Success Rate of Ablation on this Forum

Hi,

if you are planning on having an ablation in the next few days, I suggest you do not read this.

I did a sort of personal survey to keep my morale up when I first got here a year ago concerning my own ablation (in March 16) and put down all the names I found in posts reporting successful ablation.

I now checked my list after one year and found that very few still are AF free and can claim a successful ablation. I found BobD of course, and Japaholic. Besides ihm , there is Beta 44 left on my list and SRM Grandma. Cannot find pip-pip and SweetA or GregNdonette?

A lot of the rest, for ex. Barb, lallym, CDreamer, Missyj55 are back in AF.

So how can doctors claim success rates of 75 to 95%?

I DO understand that people are more likely to come back here and "complain" when in AF again. But most people stayed here for some time after ablation, or came back in between for a message, so what would have happened with success would be at the utmost that I could not find them.

Just four successes (and BobD had to be cardioverted 4 times after ablation for tachycardia, so does that count as success?)

For me success would mean nor more AF plus no new trouble like a lot of ectopics f.ex.

So four people of this whole forum over years and still ablation is very much recommended here. I want to understand, so can someone please explain to me. If those numbers were put before me in any other context I’d say do not do this thing, whatever it is.

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  • You answered the question yourself. Few if any of the successes stay around here other than we few dedicated volunteers.

    Success for me is no AF for over nine years. Add in the fact that had I still had AF it is very doubtful that I could have had the radical prostatectomy which saved my life. I would no doubt have been fobbed off with radiotherapy which alone would not have killed everything off so that's about five years I would not otherwise have had. Forget other arrhythmias as they are small beer by comparison. Remember also that ANY treatment. for AF is ongoing and may need repeating.

    Consider also that there are probably a million people in UK alone with AF and maybe 50,000 ablations done here each year (my guestimate) so the 7000 odd worldwide members here hardly give a realistic overview of reality.

  • I have been successfully AF free thus far even after enduring a massive PE days afterward. Now 5 months out I am back to near normal and drinking coffee and light alcohol and off ALL drugs pertaining to both issues. 61 and healthy!

  • As far as I can see, success is a relative term and may be interpreted in so many different ways. Your definition is super and would be everything that we would hope for, but I think such success is many years - if not decades - away and probably will be determined by a totally different approach to the arrhythmia.

    In articles which I have read, various EP's determine success in terms of 1, 2 or 3 to 5 years free of AF. I would rate success - if I ever go down that route - as regaining a good degree of quality of life, even if that means using drugs (hopefully at a reduced level). Incidentally, my EP is quoting a 50 to 60 per cent chance of success on first ablation, rising with repeat procedures for AF.

    I wonder if the claims of 95 per cent refer to the physical success of the AF ablation procedure itself, rather than its effect after some years? I have been quoted a 95 per cent success probability for AFlutter ablation, should I need it.

    In looking at the success rates of AF ablation, there are so many variables that I found it impossible to form a clear picture and I agree with previous posters that this forum doesn't really give an unskewed sample.

    Thank you for raising the subject - it's one that has caused me a lot of thought over the last years and I decided to follow advice from a cardiologist who has AF himself who said to me 'you'll know when it is time to seek intervention'.

  • I've had three ablations and still have AF occasionally. I'm pretty well where I was about 7 years ago - and highly delighted. I don't consider the treatment a failure at all. It may not have achieved the primary aim, but without it I think I would be in a very different position and probably with permanent AF and perhaps taking a lot of medication. As it is I take the blood pressure medication (Atenolol and Losartan) I've been on for 15 years and Rivaroxaban. I have Flecainide as a pill in the pocket. I've taken it once (100mgs) so far this year. I am hugely grateful to my EP for what he has done for me.

    But I do think I would have been much better and perhaps AF free if I had had the second ablation a few years earlier and I regret letting things slide and taking a lot of Flecainide for a long time.

  • Hi. I had an ablation in April last year. I had a bumpy ride for a while with a short burst of af two weeks later and a fair amount of ectopic for some time. However since March my heart has been very happy and I have been very happy too! I have been remiss in not posting positive posts but I honestly am so pleased I had an ablation and would have another in a heartbeat if needed. It has really given me my life back and I am so grateful.

  • Still here, still AF free, I just got my life back and less time to be on forums

  • I fully support Bob's view.

    Statistics state that 80%+ of ablations are successful.

    Add this to the fact that it highly unlikely that those with a successful outcome would join our forum makes doing a survey of our members to measure how successful ablation is, is quite frankly flawed.

    We are a forum for those who have AF not for those who have had it treated successfully.

    Finally if ablation were not, on the whole, a successful procedure I do not think there would be either the funding nor the vast resources that exist both in the NHS in the UK and the wider world.

    Take comfort all those who have ablations planned.

    Pete

  • The 80 % -is that first time procedures - and how far out in time ?

  • Yes first time procedures.

    Not sure on time but the main point I made was that the majority of successful patients don't hang around here or even visit our forum.

    Pete

  • that looks on the high side

    stopafib.org/catheter-ablat...

  • There are numerous sets of data available but I repeat the vast majority of ablations are successful otherwise the medical profession would not have such an extensive network of cath labs doing ablation procedures on a daily basis.

    Pete

  • as I have posted before the biggest factor in success rates is who carries out the procedure.

  • Totally agree. I have managed to work my way through 4 EP consultants all of whom were brilliant but my current Consultant wins the prize for not only skill but also for first rate communication skills.

    Pete

  • Only five months post ablation but (so far) no AF episodes Cutting down/cutting out meds and changed lifestyle to reduce stress, beginning to enjoy life again. Keeping busy, currently on holiday in Greek islands and working at Glastonbury festival next month (albeit alcohol free) so not much time for posting! Long may it last but would have another ablation in a heartbeat if needed.

  • At risk of tempting fate, except for a brief blip I have been in SR since 4th ablation Feb 2015. Still on all meds.

  • I had my ablation in Nov 2015 and had a few brief episodes in the following weeks and ectopic for a few months but since been AF free. I'm back to running and cycling. The ablation gave me my life back. Bob is probably correct the successes don't return. They probably feel they don't want to be reminded of the AF too much

  • We'll, you missed mine, then. It took two (and often does to "clean up" the first one), but so far so good. Only the occasional flutter and ectopic, but after persistent AF, I would call that and no meds a success!

  • Actually, i had my ablation in November 2013 ( you mention me in your post) and with the exception of a few very short episodes (minutes not hours) i am in NSR. If ablation is about control of symptoms and improvement in quality of life, then mine is a success. Going from 4 or 5 episodes per week, lasting 5 or 6 hours leaving me exhausted to a life where i can walk, dance, garden and do all the normal things for my age (68) is a real achievement for me and my EP.

    I would wish the same for all if my fellow sufferers!

  • To me, ablation "success" is like the airline "on-time". One can adjust the time frame to be a "success" or be "on time".

    My EP told me 60% of ablation "success", which to him means AF free for 1 year post-ablation.

    Not compelling enough for me when I look at ablation procedure risks, but as has been pointed out on this forum much, it's ultimately a personal decision.

    And while it's likely true that for those who ablation is a "success" do not contribute to the forum as often/at all, there are those who no longer look at/contribute to the forum for many other reasons. So one can't assume that all who stop looking here after ablation did so because the ablation made them afib-free.

    PS - one more item: the ablation procedure is a highly profitable one for the providers and hospital, at least in the US.

  • Not profitable in the UK for the NHS and they are trying (unsuccessfully) to peg costs and would surely minimise these procedures if they felt it was not worthwhile.

    Pete

  • Open heart surgery 22 May 2014 for valve repair - successful but heartbeat still erratic

    Ablation for atrial flutter 22 Oct 2015 for atrial flutter successful - no more sawtooth ecg

    Autumn 2017 off on a 8 week cruise- came back with very sore throat. My doctor prescribed anti histamines, cured the throat inflammation, but the Afib returned , however seems to be slowly fading away as I have stopped the anti histamines.

  • Before my ablation, success to me meant no A.F. and no meds other than anticoagulants despite my E. P. Telling me that the procedure would be classed as success if I was on reduced medication and A.F. free. I really thought I would be one of the lucky ones. The main reason I had the ablation was to give my poor liver and kidneys some free time! I expected it to come back at some stage but thought I would simply have another ablation.

    The reality? Well, the procedure was partially successful which meant I could have less antiarrhythmic drugs.. A further ablation was abandoned due to a rare complication and it is unlikely that I can have anymore. However, all that said, I am still in a much much better place than I was before and I am glad I had the initial ablation. What will happen if the flecanide stops working I really dont know but I am learning to live in the moment. Afterall

    I have already lived a lot longer than the victims of the Manchester bomb. X

  • I did my first ablation in January 2015. Seven months later another was done to fix a small "leak" that was causing occasional bouts of AF. Since then no AF and life is great! I would be on my back ready for a catheter if /when the AF returns. I'm 60 years old and being active is important to me so I said "NO" to meds and the EP said "Okay" and here we are 20 months later - in NSR with no meds. Good luck!

  • Thank you all very much for your replies. I value your thoughts and opinions very much. So grateful for such a lot of input. Will gladly come back and discuss later on, but actually we have terrible heat in Germany and I suffer from it.

  • You missed me, how could you! 😮

  • I'm just a month+ in and have no opinion on success. My af was very very infrequent so no way to tell. However, I am taking reasonable exercise now and the migraines that followed my ablation, 2.5 weeks, have gone.

  • Professor Schilling has his results fully audited each year and the figures are published on line. He has 78% first time success with ablation for PAF.

    Peter

  • Where are these figures published? I would like to check out my EP.

  • So far as I know Prof. Schilling is the only EP to have his results audited and published. You can find them here:

    londonafcentre.com/wp-conte...

  • Thank you. This makes the survey appear quite different.

    The reason I missed some people was that it was a random list I made. Every time I found a post from someone with successful ablation I noted it and the time gone since ablation. And i was rather shocked to find out one year later that a lot of them (of the few I had found) were in AF again.

    I had such a bad time after my first ablation and ended up so frightened after four horrible weeks resulting in cardioversion, frightened that I would have to spend the rest of my life in permanent AF, which with me means pulse over 100, because they just cannot get it lower (three days in hospital, still no good), so just a question of time until heart would give up. I am now back to PAF. And was pretty sure I would not try again.

    So I needed that, thank you.

  • I am now 12 weeks on from my 6th ablation and so far only some episodes of fast rate and one short episode of AF. I am feeling better every day.

    Hope your heart settles down.

  • I don't think it's fair to base any judgement about success or failure of ablations on the random self-selected group on this forum. How many people are in our group? How many ablations are performed every year?

    I know 3 people who've had an ablation and never had any more attacks of AF, but they have never posted here. They don't use the forum and have never heard of it. I will be having a second ablation as my AF has returned. Fingers crossed I'm luckier next time. I can't wait.

  • I do not think it is a question of fairness.

    Yes, of course this is a selected group. But there is no other place on the internet where ONLY people with AF gather and exchange information. Plus I value information from this forum above the information given out by doctors. Their statistics can be easily manipulated. There are complete books on how to manipulate study results. And before having my ablation I read studies which explained that the positive results of ablation were "dressed up" and the real amount of successes were much lower.

    Plus I only found out AFTER my own ablation that any sort of new ectopics were not considered a failure of ablation. So my ablation failed because I still get AF, but even with the sort of bigemini I constantly had 24/7 in the first four weeks (besides the AF) life and work were impossible. But the ablation would still have been considered a success, even though it would have rendered me very sick, if things had stayed that way. That makes me mad and very distrustful of statistics.

    Did the three peope you know really have an ablation for AF? People tend to mix this up and for ex. ablation for WPW syndrome, which I had successfully years ago, is often confused with ablation for AF, but it is much easier and more often successful.

    My mother, sister and I had ablation for AF. Not one success. Mother even twice.

  • Interesting and I understand your scepticism. I'm sorry about your and your family's experiences. I hope things settle for you ( and me!) I often wonder about this myself. Anyway to answer your question ....The three people I know absolutely had AF not WPW syndrome. No question. I was speaking to one three days ago and she had the ablation in Jan 2016 and has had no symptoms since. One other I spoke to a year ago and he'd had no AF for 3 years.

    I am one for whom it didn't work first time, but I don't get on with the drugs sadly. So I hope its worth another try. However I find BobD's reasoning about forming a judgement based on this forum is convincing.

    Best wishes

  • What do you make of this? academic.oup.com/eurheartj/...

  • Hmm, just ran over it quickly. So only about 60% had an ECG at all and not all of them several days. And so who decided for the rest of 40%? I am highly symptomatic, my mother was never sure, neither is my sister. So they could not tell for certain if AF still on.

    Plus who filled in the control results after 12 months? Patients or the clinic? Is that mentioned?

    And for the rather young patients (or did I read wrong?) a bad lot of complications....

    Still not sure whether I will go again...

  • I haven't been on this forum for a while since I had my ablation back in February and have been afib free since. I had a very easy go of it. Doc took me off anti-coagulants last month. I'm exercising 4 days per week and feel great. I get an occasional ectopic now and then but very infrequently. I would count my ablation as a success, at least so far. I still am very careful with caffeine...will only have a decaf occasionally because I don't want to take any chances. Don't really drink alcohol so that's not an issue for me. I would do it again in a heartbeat and I'm sort of mad at myself for not doing it very early on...it really was impacting my life both physically and mentally. I feel nearly "normal" once again. Just wanted to check back on the forum to see how everyone was doing because it was a great resource for me.

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