I would be interested to know what the overall success rate is for ablation procedures for Atrial Fibrillation.
I see many posts on here where the outcome has (long or short term) been unsuccessful. My conclusions from comments by others tends to suggest that the procedure is largely a total waste of time; as it has been for me on 2 occasions. If anyone has any stats I would be pleased to see them.
Likewise, does anyone know the success rate for cardioversions.
Hi
I haven't had an ablation but have seen various figures re success rates and they seem to depend on whether you have PAF, persistent etc and they all give much higher rates success after , sometimes, several procedures.
Clinicians don't seem to think it's a cure but that it can stop AF for varying lengths of time which gives a better quality of life etc.
It also depends on how much the atria have changed because of the AF- some studies say there has not been much change even with a lot of AF whereas in other patients there is a lot of change after a less amount of AF so it's going to vary from person to person.
I'll leave it to others to give more detailed answers!
Hi mycallc
Define success?, for most people I would hazard a guess it is making their lifestyle better, and whilst that will depend on how long you've had AF other factors and illnesses, then I suspect the answer would be over 50% and probably over 75% with more than one ablation.
If however you mean cure, never to have AF again, then it's maybe 5% - 10%
Re cardioversion, again depending on age and other conditions and of course length of time you consider a success, then maybe 3 or 4 % success and they usually all younger.
If however you mean converting back into NSR then yes maybe 80% or 90% but for how long? Not many last months and months.
I've not had an ablation, but I think most people who have had one would not consider it a "waste of time"
Be well
Ian
Perfect answer, which fits with my experiences exactly. At 69, cardioversion was total failure but first ablation complete "success" for 18 months and second doing as well so far. The bonus decider for me is no meds AND normal activity, hopefully for years.
I think you must remember that success is old news. I can think of many old members who no longer post because they had ablations and no longer need to. It is only the "failures" who stay apart from me.
I had three before my AF was sorted eight years ago but worth every second. Apart from anything else I think it unlikely that the doctors would have entertained the four plus hour prostatectomy which saved my life had I been in AF. I had to fight for it anyway! When they went in they found the cancer had already spread so had to remove a few other non essential bits and even then I had 7 weeks of radiotherapy and three years of hormone therapy. Currently six monthly blood tests all come back negative at five years. Without the operation they would have missed some of the cells and you most likely would not be reading this. Ablation a waste of time? I don't think so.
Firstly there is no medical definition of success for ablations or cardioversions. Those in the engineering world would set exact numbers and thresholds to define.
Re cardioversions the purpose is to return a person to NSR. In that context I am pretty sure that tgey are over 99% successful as it is rare for people to be in permanent AF at diagnosis as more are in persistent AF. However when EPs and others arrange a cardioversion for someone in persistent they know that it is only a matter of time after NSR is restored before the person flips back into AF. The key things they want to determine are can the person be returned to NSR and do they feel better in NSR. Some people may only last 30 mins, some a few hours, some a few days or weeks and much rarer months. As for those with paroxysmal AF they will last longer in NSR. This may range from weeks / months to, in some cases, years. If years then it is more likely that a specific event or vagal has triggered the AF. Also medications may assist (eg flecainide, amioderone, etc).
Again with ablations it is very variable. Look at publication on main AFA website. For some it will work first time. Others will need multiple ones. Some will have medicines to assist either initially or long term.
As I have said before we shouldn't get too hung up on % success rates because if we do then the temptation will be to only give ablations to those with paroxysmal AF and then those only with less aggressive AF.
In support of Bob's comment in the 20 months on here there are many who were on here and then had an ablation and then they have drifted away.
I'm sorry you feel you haven't had any benefit from your ablations. I think there are different degrees of success. A partial success may not be a great step forward yet can still have a big effect on quality of life.
This seems like a useful review jaha.ahajournals.org/conten...
So many factors go into whether or not an ablation is a success. There are many variables, such as skill of the EP, overall state of health, co-existing heart disease, willingness to make lifestyle changes to increase chances of success. But as my EP likes to say...Every single day without AF is a success.
I regard my ablation in Nov 2013 as a success. It stopped my AF episodes which were occurring about 4 times per week and lasting for an average of 6 hours. I was also able to stop medication but chose to stay on anticoagulant. It may come back but almost 3 years of no AF episodes is a success (not a cure) in my book.
A study quoted on one of Sanjay's (York cardiology) videos was that if you have Lone PAF the success rate for ablations is much higher.
I think there are varying degrees of success. Some people haven't had an episode since and there are some whose episodes are no longer as severe. I think we have to realise success and cure are probably not related in the world of ablations.
I'm included in the statistics of 'success' as I had my ablation 1 year ago and am now back to doing the things I couldn't have some before the op. Success in getting my life back. Sucess in coming off all medication. Success indeed. Live in hope not dread.
I've had two RF ablations and one Cardioversion. None have worked at all. I'm now booked in for an AV node ablation as I have exhausted all of the medication regime. For the last four months my pulse has been fluctuating between 95-110 resting. I'm normally around 60 etc. I have both AF and A Flutter. I go in and out of both all day and night.
I never went into an ablation with the thought of a cure, neither was I ever given the possibility of that outcome by the EP. However, the alleviation of AF to a manageable level is fantastic and totally liveable with. Three ablations later, all done in ever increasing 'strength' and I have reached this point. Is it worth it - a very definite yes.
Not sure where you are coming from but ablation worked for me 100%. I had three, and the third has lasted 2 years. Changed my life. Cardioversions only lasted short time.
Sorry they have not worked for you, so far.
Phil
When I am in SR I have better quality of life, able to have other procedures without sending the anaethetist into apoplexy and am immeasurably happier. Ablations a waste of time? No way!
Interesting comments from mycalic (is ablation a waste of time?), and beancounter (complete ablation success - 5 to 10%). I can throw in my two penn`orth by adding that two ablations I had for A.Flutter were a complete failure. There can be no-one who suffers from AF that doesn`t seek a complete cure. The almost euphoric relief that`s felt after an ablation always ends in a shattering disappointment if and when the AF returns again - which frequently happens. This is a fact.
Many AFibbers may already be aware of this, but there is an alternative ablation treatment available that appears to have a significantly higher success rate than standard catheter ablation. It`s called thoracoscopic ablation. It`s minimally invasive and the higher success rate is allegedly because the ablation is performed on the exterior of the heart, rather than on the inside, as in standard CA. My understanding is that it is available on the NHS subject to acceptance by your local NHS primary care trust. I can`t confirm the cost of having the op privately, but I think it would be around £17000 - £20000. Not cheap!
The person who pioneered this procedure in this country is Jonathan Hyde, a cardiothoracic surgeon based at the Royal Sussex County Hospital, Brighton. I was referred to him about 3 years ago, but my PCT refused to fund the op at the 11th hour!. I believe that there are a number of surgeons around the country who now perform the op. These could be googled.
Anyone interested should speak to their GP who would no doubt, establish whether or not your PCT would fund the op. If they would, then a referral to an appropriate surgeon would set the ball rolling.
It`s worth thinking about for those who have had a number of failed ablations, and it won`t cost anything to go through the motions.
I have PAF. Had my ablation July 11, this year. Several episodes of short afib- less than a minute, no more than 5 minutes. Normal until my blanking period is up. My afib when I had it was so wild and so out of control. No way I could live a normal life with that. It was all-consuming. I am so sorry for those who have
This. Even my small episodes while healing scare me. I am afraid they will get longer and more frequent. Just have to wait and see.
I have also found some of my triggers. Eating too much, eating too late, yelling at my husband. Sorry Boyd.
Good luck to you. Keep reading. U learn a lot here.
Here are the 2013/14 results for the London Bridge Hospital, which I believe has one of the highest ablation success rates:
network.londonbridgehospita...
To summarise, for paroxysmal AF, 69% were completely successful after one ablation and 83% after more than one ablation. For persistent AF the figures were 38% and 63%.
Complete success is defined as no AF and no anti-arrhythmic drugs after 18 months.The percentages are higher if partial success is included.
Thanks Davidgwilym - that makes interesting reading. However, the success figures for the thoracoscopic treatment is approaching 90% for 1 off treatment.
There are several websites on the subject that can be googled - typically :-
I had an ablation in May, so far, so good. EP stopped my Sotalol after 30 days. Had a few runs of tachycardia after that for a month or so. Get a few skipped beats here & there but no Afib! My episodes were getting closer together & cardioversion didn't always work so I opted for the ablation.
Many thanks to everyone who responded to my question regarding ablation success rates. Just to clarify, I am not as glum about life as my picture suggests even though my AF has lasted for 11 years. I am very positive, lead a very active life-style and am largely unaware of my permanent AF. I am able to walk 10 miles a day, play tough badminton and table tennis weekly each for 2 hour sessions and cycle a fair bit. All my spare time at home is principally in the garden doing pretty labour intensive maintenance.
Possibly, I should consider my ablations as successful as the condition rarely causes me real concern or disability. And, at my age, I consider myself very lucky health-wise compared to many friends who have suffered with the dreaded big 'C'. I would never wish to swap places with any of them !
It was interesting to read the views of others on just what success means. A successful abalation for me would have been a return to life without AF. Nothing more, nothing less.
My overriding attitude is that this is my life and regardless of my condition I will live it my way or at least as much as I possibly can within the bounds of common sense. 'Be the Boss' as I have said on here before.
Hi mycallc. I too am in permanent AF with virtually no symptoms. Because of this, and after my PCT turned me down for thoracoscopic treatment (see above), I chose to stay in AF. I`m fast approaching 80, so I restrict my excercise to walking, sometimes several miles a day. Being otherwise in good health, I live a pretty near normal lifestyle, for which I too am very thankful.
Good luck!
Hi Wilen
Well, You can give me a few years....just a few mind and I'm glad you are doing well. At our age we have to count our blessings and enjoy our lives as much as we can. I know I have to depart this planet one way or another and if it's because my heart suddenly says 'Goodbye' then that'll please me and my loved ones rather more than reaching a demise in certain other ways.
Stay well.
'Goldfish' very kindly provided a link to an exhaustive study on AF ablations. There is very much detail and analysis which I admit to not having (yet) fully read; but the conclusion below will conform with the views and experience of many on this site.
I wish you all well.
mycallc
Conclusions
'The data presented in this review showed encouraging rates of success at long-term follow-up after early experience with catheter ablation of AF. Although single-procedure outcomes were associated with significant heterogeneity, with the inclusion of multiple procedures, long-term freedom from atrial arrhythmia was achievable in the majority of patients.'
Ablation in Nottingham
HEART ABLATION...SUCCESS OR FAILURE
catheter ablation success
Ablation success stories
