Shorter time from diagnosis to ablation improves persistent AF outcomes

[EngMac]

This article could be of interest to some people.

healio.com/cardiology/arrhy...

[jeanjeannie50]

It's interesting that this report says that scar tissue appears in the atrium because of AF and can be present before having an ablation.

[PeterWh]

A couple of other really interesting bits are:

The medication is probably effectively suppressing the symptoms but it is still dfeveloping.

"These findings reinforce the fact that we should be careful and NOT just have patients LINGER FOR A LONG TIME before we offer them an ablation". [My caps].

[BobD Volunteer]

I have been saying for some time what leading EPs have been saying. Early intervention by ablation gives the best outcome. People often hold back thinking procedures and outcomes will improve whilst ignoring the fact that their AF is getting worse and making their own outcome less positive.

[PeterWh in reply to BobD]

I am not medically qualified but I am very good at analysing things, logical thoughts and research!!!

To me the big step forward was in the 90s when catheter ablations were started because previously surgical ablations were the only option and were very rare and often only done in conjunction with other heart operations. The next step was the use of cryo (cryogenic) ablation rather than RF ablation though cryo appears to be good at doing the PVI ablation but often later an RF ablation has to be undertaken to touch up and to eliminate sources within the atrium.

The area where there has been a big step forward and will be further steps forward is in mapping techniques which will obioulsy make success easier.

Obviously the skills and expertise of the EPs has, and will tontinue to, improve.

The combination of things will, I believe and from what some articles have said, push up the success rates first time and second time which is better both for the patient and for the costs. However for those who had 3 ablations that would have saved an ablation but they would have lost many years of being AF free in the meantime. In addition if they had waited they will have reduced the chances of success because current knowledge and opinion shows success rates diminish the longer AF is present.

Obviously in addition people have to weigh up the detrimental effect that many medicines have, short and long term.

I would love to have a copy of the full report.

[Hidden]

I don't really understand. Is it the AF or the AF symptoms (assuming you are not asymptomatic) that causes the problems and are the main driver for an early ablation?

As a backdrop, I had persistent AF 12 years ago, which was diagnosed fairly early, say a few months from when it became persistent, difficult to say really as it progressed and I wasn't being monitored. First off, I was put on drugs which took away all symptoms for 2-3 years. Then I had an ablation to get off the drugs, not to get rid of the AF because it wasn't a problem. That ablation worked 100% and immediately.

Koll

[EngMac]

Hi PeterWh, you might learn more if you contact:

Oussama M. Wazni, MD, can be reached at Cardiac Pacing and Electrophysiology, Department of Cardiovascular Medicine/J2-2, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195; email: [e-mail].

This was at the bottom of the article. Often the articles on this site are found on the source site such as Medscape or others; so if you search, you may find the original.

[djmnet]

Am I the only skeptic who thinks the reason they recommend early intervention by ablation is to stimulate more interest among patients in having the procedure done? If you have it done early, you'll obviously never know if it would have progressed without it. And what about all the people on this forum who have had multiple ablations? I was diagnosed a little over a year ago and mine has gotten BETTER not worse, since I elected NOT to take daily drugs (beta blocker and/or anti-arrhythmic) but instead rely on PIP. I also take a magnesium taurate supplement and feel that has made a world of difference. My episodes are shorter, and my HR is only elevated from 60 to about 85-95 -- hardly even counts as AF except for the irregularity of the heart beat. So there is no chance I would have an ablation done unless/until my AF became persistent. This is just another sales technique by the medical community and it's too bad so many people are buying into it.

[DavDug in reply to djmnet]

No I do not think that you are a sceptic djmnet, my friend. We can all look at a subject from a different angle. It's like a road accident!

When I look at the list of drugs that I have been given over the last 8 years, the tests that I have received, the trips to the hospital, the wasted time both for the NHS and me, the return to primary care to be booted back into secondary (hospital) care, which wasted a year, the time off work, the loss of money and the periods of time I have felt so damned ill and debilitated, preventing physical exercise? Then to pass though the hands of a goodly Electrophysiologist in Leeds and experience a wonderful transformation of wellness as the ablation puts me into sinus rhythm, I just wonder where the learning is coming from? The patients seem to know a lot as this blog proves. I wonder who is talking to who in the NHS and do they get together and compare notes? Does anyone in the UK cardiology discipline look at this blog or the AFA web site? One wonders?

Don't discount the ablation, it really is doing a lot of good for a lot of people.

Get well. Dave.