Pulmonary vein isolation

Hi all , I'm still awaiting my ablation of the pulmonary veins by rf ablation, does anyone know the chances of this curing my af what's the percentage on the success rate for this procedure ,I'm having general anaesthetic and also wondered if they'd still be able to stimulate the af to find its path if I'm under general cheers Paul

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  • Don't worry about that Paul as they have some clever drugs they use for that purpose.

    Re success rates. ablation must be considered part of ongoing treatment and whilst you may be lucky with the first it is quite common to need a top up or even a third as I did before it is sorted out. The point is that no EP will go in with all guns blazing as there is no return from that so will almost always under ablate the areas. With RF ablation they can do other areas than the four pulmonary veins which may allow a good result. Cryo ablation only allows the four PVs so if other areas are firing off then they can't touch them. Cryo burns are usually more even so it really depends on where the impulses are coming from.

    Bob

  • Thanks bob , with it taking so long to get the appointment through I just keep going over and over the what ifs and so on ,I've been trying to put it to the back of my mind now the meds have settled in a bit but when I'm having a off day is when It gets to me the most , thanks again bob cheers Paul

  • Relax Paul it isn't half as bad as you worry it will. As a devout coward myself I can assure you of that. Worse part is having to lay flat for some hours afterwards so be prepared and take a sports drinking bottle and a bag to keep close with anything you might need like phone . lip salve, tissues etc. . You will be sleepy anyway but you do get quite dry.

    Ask anything and we will try to help.

    Bob

  • Thank you bob , I like reading your replays to people on here your very well informed even more so than many gp s mine know very little and the appointment with the ep seemed very rushed not enough time to ask all the questions I'd written down , on the other hand my cardiologist seems to be a lovely man who calmed me down no end and seemed to have all the time we needed thanks again bob cheers paul

  • I,ve just been told its ,80%+. But that the return to AF within a year is 50%.

  • Hi fuzz , that seems to contradict itself to me and brings the overall success rate down to 40% ummm don't understand, I did read somewhere it was 80% plus then I read 60% so a bit confused with it all cheers Paul

  • The success rate will depend on many variables - age of patient, experience of the EP, how long patient has had AF and severity of episodes, any other illnesses experienced are but a few of the variables so everyone will have a different and very individual estimated succes rate ie. The success rate will vary with each patient.

    I was told 97% a first time ablation succes and 99% for a second if the first failed. Well the first did fail and made things worse but the second succeeded and I have been free of AF ever since, thankfully..

  • Hi there , I'm 46 , always looked after myself run regularly not obsessively tho never competitively , not over weight don't smoke never have only ever had the odd beer here and there maybe half a dozen bottles of Budweiser a month , until this year been quite well , now I'm on bisoprolol and flecainide felt terrible since Christmas when the af was the worst in and out hospital for months with it , it all only started last September first time then not again till December , it's paroxomol at the moment , I'm pleased to hear your in the clear with it now must be a very good feeling for you , and it's good to no there is maybe light at the end of this dark tunnel thank you 😊

  • My understanding is that the earlier it is treated the higher the chance of success. So sounds like you would have a good chance of ablationing AF.

  • Hello Paul, I had a cryo ablation under general anaesthetic on the 15 January and touch wood, everything is still calm. I have come off the flecanide and still taking 1.25mg bisoprolol. If I am running late or a bit stressed I feel my heart having a few wobbles and trying to get into AF without success. Life changing while it lasts. I would have another one if needed without any hesitation. One side effect is a faster pulse rate afterwards which they don't tell you about beforehand. Your autonomic rate speeds up and should go back after time. All the best and feel free to ask anything :)

  • Hi kiwi , yours sounds successfull to me be even better wen you get off the bisoprolol , my friends just had cryo ablation last week and he says he feels better already and they stopped is bisoprolol too , his was of the av node ? And his af used to go into 220 plus bpm , mine goes about 150/180 and erratic I didn't realise there was different types of af ,thanks for your reply and hope you continue to be rid of this horrid condition cheers paul

  • Prior to agreeing to go ahead with a PVI a year ago, I was told a 75% chance of success with 1 in 3 needing two goes.

    So far, fingers crossed, its been ok and the actual procedure is in my view nothing to worry about.

    I have my 12 months follow up consultation in 2 weeks time.

  • Hi Dave , that's great news and 12 month af free 👍👍 hope it stays that way for you , how long did you take off work and exercise after the procedure all the best mate Paul

  • Paul

    I had my ablation on Monday the 9th June and went back to work the following Monday. Big mistake - and I am certain put my recovery back by probably a month.

    As regards to exercise I have never been one for formal exercise as such but started out walking the dogs and some gentle cycling after about 4 weeks.

    I did have two episodes of AF in the first two weeks which on consulting with the EP is quite normal and is due to the disturbances caused by the proceedure. Since the third week I have not had any AF episodes that I am aware of and the 7 day monitor at 6 months only recorded benign ectopics. These have gradually faded away in the last 6 months as I now rarely aware of them.

    I still have a slight doubt at the back of my mind that an AF episode could happen but fingers crossed everything is ok at the moment.

    Certainly no second thoughts about the ablation - it can really sort you out.

    All the Best

    Dave

  • Hi Dave , I think that feeling of mite go into af will be there for a while but hopefully fade with time , at least things are looking positive for you and I hope it stays that way for you ,i was just worried how long i would be off work because i dont get paid if im off even after being employed by them for nearly 20 yrs ,i can take my holiday pay there telling me lmao , cheers paul

  • It depends on what sort of work you do as to how long off you will need. I had a sedentary job and was in control of my own schedule so I went back to work about 10 days after but was only doing a few hours at a time. You need to take time to heal and for the first few weeks you need to do nothing or very little. Then Ease yourself back in to normal life gradually.

    Do not do as I did as I did too much too soon as I ended up in coronary care and then had a second ablation, after which I was much more careful and am pleased to say now AF free.

    I hope you will take advice as to your entitlement for sick pay, this is not something that is ethical nor legal - to pressure you with not taking the time you need to heal could be considered cause for a tribunal. I think you would have a case against your employer, if you decided to fight for your rights but certainly not helping as the stress from worrying about that could easily exacerbate your AF. Get some help for this and advocacy.

  • I had conscious sedation but it might as well have been a general for all I remember. I don't know how common it is but I had cryo ablation and because they couldn't get it all they also did some RF ablation at the same time. It's been over a year now and not even any ectopics let alone AF . It will either work or it won't but believe me when it does work it makes it all worth while.

  • Yes I can imagine how good it must feel for you , I've got everything crossed at the mo that it will go my way too we haven't even dare book a holiday abroad this year has I don't want to end up in a foreign hospital although I no some are good ,all the best Paul

  • Hi Runcrans

    Who is your EP? If I remember correctly you were referred to Glenfield. I had my ablation there at the end of February. They told me the expected success rate at the EP appointment. Trust me not worth stressing over. Why General anaesthetic? I had mine under sedation without problem. Just started reducing medication so far so good. Time will tell. Would have a second ablation if necessary. Try to relax while you are waiting, hope you hear soon.

  • Hi. There , thanks Debbi my ep is dr Stafford , I rang couple of weeks ago and they said we will write to you whith an op appointment , I was just really worried about the procedure still am that's why I chose general especially with it being a four hour procedure seems a long time to be lying there with them poking about lol , how have you been upto now hope alls been good cheers Paul

  • Hi Runcrans, as many people have stated I think the success rate depends on numerous things. I had my first ablation in February and have had the odd episode since (Not lasting anywhere near as long as they did). I was quoted 60 - 70 % chance of being drug free, but that could be off the back of more than one procedure. As Bob states ablation is an ongoing treatment for AF and as far as the procedure goes I found it no problem at all, but again people have had different experiences. I was sedated with the procedure taking 3.5 hours, but it felt a lot less, as I was in and out of consciousness most of it.

    Good luck,

    Jason

  • Hi Paul

    My consultant is Dr Stafford, however the procedure was done by Dr Riyaz Somani. The 4.5 hours didn't feel anywhere near that long with the sedation, they said it was successful at the end of the procedure and a textbook case! A couple of episodes since, but still early days. Have you called the cardiac rhythm team nurses at all? They were quite helpful beforehand, you may have to leave a message but they always get back to you. I had to wait 4 weeks after being on Apixaban for a month so would have thought you'd hear fairly soon. The discharge lounge was the worst thing about the time in hospital! Take care. Debbie

  • Hi Debbi, yes it's been about 13 weeks now since I went to see dr Stafford , and about 12 weeks since I've been on warfarin for the procedure with quite stable inr , think I'm at the back of the cue because of the general anaesthetic thing , I did ring two weeks ago now and was told they'd write to me and shouldn't be waiting much longer , keep me posted on your progress keep well Paul

  • I am having an RF PVI in about 4 weeks time. My EP tells me 60% for a first time fix and up to 80-90% on the 2nd go if needed.

    Judging by the way I feel right now I'll take those odds. 20 hours into an AF episode 60% chance sounds just fine.

    (PS--- I wanted to ask those who've had it, do you get catheterized for urine? I dont think I could accept that without being sedated.)

  • Hi jap , I think I read a reply the other day on the catheter for urine I don't think you do , most of my af episodes go on for about 20/24 hours its not nice , you'll probably get sorted before me then I've not even had a date yet after going to see them in march , hope you return to nsr soon cheers Paul

  • Hi Japaholic....I have never been catheterised for any of my 3 ablations. I don't think it is the norm. However they may do things differently in Japan!! Best of luck to you. Look forward to hearing how your ablation goes. Sandra

  • No I wasn't either.I had no desire to have a wee as I hadn't had a drink for at least 12 hours. X

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