AF Association
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Ablation/cardioversion

Hi all. Had ablation on March12th 2018. Still in persistent AF but early days yet. While having the ablation I also had a cardioversion, had the slight burn marks to prove it and a vague recollection through the morphine haze of hearing the EP say something about it. Got home the same day still a bit silly from the morphine so wasn’t able to ask about it then, next appointment May12th and will make enquiries then but wondered if anyone else had experienced the same and knew why it was necessary.

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I had this and would not have know about it if the EP had not told me. He said that my heart started to fibrillate during the ablation. I said " Was that helpful?" He replied " Not really."

That is the only time that I have had a cv.

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I have had 7 ablations. In the 6 that were for AF they cardioverted me each time.

What happens in the procedure is that you will often go into AF spontaneously the aim of cardioversion is to return you to NSR.

Nothing like the feeling of being in NSR after being in AF and having an ablation. Both relief and a sense of euphoria.

Pete

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Quite common I think mastiff, I recall hearing my EP saying “pace” and then receiving a bit of a jolt....I probably should have had more sedative!!

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Yes they also sometimes pace the heart to try and stimulate AF.

My last ablation was for Atrial Tachycardia. My EP told me that after they had done some of the ablation “burns” they gave me a type of adrenaline to try and stimulate Tachycardia. In the end they decided all was well.

No wonder it took 7 hours last time.

Pete

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My second ablation was for atrial tachycardia which turned out to be perimitral atrial flutter. Unlike you, my procedure was one hour instead of 7, or two hours if you count set-up time. In addition to catheterisation of the vein of Marshall, ethanol was also injected. My report is like Flapjack's whereby there is atrial pacing down to 180 ms. So, are there two types of "pacing" - jolts as per FlapJack and a type of adrenaline like yours?

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I am not sure I was asleep.

Flutter is in the right atrium and therefore easier to access as for AF they have to make a puncture through the central wall of the heart to access the left atrium. This is a much longer procedure.

Pete

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Your experience, knowledge, and consul have really enhanced this forum. I do look forward to reading your thoughts and replies. There can be flutter either in the right or left atrium. When it is in the right, from memory I believe 90 % of cases, it is easy to ablate with a high success outcome. However, when it is in the left, the results are way lower. My second ablation was for perimitral atrial flutter in the left atrium.

This site gives insight:

academic.oup.com/eurheartj/...

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Thank you for the kind words.

I stand corrected on the matter of Atrial Flutter.

I was basing my comment on what was said to me by my EP prior to my first ablation 11 years ago. .

I had seen the No.2 in the team and he said that they were going to do an AF ablation. However, he was overruled by No.1 Consultant who said that on the last ECG they had it showed Atria Flutter. He went on to say that it was easier to access as it was in my right atrium. He said it was less intrusive and safer.

The As they approached my heart with the catheter I went into spontaneous AF. They were committed to the Flutter ablation and it was then necessary a few months later to carry out an AF ablation - the first of many unfortunately.

We learn something every day.

Pete

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I can't seem to locate a good site on Dr. Google to explain "pace." Do you have any insight for me?

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My understanding is it was a CV to return my heart back into sinus rhythm after the ablation. Unfortunately, I could have done with a tad more sedation, it was not a pleasant experience!

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I had a Cryoablation for PAF 13 months ago - I was in AF when I went into the procedure - I was told they'd cardioverted me at the end to get me back into sinus rythmn - I would not have known at all if they hadn't told me - I just know that the peace I felt in my chest was sheer bliss when I got back to the ward. Cathy

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I had two CV s during ablation, only knew because it was on the report but it explained my very painful neck!

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Is a CV also called an 'external counter shock' ?

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