AF Association
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5th ablation on the horizon!!!!

I have an appointment to see my ep tomorrow to discuss my options going forward, which apparently include the option of a 5th ablation. I have been on Solatol, flecainide,nadalol and bisoprolol so far with the latter being the drug that I cope with best but unfortunately I still have episodes of paf. Has anyone got good results from anything I haven't mentioned? I really haven't got the stomach for another ablation!!!!!

13 Replies

It's strange that you may be offered a 5th ablation (poor you), when my EP says that after 2 my heart is so scarred I can't have any more. I just don't understand!

How bad is your AF now?



1 like

Sounds like an insult bob!!! :)


Wow! 5 ablations I couldn't do it either you poor thing, mind I had three then an AV node ablation after having a pacemaker fitted.



Propafenone and Diltiazem, first to prevent PAF, second to slow heart if first doesn't work!

How bad is your PAF? Is it a nuisance or a blue light job?


My PAF has never been blue light. but I have made my own way to hospital on about 5 occasions over 7 years. I get periods of PAF/flutter on a daily basis and some days it is a mere nuisance but on others can be a bit debilitating. And I have no obvious trigger!!


That does not sound a great result after 4 ablations!

Suggest you get a second opinion or make up your mind to live with the PAF and make some lifestyle changes.....


I agree. If the EP hasn't fixed it after 4 ablations then I certainly would not use him again.

You could consider a surgical mini-maze which I believe should only be used as a last resort for cases like yours.


I`m just back from the appointment and he says he is not going to ablate again!!! We are going to try different drugs and then the next step will be a pacemaker but not for at least ten years as he feels I am to young.


Will be interested to hear how you get on, as your journey sounds very similar to mine. Just had 4th which EP says will not last as I have so much electrical disease. Won't do pacemaker yet as 'too young' (62!) and irreversible procedure. When in AF is persistent. Have wondered about mini-maze. Would love to hear from those who have had multiple ablations and then a mini maze.


What is a mini maze ?


Propafenone works for me, as does Disopyramide which is what I'm on now.


The mini-maze procedures are cardiac surgery procedures intended to cure atrial fibrillation (AF), a common disturbance of heart rhythm. They are procedures derived from the original maze procedure developed by James Cox, MD which was open heart surgery.

Microwave minimaze

Completely Endoscopic Microwave Ablation of Atrial Fibrillation on the Beating Heart Using Bilateral Thoracoscopy

Wolf minimaze

Video-assisted Bilateral Epicardial Bipolar Radiofrequency Pulmonary Vein Isolation and Left Atrial Appendage Excision

High Intensity Focused Ultrasound (HIFU) minimaze

Surgical ablation of atrial fibrillation with off-pump, epicardial, high-intensity focused ultrasound: Although the HIFU minimaze is performed epicardially, on the normally beating heart, it is also usually performed in conjunction with other cardiac surgery, and so would not be minimally invasive in those cases.

But I don't think that it is offered in all NHS regions


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