Can ablation cause scarring in a health LA

[deniseas]

Hi,

I had an a lagoon in 8/17/17 and a second one on 1/24/18 bc I had symptoms. The first on had my P. Veins a latex, a path of scarring in the right atrium, a regular cycle and an atypical flutter. All in all I think Three sites or four were ablated. However, the good news was that there was no scarring in the LA where there were some flutters a latex.

However the secon ablation presented my La with heavy scarring and moderate scarring. I am worried bc the scarring was not there only 4 or four months ago. I will have to be on medicine always now.

My question is did Long and lengthy first ablation cause this scarring and will the scarring continue to worsen my condition even if I am on the medication. I had a choice to go on the medicine but chose the ablation bc originally they thought I had a very good chance of success bc by testing looked so good and I am 63 and had bouts infrequently. I also chose to do the ablation because some of my bouts raced my heart up to 250 beats a minute which pretty much incapacity do my with dizziness and the ablation would slow the beats down.

I am concerned about the rapid deter action of my LA and wonder if it will continue or if it will get better.

[rosyG]

Don't worry- ablation does cause scarring but it's meant to do this. The scars stop the electrical signals going in directions they shouldn't. Sometimes the scars heal and a little gap appears and people get a little AF again and these gaps have to be re-done. Fibrosis caused by AF itself has a good chance of healing up when ablation works and stops the constant AF

Good lick!

[deniseas in reply to rosyG]

Yes, the doctor did make intentional scars and they worked. He did this in several areas. But the other scarring is patchy scarring that is causing more arrythmias and are causing an electrical cycle that is unpredictable and he cannot map and fix. I am afraid it is fibrosis and wondered how it can come so quickly. I am hoping it is just irrational that will go away but I think he said it is fibrosis and this caused more arrhythmia so that he can not capture because the electrical signals bounce off the scars differently. So I am very upset and just wondering if this kind of scarring ever get better . I am afraid it increase. Iknow he said it causes more arrhythmia so amd that is why he cannot take me off the medication even with all the ablations he has done.

I wonder if anyone out there has a similar problem amd if it can be controlled. My afib comes and goes amd I am worried that if this progresses I will lead to constant afib

[rosyG in reply to deniseas]

I'm sorry to hear he was unable to map this- it's not necessarily new - they may just have not noticed it before.

See what others suggest on here- some have had several ablations until things worked properly

[deniseas in reply to rosyG]

Thanks. He said he would not recommend another ablation bc he did so many areas the first time and bc this one flutter is so atypical that all kind of triggers from everywhere excite it. He has ablated Atwood typical flutters and a patch of fibrosis in my RA successfully. He said he would only go in again if the saw a predictable flutter. I think he has ablated so many areas that he has no more space to work with.

[rosyG in reply to deniseas]

I hope this changes over time and something can be done- re your other post, AF won't affect your life expectancy if you keep as fit as possible and are anti-coagulated. Also some of the AF has been dealt with so it should help

[deniseas in reply to deniseas]

Thanks so much . I really appreciate it.

[pottypete1]

My understanding is that there are two types of scarring.

The scarring caused by the ablations is therapeutic scarring. The purpose being to interrupt the chaotic arrhythmia thus reducing or stopping the AF.

The second type of scarring is caused by the actual AF itself after time. There is nothing that can be done about it.

I have both types and since my last ablation my rhythm is more organised albeit I have severe nausea from time to time mainly associated with ectopics. Better than AF all the same.

Pete

[deniseas]

Yes, I am worried that I will not be able to be controlled because of the scarring that comes with the afib not the ablations. Thanks so much for the reply. I just learned my la which had no scarring in August has heavy scarring now and bc to that I must always be on medication even though I had extensive ablation. So I am just in shock as to why it can progress so quickly. Plus I am worried about life expectancy if they cannot control it I am only 63.

[Spoiler]

I just had a partial ablation on Jan. 05, they were only able to complete the 2 left pulmonary veins And 1/3 of the 3rd right pulmonary vein. I developed cardiac tamponade and it was stopped. The plan was to be off of meds, but after the surgery the EP said I had a lot of scarring in the left atrium, it was not expected. I am waiting for the 3 month follow up, I was put on flecainide 50 mg every 12 hours. I am not sure at this point if they were attempt to finish ablation at a later time since they found extentsive scarring😞the good news was a normal size heart which had been enlarged, ejection fraction 55%, and great coronary arteries. I am 62 and otherwise a healthy nonsmoker. Apparently my beggining with this 4 years ago when I had just a cardiologist that was not aggressive and allowed me in 100% afib at a high rate for over 3 months took a toll on my heart. I should have seeked another Dr. I have persistent afib that requires DC cardioversion (11 DC cardio versions in 4 years)(2 with drugs) tikosyn caused a cardiac arrest second dose, my heart rate went to 33 NSR converted on tikosyn.

[deniseas in reply to Spoiler]

Good to hear your heart is strong. I think I had quick bouts of this most of my adult life but they could never see it on a monitor. I had pacs for about 13 years but the cardiologist said they were not a bad thing and I was on metropol only bc of their feeling . Always had normal ekg every year then. In fact when the monitor did show an episode doc thought I had an Avnet which could be corrected. Pior to that I went to him bc pc suggested it bc I was short of breath. Cardiologist sad I was fine and questioned why I even came. I thought I had asthma. Ep was shocked to see all the hot spots bc prior testing looked healthy. Thanks for the reply. I appreciate it.

[Spoiler]

I have always had a slow heart rate and pvc’s. Saw a cardiologist over 30 years ago for them, drugs were tried but did not work. I dropped it and just was careful about caffeine and resting more. Strangely as It might seem, I saw that same Dr 30 years later in ER in full blown afib and rate of 230. He said, you just have a bad electrical system as nothing else is wrong with your heart.

[deniseas]

Yes, I know what you mean. My other heart test came back good. So we should be thankful for that. I used to drink too much coffee never knowing that that was bad so I am sure that did not help.

[Hidden]

deniseas

So this is in answer to your post to me in another thread on 1st February. I think you must be in the USA and because I don't understand the healthcare system there I may get this wrong. I can not give you a medical opinion, or advise you about treatment because I am not a licensed doctor.

The first thing that strikes me is that you already have a lot of medical knowledge and are well informed about your recent procedures. You say you are depressed and you give the impression of being anxious.

Your anxiety centres around the fact that your LA was apparently healthy at ablation 5 months ago and scarred at second ablation 1 month ago. It appears you had a different EP the second time, because you mention he did not believe the LA was normal the first time.

So one way to resolve your immediate concern is to talk to your GP as we would call them, essentially a generalist primary care physician. Ask for a print out of the findings and interventions at both procedures, to ascertain whether you are correct about the changes in your LA between the procedures.

This could lead to a discussion about possibly seeing your EP again to,plan your care from here on and whether you should be taking an anticoagulant if you are not already doing so. Also how to address lifestyle cofactors in AF, relaxation techniques, vagal manoeuvres if relevant and appropriate to you. Remember too that many millions of people with permanent AF have a good quality of life, and that a relentless pursuit of freedom from AF may not always be helpful if it comes at too high a cost to our mental health, because the latter can impact very negatively on our AF.

I don't believe I can offer you any further opinion than that, and I wish you well

[deniseas in reply to Hidden]

I had the same doctor for each procedures. Right after the second procedure when he said I have a lot of scarring in the LA and a lot of flutters. Then I said , NO the scarring was in the RA and you incorporated it into a path and then terminated it. He said I must have been incorrect when I said to him there was no scarring presented in the LA In August only in the RL. He even said to me after the first procedure was done that even thought the procedure was so extensive the good news was that there is no scarring in the LA. After the second procedure when I told him that he said that he would not have said that bc all the activity of afib usually presents in the LA. Then I showed him the two OP he wrote he said I was correct about the scarring in the LA in the last procedure but did not say why it appeared so quickly.