A/F Success Rates

[mullikg2]

What constitutes a success? I am particularly interested in the claim that ablations for A/F have a 95% success rate. From what I see on this site, and from personal contacts, ablations don,t appear to be anyway near as successful as the 95% claim suggests. How long does one have to be free of A/F before it is classed as a success?

[BobD Volunteer]

I think that is after multiple procedures to be honest. Mine took three but I have been AF free for nearly seven years. That is a success to me. It also depends on which procedure . eg Cryo has a good results 80% on firsts attempt according to Richard Schilling but as I said recently this is where it is simple AF with only the four PVs firing off. More complex electrical disturbance may take more work and RF to touch up other areas.

[Tricia239]

My Consultant told me the success rate is 8 out of 10. I assumed that meant a complete recovery.

[paulh1]

Depending on what type of Afib you have the success rate will vary. I have Paroxysmal Afib. My ep told me success rate was around 70%

[SRMGrandma Volunteer]

When I asked my EP 6 months post ablation, whether or not we could call it a success, he answered "every day without AF is a success, let's just say that." I know that doesn't answer your question but it is the truth, and he makes a great point.

[PeterWh]

Look at the October 2015 patient day slides. Success rate is higher for paroxsymal rather than persistent AF even after multiple procedures. At the end of the day too much emphasis should not be put on success rates because otherwise some EPs might be encouraged not to treat the more difficult cases.

[Kodaska]

My first ablation was for a-flutter, done in spring of 2014. I developed paroxysmal AF and a cryoablation was done a year later. I've had zero breakthrough arrhythmias and at my 6-month checkup everything looked good. Dr Cardio said I can consider the procedure a success if there's still no AF-related activity after a year.

It's possible AF can return, but it won't be in the area that was ablated.

[PeterWh]

An analytical approach (which won't suit some).

I have not seen a duration over which the success rate is measured. The percentage success rate will be higher the closer to the procedure you do the assessment. For instance if the measure is at the time of the procedure it will be the highest then if at 3 months it will be a bit lower and then at 6 months a bit lower still, then continuing to diminish at 1 year or 2 years or 5 years (and so on).

Also do some EPs do the measure including patients taking medicines after an ablation (which increases the % success) and some others not.

AT the end of the day you would have to have a very clearly defined and tight set of rules / parameters and measure over a few years so that oranges and apples are not being compared.

I general life we have all heard the saying "lies, damned lies and statistics" (I am NOT saying EPs are lying). Wikipedia definition at

en.m.wikipedia.org/wiki/Lie...

[MarkS]

Are you sure the 95% success rate was for atrial fibrillation rather than atrial flutter? The latter does have that success rate and it is a much simpler procedure,

[mullikg2 in reply to MarkS]

Thank you Mark S

Yes the 95% figure is for Atrial Flutter but the claims of 70% for Atrial Fibrillation still seem high and because there is no definition of what constitutes a success perhaps it would be less misleading if quoting percentages were avoided.

[MarkS]

Yes you're right, there isn't a definition of what constitutes success. Some people have tried to set up a definition but it doesn't appear to have caught on. I think 70% can be achieved by the really top EPs such as Richard Schilling, I had a close look at his figures. However for the majority of EPs it's closer to 40% success after the first ablation and possibly 70% after a second or third.

[Dadog]

SRMGrandma is right in that it is hard to quantify success. It is what it means to each individual. Personally, I am happy so far with having a cardioversion every year or so. It gives me a good quality of life between AF episodes. Things may change. They may not. I shall stay mentally positive. maybe, in time to come, they may come up with a positive 'cure' for the likes of us!

[Hidden]

Just watched the Professor Schilling video kindly posted here. He is one of the 'A team' on ablations and for non complicated cry ablations he is now quoting patients 80% success - that means no AF and off drugs.

I have postponed an ablation for two years but that new success rate up from 70% is getting me interested.

[Beta44]

Prof. Schilling told me, after successful cryoablation that his success rate for PAF was greater than 80%.

Peter

[PeterWh in reply to Beta44]

If he used the word PAF then that means paroxysmal AF. The rate for persistent AF is lower.

[Beta44 in reply to PeterWh]

Exactly!

[PeterWh in reply to Beta44]

I knew you knew that but unfortunately some people on the forum don't and think that persistent AF is also PAF !!!! (which as we know it isn't).

I have also known people think that occassional "anxiety" flutters are permanent AF!!!! Wish it was!!!

[PeterWh]

That only relates to flutter and not AF at all. Paroxysmal AF has a higher success rate than persistent AF. Flutter has a higher success rate than paroxsymal AF.

[Beta44]

Yes, I was treated for paroxysmal AF so the cure rate for persistent was not discussed. I think, but don't know, that he must use cryoablation on all paroxysmal patients unless there are issues preventing this as it is a simple highly successful treatment leaving a small minority needing a top up procedure.