There are allot of posts re. ablation & I am getting the impression that ablation very often does not work i.e problems continue or a 2nd

[David21]

ablation is needed. Are there any statistics detailing the success rate of this procedure does anyone know ? Thanks

[dedeottie]

My E.P. says 70- 80% success but to achieve this you may need 2 or even 3 attempts and success for a third of people could mean that they are still on a small amount of medication that previously may not have worked. I have read some official figures but can't remember where. Also I think the rates are higher if you have not had it for long. Although mine is more or less still paroxysmal apparently, I have had it for 15 years. Someone else on here is bound to know some official figures. X

[Finvola]

NICE produced a booklet (dated 2006) with information about AF and quote various trials which put success rates at around 76% to 78% in 1-year and 3-year trials. There are also comparisons with drug treatments and percentages.

It's available to download from nice.org.uk.

[jennydog]

My EP in Liverpool has told me that he expects my ablation to have 70% chance of success. He said this was because of my weight. I am well built but not fat and I am on a diet in the hope of improving things.

Surely a lot depends on whether or not they actually find the pathways which cause the faulty signals. If they don't find them first time then they need to expand the search area the next time.

There must be some statistics available but I suspect that judgement of "acceptable success" will depend on each individual patient.

[BobD Volunteer]

The specialists will always tell you that ablation does work. The reality is that it may require a second or even third.procedure to fully eliminate all the rogue impulses. In a very few cases this may not ever work. There is also some evidence that the procedure may need to be repeated some years down the line to eliminate new pathways which may form.. Those like me for whom it has worked will tell you that this is very much worth fighting for and any time spent in NSR is a blessing. I'm six years post my third and doing fine. Not having to take shed loads of drugs with the attendant side effects makes it a really good solution.

Now as to reasons why it may not work. The procedure requires the EP to make as series of burns around the four pulmonary veins and sometimes a line across the left atria as well. Since these are made with the tip of a catheter about 1mm across you can see that making a continuous line is long and difficult so small gaps may be left which could allow electrical impulses to pass. EPs will generally under ablate as it is easier to go back and repeat he procedure than try to undo excess burning which may cause other problems.

As methods improve I am, sure that success rates will and are rising but it is also important to understand how new this science is. It is only 20 years since the first such procedure was done an we have come a very long way in that time.

Bob

[jeanjeannie50]

Before I had my first ablation I always got tired very easily. I would come home after a walk and fall asleep exhausted on the settee. After the first.procedure my heart didn't pound in my chest when I walked up hills. Before I had thought that everyone's heart pounded like that, also I had more energy. However, my paroxysmal AF persisted.

After the second ablation my energy levels zoomed up and I now have periods of feeling extremely well with lots of energy. However, I still have the paroxysmal AF and some attacks can now go on for weeks (6 has been the maxium on two occasions since my last ablation in June 2013), both were only halted by having cardioversions. When I have these long attacks I am totally disabled, feel short of breath and cant walk far (the supermarket is a struggle). When I'm not having them I'm out walking the coastal footpath and doing the garden - I love those periods. So far ablations haven't cured my AF but on the whole I feel so much better for having had them. Others on this forum have said it was their third ablation that provided the cure.

[johncb]

I had ablation about 15 months ago, had Paroxysmal Afib. Was told before the procedure that because I was fit, and no other problems that he expected it would be successful on first attempt but it may take a couple. It worked first up and it has been absolutely perfect since. My EP said that the 70% success rate can be misleading and he thought it was closer to 60% but jumped dramatically after the first one. I am speaking only of Paroxysmal AFib. If it hadn't worked I would have had as many as it took to get rid of it. How long will it last? don't think anyone knows really, just hope it is a long time before I need it done again. I would certainly advise anyone to seriously look at ablation and earlier the better. The procedure is nothing to be concerned about when performed by an experienced EP.

[Barb1]

I am having my 4th ablation in September. My 3rd was successful for 18 months and then the AF returned. In my case it is persistent ie all the time. This time my EP is using a new instrument to ablate that is more sensitive and apparently successful. Unfortunately it is not approved for use on the NHS and that makes him very angry. I am very overweight because of the limitations on exercise with the AF and a hip problem but that has never been mentioned as a problem.

[Offcut]

My first Ablation was on the four pulmonaries and then I had one that was in the main chamber and I had 38 burns over 7.5 hours My third failed and they were going to go through into the second chamber but once in and doing a few tests. I even saw me briefly flatline which was a bit weird, they stopped.

I was diagnosed in 1992 and they told me about the procedure and of the only 2 hospitals in the midlands that could do them then. But it was a 80% fail rate then! My last doctor to do my last Ablation was trained by the doctor that did my first and second.

I was diagnosed very late and afraid I have not responded well to treatment and now have additional conditions that are not helping.

[MarkS]

The success rates of ablations are highly dependant on the EP. The best can achieve success rates of 70-80% for paroxysmal AF (less for permanent). But that's probably only the top 10 or so in this country. For the majority success rates are around 50% or less.

I've seen independent stats from Hans Larsen's site, afibbers.org/.

There are new techniques coming along including better mapping of rotors (FIRM ablations) which should boost success rates and make ablations easier for less experienced EPs.

Mark

[CDreamer]

Interesting comments. I was quoted by my EP 97% success with the first and 99% with the second, that was purely his figures, he says. The first made things a lot worse, since the second I have not had anything other than the occasional ectopic when I over exercise.

Thanks for your excellent explanation Bob.

I think it really is very difficult to decide who and what to believe, other than being informed by your own research and experience, based on age & general health. Other than AF I was reasonably fit and healthy at 62 so I am assuming that the figures will vary hugely, dependant upon age and general health and who you do and don't include in your figures and as MarkS rightly says, the skill and experience of the EP.

I think that we all need to remember that statistics are always conditional and even a 9:1 chance of success still means for you as an individual it will be 50:50 because you may be the 1 it doesn't help. For me personally I thought the benefits out wayed the risks and feeling so well and energetic again, really glad I did.