maybe, I had what I would call permanent AF which had been gradually developing for years, I now realise in hindsight. I asked my EP what I should call it, and he said 85% permanent. He also said that my ablation (10 years ago) would be easier because he would know immediately whether it was successful instead of having to wait to find out. I'm not 100% sure what he meant by this, i.e. would he know this during the op, or after.......pass!

    Anyhow, I had an immediate, 100% cure. After the op, I didn't even know I had a heart, couldn't feel a thing, it was great.

    Gradually, as he predicted, it has come back over the years (8 years or so) and I'm probably due for another ablation in the not too distant future.

    So I'd be careful about interpreting what has been said by the EP's. It could be that having permanent AF makes it simpler to fix, but also makes it more likely that it will come back, if you see what I mean. I'm half-guessing just based on my experience and my EP's comments.

  • I got the date for my 2nd ablation - 5th December :-). I will ask about a General Anaesthetic ( I had a local the first time).

    I would be very interested to know how many people on here had had a General or Local and why their choice was made. Anyone? Thanks. Joan

  • Froggy, My first ablation, 8 years ago, was under local. The second, a year ago, was under general. I don't remember saying I had a preference, that's just what they did.

    Can't say I'd mind either way although under local I do remember it hurting when they started burning, all I remember is groaning and the word Morphine being said three times, then I was out with the fairies.

    If I have a third and the choice, I will take their advice, but if it's swings and roundabouts, I'd go for GA myself.

  • I asked if I could have a general anaesthetic a month or so before I had my 2nd ablation in June. I was told I could but it would take a while to set up the staff etc and I would have to wait longer. I chose not to wait, so my advice to you would be ask as early as you can about a general one.

  • Might be too late. It makes sense that they would have to do more setting up though. Thanks

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