It would be interesting to hear, when people talk about their ablations, whether they had RF., or Cryo Ablations and also which type of Ablation people have, ie., PVI Ablation or other types of Ablations. I also see that many people are saying that they have had 1,2 or 3 Ablations! If its PVI Ablation then I presume rightly or wrongly that the reason for more than 1 Ablation is because the procedure didn't cause a complete 360 degree burn of the cells, therefore requiring further Ablations after the scar tissue has healed. I don't know if anyone has seen the Sky News video on The London Heart Hospitals website about the Laser Ablation procedure that was first carried out in August 2011, by a Doctor Segal, very interesting video, well worth a look. Apparently they use a catheter that has a camera so they can visualize all the structures on real time video and also use a Laser with a Balloon to cause the burn. They say its got a 90%+ success rate for a first time Ablation, problem is as of this moment as far as I'm aware London is the only place that has this latest equipment in the UK., Dr. Segal says in the video, that because of the better rate of one time Ablation success, it has to be cost effective to the NHS. He also says that he hopes it will be rolled out across the NHS., at all the major heart centres in England and Wales, but as there's London and then there's the rest of the UK., only time will tell if any other hospitals will have this new technology in the future.
Pulmonary vein isolation is actually the correct term for the procedure in most cases and whether that is done by RF catheter, cryo balloon or laser is largely up to the centre where it is performed. It is thought that most of the rogue impulses come out of the four pulmonary veins so they are isolated by making rings of scar tissue. Many EPs will also add a line across the atria as a back stop as it were. Ablation the word means to cause not to exist so I often smile when people talk about pulmonary vein ablation as you actually wouldn't want that at all. Interestingly when I mentioned once to a nurse that I had an ablation she thought I was talking about varicous veins so the term is used in several ways.
My EP told me that they have to be careful not to burn too close to the PVs as this can cause stenosis which brings a lot more problems. As a result they will always err on the side of caution which I think is why it is often needed to perform a second or third procedure as gaps will be found. In my case. my second RF procedure worked very well until a few of the pathways re-established which required a third go since which time I have been fine in the AF department.
Remember also that Atrial flutter which occurs in the right atria can also be treated with ablation.
New methods all seem to promise better outcomes but I still feel that waiting for the magic bullet as opposed to getting treated asap is not a great idea.
My E.P suggested the new laser balloon method and commented that they are initially having a higher success rate, with less repeat proceedures needed. The laser tool is crescent shaped and seems to give a more continuous line of ablation.
John I am mystified by your part post that my e mails told me about which for some reason has not appeared here. I was not in any way ridiculing anything but trying to explain different types of ablation and how the word has come to have a different meaning over time. I'm sorry if something in there offended you and would be happy to discuss this over message service rather than on forum since your post seems to have been pulled.
Regards
Bob
i had cox maze procedure alongside some other open heart surgery. Cured AF but got a few other arrythmias which may have been masked by AF. Pacemaker Monday to try and sort some of it out and maybe meds for others who knows
Hi. I had PVI under Doctor Segal at London Heart Hospital who performed the ablation. I was good for a year and then things started getting awkward again. So i am now looking to have 3rd ablation 2 years later, as problems worsened slowly. However as far as I am aware I did not have the procedure as described in the video, altho I can't swear to that. The ablation will be performed by a colleague of Dr Segal in Brighton hospital, who trained at the London Heart Hospital, and told me it was unusual the AF would return after a PVI but it does happen.
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