AF Association

Is it important to return to your original EP if you need another ablation?

4 years ago my EP told me my ablation had been a combination of what he usually did in 2 stages. I guess he meant if the first procedure did not work, so he presumably thought I would need a redo anyway.

The signs are that I will need a second ablation. Only now we have moved 200 miles away. I have confidence in him but it will be quite a performance and possibly expensive to decamp to London for several appointments.

So two questions.

1. Has anyone had a redo with a different EP? Were they reluctant to ablate where another EP had been before?

2. Would I rapidly become persona non grata if I asked the local EP whom I hear is very good, to do my assessment and the relevant investigations, and then if I needed a redo, ask him to refer me back to my original EP.

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I have had ablations by 5 different EPs.

The last was the best but the others were not far behind him.

It is touching up not so much a redo when you have subsequent ablations.

Pete

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Ah I see. So were your touch ups fairly brief and therefore under sedation rather than GA?

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No they were not brief.

I have had 6 ablations for AF and one for Tachycardia which was a 'good' development from the 6th AF ablation.

I am now 6 months into AF free life, 3 of which were in Tachycardia. Taking each day as it comes of course.

My last 3 AF ablations and my Tachycardia ablation were all under GA and on average took 5 - 6 hours each.

Don't you worry "It's just a little pin prick there will be no more Aghhhhhhh" (Comfortably Numb).

Full of encouragement me.

Pete

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Well you've definitely got the T shirt. Because you gave the EPs a good report, I imagine you had no complications from the ablations.

Is it widely known here that serial ablatees like yourself see the procedure as routine?

It would be a source of much reassurance to weak kneed badgers and the like.

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I don't think I would go quite as far as that. My knees are weak too.

On the level of relativity then I can say that I got to the stage where whilst I was scared and counted down the weeks, days, hours and minutes prior to my procedure I had great faith and confidence with the EP I now have.

The great caveat is that he is a good communicator even phoning me to see how I was after the event.

The whole team put me at as much ease as could be given in such circumstances and I often say on this forum that the success rate for abation is much higher than a casual reader of this forum might believe. They say 80% are successful.

Therefore I was of course part of the 20%.

I don't know the long term prognosis for me but I do think that I really had to trust them as they do not occupy about 10 professionals with me on so many occasions without some belief that they would be able to make my quality of life better.

My QOL was awful in PAF and now except some Ecotopics I am better than I have been for years.

My advice is research as much as you can and then write it all down and then when you next talk to your EP have a full and meaningful conversation. After all it is your body they are invading and you have a right to know the ins and outs of what is going on.

Don't be fobbed off and do your best to be treated at a centre of excellence rather than any other location.

Hope that helps

Pete

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Badger25 I would say to discuss it with both EPs, you can never have too much information. Approached openly, if an EP got uppity about such as discussion, I'd have said that's a reason for not using them! There might be technical issues around your particular case, the two EPs might use different techniques (RF vs cryo, different mapping, etc). In my case I had to go back to the same EP as that what all that was around at the time (early days when very few centres did it), plus we knew that my first zapping was incomplete due to my cardiac anatomy and the need to change catheters and what would have become an overlong procedure. However, I would have gone there anyway. HTH

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Thanks John. I hadn't factored in the technical aspects. Of course the local EP may prefer not to get involved, which would be fine too.

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I had my first ablation at Wythenshawe Hospital and subsequently patients in Cumbria were allocated to Blackpool instead. I was slightly miffed until I met my new EP and I have been happy to change. He has had access to my original notes it would seem. The first ablation was fairly brief - they had not been aware that I had AF - and the second one (in Blackpool) was more significant. I had a touch up about 18 months later.

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Thanks Rellim. I'm getting a picture that as long as the EP is on top of their game, it's not a problem switching

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That's a very good point - the skill and experience of the EP is paramount.

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I haven't had an ablation but think, as in Relim's case' it would be wise to ensure the new EP had access to your notes where any specific problems would have been recorded

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That's a good point, thanks.

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I had 2 ablations in the space of 9 months, at the same hospital but by 2 different EPs

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That's a surprise. May I ask how that came about? Was it a problem ? Thanks.

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After the 1st ablation I went back into AF after 2 weeks and at my 3 month check up AF was raging. So they told me I needed a 2nd ablation, so booked me in with the next available EP.

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Ah that makes sense. Thanks Millie.

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My original EP who performed 2 ablation referred me to a colleague of his who had recently moved to my area, purely because of the reasons you give regarding logistics.

I really don’t think there is any problem at all changing EPs.

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That's very helpful CD. If my original EP suggests it would be sensible to see a colleague up here in Yorkshire and recommends one, that will indicate he sees no problem switching EP, like yourself.

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