Two Ablations and sadly AF returned...

[Swale]

I had my second ablation in Feb 2015 and everything went well. I get the odd ectopic here and there but nothing major. Then yesterday after 15 months of being AF free I was disappointed to wake up in AF . Although it felt mild it was still out of rhythm, took my 200mg of Flecainide and normal rhythm returned.

My question is how many times can you have an Ablation and is there an average amount of times before it has a lasting effect, I appreciate this is not a 100% cure but wondered how many times I can try?

[BobD Volunteer]

My third was eight years ago and whilst I have very occasional atrial tachycardia and do have ongoing ectopics no AF as such. It really depends on your EP if he thinks he can get in there again with all the scar tissue.

[Eliza2 in reply to BobD]

Hi bob, what do you consider occasional?

[BobD Volunteer in reply to Eliza2]

Very occasional extremely short bursts (less than five seconds) and one in eight years that needed DCCV. Atrial tachycardia is a regular but fast heart rate where the signals are coming from the atria Sometimes called I think SVT. See AFAssociation website for more details.

[Swale]

Thanks Bob, what actually is atrial tachycardia if it's not to hard to describe 😊

[Barb1]

My 4th was Feb last year. EP said he will do no more.

[Swale in reply to Barb1]

I hope that was the one that sorted it for you 😀.

[Barb1 in reply to Swale]

Thanks. Not sure what happens when/if I go back into AF. Still on all medication

[frenchgoose]

Oh I do feel the same disappointment as you do!! I had second ablation in 2014 and apart from ectopics of various types, had just got my life back, confidence and travel Planned. Then wham, I woke up last Tuesday during the night with AF, A Flutter, RBBB and heart rate of 150 ish. I was like this for 14 hours and while waiting for cardioversion in hospital, it went back into normal sinus rythm. Had lots of tests in hospital in Leeds and angiogram which was clear, so third ablation planned for end of July. We all spend hours wondering why it comes back, what could we have done to stop it returning.... But that's the nature of the beast. It takes me months to recover from an ablation so not a happy person right now.

[Swale in reply to frenchgoose]

Hello frenchgoose, I know how you feel. I had gone 15 months AF free but had the usual odd ectopic. The ectopics were becoming a bit more frequent last week and then on Thursday I woke up with what felt like mild AF (if there is such a thing) I wasn't getting the huge pauses and erratic beats , it was just out of rhythm. I'm going to wait a little while to see if I get anymore before I see my EP again.

I recovered fairly well from both my ablations but could just do without going through it all again.

How long were you AF free?

[frenchgoose in reply to Swale]

Hello

It is strange how the ectopics become more frequent before the AF beast comes back...I suppose it is those rogue ablated connections being reconnected. I hope they have not been troublesome anymore!

It is just so hard when life had become normalish again, to have to go through it all again. Maybe 3rd time lucky for me....where did you have your ablations done? I am also going to ask about cryoablation this time.

I now have to live with wondering when it is going to strike again, until the next ablation. I am on the floor and unable to function when I get these AF/A Flutter/RBBB/tachy events.

[Swale in reply to frenchgoose]

Yes I'm also wondering when I might get another episode , just hope it's not too soon. When I get AF I'm not in any discomfort, I'm just very aware of an irregular heart beat.

I had both my ablations at Harley Street.

[frenchgoose in reply to Swale]

We can just enjoy each day being AF free.. I am so happy to be back home and I know my cat has missed me!! I see my EP next Thursday as a follow up to all that happened last week and he has booked the ablation for end of July.

[Swale in reply to frenchgoose]

Good luck with your next ablation, let's hope that three is the lucky number 😄

[frenchgoose in reply to Swale]

I keep telling myself that!! Thanks!

[Eliza2 in reply to frenchgoose]

Yes an ablation certainly can take a lot out of you. I had one last September and feel I just got my strength back and think I may have to get another . It is a daunting thought. And yes I have spent many moments questioning what I'm doing or have done or will do in relationship to afib etc. yes.....upsetting to say the least.

[Jason71]

I'm so sorry to hear your AF has returned Swale. After having recently had a 2nd ablation myself I'm hoping for some AF free time (Without taking meds to control it). I would be delighted with 15 months and if it was to return and my medication pulled me out without too many symptoms, I would be happy with that too. Can I ask did your life return back to normal during these 15 months? After my 2nd ablation the EP did say they thought they hit all the right spots, but if it was to return, I was to consider another. Fortunately the recovery time for me was a couple of days for both, so I'd gladly hop on the table again.

I hope it was just a blip Swale and here's to another 15 months of AF free living for you.

Take care,

Jason

[Swale in reply to Jason71]

Hello Jason, yes everything went back to normal and I even got used to the odd ectopic.

My EP also said he thought he hit all the right areas too and as time went by I thought so too.

I'm going to see how I go before getting in touch with my EP. Hope you stay AF free 😀

[KipperJohn]

I suppose the number of ablations must differ from patient to patient and the advice given. I had my second 5 weeks ago and my EP had said he won't attempt a third as it will be of no benefit as he has treated everything he could find - which was not a lot. At least I know where I stand and if PAF should return then presumably will have to rely on drug therapy - which incidentally has not yet been reduced. I understand fully the depression that goes with a return of AF - but having lived with it for 6 years now I try to look upon every period without it as a positive.

I once worked out that my actual episodes totalled about 0.02 per cent of actual living time when it seemed considerably more and rather puts it into perspective. I was averaging about 18 hours AF once a month. In between bouts one tends to worry about the next one and so it's easy to get into a loop of anxiety, rather than focusing on enjoying those AF free periods.

Easier said than done but I don't see a lot of alternatives.

[Swale in reply to KipperJohn]

Thanks Kipperjohn,

I know exactly where you're coming from with regards to worry and anxiety. I try not to , and for the last year I've been pretty positive. Just hope this little blip doesn't set me back.

Cheers.

[KipperJohn]

15 months without an episode sounds pretty good to me although I take my age - approaching 69 as a factor. Hopefully it is only a blip - do you still have access to an arrhythmia nurse? Perhaps a chat with someone like that who knows your case and understands AF would be better than a visit to your GP. Just a thought.

[checkmypulse]

I feel your disappointment, I know how it felt when my AF returned after the first procedure, second one coming. My EP has said he only does a max of three. Must ask him if that is 'set in stone' or there is any flexibility depending on patient.

[PeterWh in reply to checkmypulse]

There is no national set in stone number as far as I am aware of and there are a number of people on here who have had more.

[checkmypulse in reply to PeterWh]

Yes I am aware of that. Sorry I meant I will ask him why HE say's he will do only three. It makes more sense to me, as a layman, that it would depend on the patient and the the outcome of their previous procedures. But what do I know?!

[PeterWh in reply to checkmypulse]

OK. I read it differently. Yes I agree with you. In my view some might be one max, others two. He maybe basing three on his experience or research not published or the CCGs view or diminishing returns. The only way as you say is to ask.

A suggestion as to what I would do is to write a dedicated new post. Suggestions.

Title. Who has had four or more ablations?

Body. My EP has said that he does a maximum of three ablations but I don't see why as I believe that the maximum number ought to be tailored to each patient.

Please could you respond ONLY IF you have had four (4) or more ablations and indicate success or improvements. Thanks.

[Swale]

Haven't heard of that Aufgeblassen, but think if I have to I would try one more ablation first. Then maybe look into the pacemaker type device.

[Melleray]

Hi - So sorry to read that you had more AF after such a long free period. I have had 5 ablations. and still have PAF. My cardiologist said he cannot do more and I agree... The first two were cryo procedures, but then three radio. So now I am left with this condition which as others have said, causes underlying stress, as I never know when it will strike, so cannot really do things I would like to. But that is the way it is. Regarding the pacemaker option someone mentioned. The only pacemaker that will normally help is when the AV node (your natural heartbeat) is ablated and a pacemaker inserted to beat your heart. You are totally dependent on this, which I find scary. Also, my cardio has told me that it is not a cure, but should be a last option resort. The atria continues to fibrillate as it always has, but the heartbeat is more controlled as the atria is bypassed, however, if you suffered things like breathing difficulties when in AF before, then this may continue, which is not a good outcome.