AF Association
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Ablation "Success"

This post is written knowing the old phrase “one swallow does not mean it is spring”.

Make yourself a cup of tea or coffee and read on.

There are regular posts on this forum asking, before and after, the question - “how successful is an ablation”. For this reason I thought I would give you all an update on my progress. Please forgive me if I repeat some of what I have said before.

As many will recall I am somewhat of an exception and I have now had 7 ablations for a combination of Atrial Fibrillation, Atrial Flutter and Atrial Tachycardia.

I have often had comments alluding to the fact that the first 6 must have been failures. However, the truth is that it is not always possible to identify all the paths on the first or even subsequent attempts.

It must be realised that under a microscope the inner walls of the heart must look like the surface of the moon and that coupled with the EP working on a beating heart makes the ablation process all the more remarkable. It is without doubt a procedure that should only be carried out by the highly skilled Cardiac Electrophysiologists.

I had my 6th Ablation in March 2017 which was aimed at Atrial Fibrillation and Flutter. After that, for the first time, I then developed Atrial Tachycardia and all Summer 2017 my heart was beating at >125bpm resting. On August 24th I had my 7th ablation when my remarkable EP addressed the Tachycardia, this procedure took around 6 ½ hours.

I have been a PAF sufferer for 26+ years that was occurring on a very regular basis. However, in the past year I have only had one short bout of AF and have been in NSR (apart from that blip) for longer than I ever have in all the years I have suffered this awful condition.

Over the past 2 years my ECG results have been non too encouraging and my EP has said to me that because of my poor conductivity I would most likely need to have a pace and ablate procedure sooner or later. Because I have multiple allergies I have resisted this option.

The good news is that I had my four months follow up yesterday with my EP and he says that my ECG was significantly better than he had seen it for over 2 years and that had I been anyone without my history he would have discharged me back to the ‘care’ of my GP. In my case, he has promised to keep me monitored and to see me every 6 months.

Despite the fact that I have been having ablations almost annually since 2009 I would still recommend this procedure should anyone with AF be offered this. My only caveat is that wherever possible you ensure that the EP has the necessary experience and success rate to ensure that you have the best possible chance of success.

My quality of life has improved immensely, and I am now feeling that I can approach my impending Hernia operation without having something else to worry about.

There is no such thing as a cure for AF but it is possible to improve your quality of life immensely.

Pete

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Oh well said! x

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Thanks for this. You must be very encouraged. - and so are we as you are much further along this path than so many of us.

I sometimes think that, instead of asking if an ablation was a success, it is more relevant to ask where one would be if one had not had it.

All the best for the surgery ahead.

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Excellent post Pete, thanks for sharing!

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Well done Pete! I'm sure many will find your post very encouraging.

I'm writing this in the ER of my local hospital waiting for my 18th DCCV 😯

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Thanks for your reply Yatsura.

I think you and I have had a similar number of DCCV procedures I lost count a while ago. It almost becomes a matter of routine doesn't it, and such a relief if successful.

I wish you all the best and hope that you are soon home taking it easy again in NSR. Have a good rest afterwards and let me know how it went.

Pete

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Thanks Pete!

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Has your AF just kicked off within the last 24hours or have you waited a while for this cardioversion?

Jean

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No Jean....started 3.30pm yesterday. Bit of a story....i took Bisoprolol as PIP but due to my own stupidity from 4pm to 8pm I took 15mg instead of 7.5mg so was pretty much loaded and had nasty headache. I was then going at about 145bpm so thought I could wait overnight and see how things progressed. However I phoned 111 for advice re overdosing on the Bisop and they despatched a Paramedic practitioner who ended up taking me straight to the Emergency room, bypassing A&E because of my AF. So here I am loading up with potassium waiting for a theatre slot😑 ( and starving hungry...still good for the diet)

Sandra

And I've been given a further 5mg of Bisoprolol...making 20mg in less than 16 hours 😕

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Dear Sandra

Oops

I hope it all passes through your system soon as I cannot image what 15Mg of Bisporolol feels like. I use Flecainide as PIP with added 1.25Mg of Bisoporol. I go into Atrial Bradicardia if I take 2.5Mg.

Hope you feel a lot better soon.

Pete

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On dear!hope you are doing better now!xx

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What a wonderful uplifting post, can feel your joy from here lol. Very inspirational, it takes guts to go through so many procedures, you might say well it was Hobson's choice but I call it guts all the same. It's paid off yay.

Finding a highly skilled EP is crucial as you say and it's great you found yours. Well done all round and here's to your improved Qol. Good luck with your hernia op. X

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Thanks for your lovely reply.

The biggest shock yesterday was the EP telling me that my ECG was significantly improved on all the other ones that had been taken over the past couple of years and that currently the Pace and Ablate option was not on the horizon any more.

I had significant serious issues with allergic reaction to electrodes during my 3, 4 and 5th ablations and for that reason I had refused the Pace and Ablate option. I am so glad I did as whatever normality I now get between now and when the Grim Reaper comes for me this will be a significant bonus. The Urticaria I suffered was every bit as bad as the AF.

Pete

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Just goes to show things can improve expedientially even when not expecting it, double bonus! You must be stoked at such good news. It a long long time till the grim reaper comes for you, if he does throw your slipper at him, that will chase him off. Enjoy your new found health. X

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Still got the hernia operation to come and that problem is not very enjoyable right now, but it sure helps having my heart more stable. I've been waiting 4 1/2 months due to communication breakdown between two local hospitals. Got to see the Surgeon a week on Monday and I am then hoping it will not be too long.

Pete

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Good luck with the surgery, you will be fine. X

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Pleased to hear you are doing so well Pete, are you not reliant on AF drugs anymore ?

I would say I felt better after my third ablation, or is it the Flecainide that I'm now taking daily? Who knows!

I had 6 months AF free last year and thought I was cured from it. I gradually started reducing my drugs very slowly and was soon troubled with AF again.

Jean

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Dear Jean

Thanks for the reply.

Yes, still taking the tablets but reduced from 150 -100Mg x 2 Flecainide per day plus Warfarin. He said that I could go down to 50 + 100 per day but I said I feel safer this way. It was my decision. At the end of the day we cannot evaluate exactly what has been cause and effect. So as they say in a Black Jack game, I am sticking rather than twisting!

Taking tablets has become part of life and unlike some it doesn't bother me. I have no noticable side effects at all.

Pete

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Yes, I can certainly understand why you're still taking tabs - very sensible. Wish I hadn't attempted to come off them as was feeling so well. Been in constant AF now since last October, but don't feel anywhere near as bad as I used to.

Jean

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You won’t believe this but despite having a tablet by day box I forgot to take my Flecainide and Warfarin last night because we had a visitor.

Still ticking and all seems to be well.

Pete

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Totally believe it Pete!

I hate the way my memory is so poor now! Wonder if I could blame that on to heart medication?

In my last year at work, I was booked to see a solicitor the next morning on behalf of one of our residents. She'd rang me and I assured here I'd be there, forgot all about it and she rang to see why I wasn't there. I apologised and said I'd be there that afternoon - forgot again, but did go the next morning! How can you forget to go and see a solicitor!

My INR was 1.6 today. That's because for the first time they let me go for 6 weeks. Does make me cross.

Stay well.

Jean

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I do believe it!any changes to routine can result in the not taken for me!

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I love this post Pete and your comments about the skill of the EP reminds me of a lovely story I heard some years ago.

A cardiologist went to his garage to collect his car which had some engine work done. The mechanic said to him. "Look doc I have taken off the cylinder head, replaced the valves put it back together and it is now running fine. Similar to what you do with people's hearts." "Thanks "said the doctor. "So says the mechanic, how come I am on £23k a year and you are on £200k? "

The cardiologist leaned across and said quietly

"Try doing it with the engine running!."

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I like that very good

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Wonderful post, Pete. You must feel as if a massive weight has been removed with the news about your ECG.

Keep well and enjoy your heart health - you’ve earned it.

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That is very encouraging information, thankyou for sharing. My initial response in the beginning 2 yr ago was " hell no" to ablation. Now, its a " maybe". If my a fib got worse, Im sure I would go for it. My biggest question is the theory of ablate early vs the occaisional person who says their a fib got worse after ablation. If I could find the batteries for my crystal ball, it would b easier.

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Since AF begets AF it is best to try and stop it before it creates too many pathways. Don't forget that this forum is heavily weighted towards the failures as success stories seldom stay around. They skip off into the sunset singing happily like Morecombe and Wise. .

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I believe that, just taking my skeptical, " what if" mind to come around but I think Im leaning that direction. This forum is a huge help

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It would be nice if the success stories from Newbies on this Forum before 'skipping off...' could be encouraged to check in and say good bye for that reason and we would all have a lot more confidence with the percentage of successful ablations.

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PVI ablation June 2016 after recurrent bouts of fast AF. In 18 months only had one 18 hour episode terminated by out of date Flecainide. This was brought on by an all inclusive holiday food & drink binge 😂 first thing I did was come on here and ask for support - got it straight away and I was in Spain. Priceless resource with regards support in coping with this arrtyhmia so well done everyone

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Well done, thank you!

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OK I had a Cardioversion(NHS) in January which worked, and it was such a relief to wake up in normal rhythm. I had only been in permanent AF for 2 months, but it was so unpleasant I could not face the prospect of a return.

I am an aging but very active sportsman, exercise is like a drug for me, and I missed it when in AF.

So I counted up all my pennies and went 2 weeks later for a private ablation, even though I was in NSR at the time, and no sign of a return to AF. The fear of a return to AF was so great for me, that it overcame any fears about the ablation.

Anyway it all worked out well, easy procedure, no pain, rapid recovery, and no AF now for 6 months. On 1.25 mg bisoprolol, and have decided to stay on Rivaroxaban for life.

I am back to my fell running, cycling, and have a very strenuous 2 week mountain trek in September.

You are right, these forums usually have posts about things that go wrong,so this is one that went right.

Many people would not normally choose a voluntary ablation, "Just to be sure", but I did, to ensure a return to my quality of life. AF for me was miserable.

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I can't answer the early or late question as I had been suffering for 15 years before I was referred to a cardiac unit that did ablations.

I think the consensus is that early is much better than later which is perhaps why it took so long to make my QOL better.

Pete

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Yes I agree. Thanks for the encouragement.

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I wonder whether your last phrase is true or something propagated by cautious sufferers and doctors alike. I haven’t studied this point but I expect there are plenty people out there who have had one ablation and have never been heard of again.

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No doubt about that.

Pete

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Great to hear PP! Who did your most recent ablation?

Cheers,

Mike

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Oh Pete, that's such good news on all fronts. It must be a comfort to know that you can now hopefully avoid the pace and ablate option and also that your EP is going to continue to monitor you rather than discharge you. Having had four ablations myself I've been following your posts with interest and cheering you on for the upbeat attitude you've managed to uphold in spite of everything.

Wishing you all the very best for the hernia op and for a long-term AF-free future.

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Brilliant post, so encouraging. Only two procedures in my case, pure novice. Wouldn't hesitate if it comes around again.

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Really good post.Hope you get the hernia sorted soon,and enjoy your new quality of life.

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Thanks for such an uplifting post Pete. Good luck with the hernia operation. X

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Fantastic news, Pete. So pleased for you.

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Thank you Pottypete! Very informative ,honest and supportive.I am confident my EP Dr Osman at University Hospital Walsgrave is excellent,I do fret sometimes as I've heard you may not get your own consultant perform the procedure.I am due to see him next week,so shall bring it up!

Thank you again for your positive post,and for many others.It does help a lot xx

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I was told that even if your specialist doesn't perform the procedure, they must be present at the time, in the room. How true that is not sure. Perhaps you could ask that?

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thank you!

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I think we are all impressed with your EP! Do you mind sharing who it us?

So glad of your unexpected good news. X

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I prefer not to post this information but will PM you.

Pete

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Thank you so much for writing such an uplifting post, I am so pleased that you have had such a positive outcome. I hope you don't have to wait too long for your hernia op either. How is your nausea?

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Hello Irene

Thanks for your reply.

Thanks for asking about the nausea. It was awful for weeks. However, I am pleased to say it has gradually abated. I have an appointment with a Gastroenterologist in June made in January, as always a long wait. I decide to keep that appointment even though I am better because it hasn't gone completely and I was so bad that I want to see if a root cause can be identified.

Pete

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As someone with a date with ablation in a month, these posts are so reassuring. Thanks everyone for taking the time to share your experiences and support. Hope you all keep as well as possible. Kindest regards,

LizC

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Good luck with your procedure LizC, and please, do come back and tell us how it went.

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Brilliant! Great to hear such good news, I am so pleased for you.

I'm still at the "so far, so good" stage after my second ablation just over a week ago.

Good luck for the hernia op.

All the best, Jan

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Thanks for that post PP. It is so reassuring, not only to those of us who are considering an ablation, but also it is so uplifting for those who have just discovered they have this condition. The fact that you have survived all the PAF and all the following complications for so many years proves that AF doesn't kill you - at least not directly!

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That is wonderful news. Enjoy the rest of your life.

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It epitomises the value of this site by hearing so many positive versions about Ablation, as opposed to the negativity that I was fed. The value in it has all come from people outside of the medical profession, confirming that you cannot beat the customer when it comes to the product knowledge.

Unfortunately my GP is one who is NOT in favour of an Ablation - as in his opinion they generally do not work!

Anyway; It would seem that the mantra should be......"If at first you dont succeed.....then try, try again", as it does have its success. It has most certainly opened my eyes, hopefully if the opportunity of Ablation comes along then I will take it. PP well done, hopefully better days are ahead of you.

PS. What will you do with all of this spare time you will have? lol.

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Change GP if you can. Mine kept me, acting like an EP, so my condition went from atrial flutter to paroxysmal atrial fibrillation to persistent atrial fibrillation all in one year. Instead of having just one ablation for atrial flutter, I have had to have two ablations so far.

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Hello John

As you will have read I have had 7 ablations.

After the first 3 my EP, a Professor in Arrythmia close to retirement told me there was nothing more he could do for me.

A couple of years later I was in hospital having my umpteenth Cardioversion. The duty Cardiologist spoke to the new senior EP who came to see me and said he was willing to do another ablation but this time under GA as I had had some problems with being far too awake during ablations under sedation.

The next ablation waa an improvement. That EP was headhunted and I was then placed with my current EP who had previously practiced at Barts in London in the same department as Dr Schilling.

As time has passed technology has also improved and my last ablation in 2017 was performed using 3D imagery.

In summation I think you are absolutely right. If at first you don’t succeed, try, try, and try again.

Pete

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It would seem that success can be down to luck of the draw re medics. I'm 2.5 years into mine, having been forced to seek a medical opinion through my condition making me do so. All I have had so far is an Ultra Sound confirming that I have Afib, followed up with Bisoprolol 5mg once a day........and that is it! Not once that I can remember have they done any blood tests, neither has anyone asked me to come back to see if any progress has been made Or not is the case. I feel that I apart from one tablet I have been left to fend for myself. Probably a lot is down to a lack of knowledge, certainly by my GP who looking back seems to have a general acceptance about it all. If I had been a young man at the time then he would probably have looked into it deeper - being 68.5 at the time, then It seems that it is regarded as a bit of an age thing.

Having read up on many cases on here which does give me some hope, plus emptying my brain cell of ideas to keep myself well, I am starting to pester my GP. In doing so I have gone from being the forgotten man to having a further 24 monitor strapped to me that picked up abnormalities, this has gained me another appointment next Tuesday. It shows the value of the forum, through people bringing their experiences to light.

This dreadful condition has been around for 100s of years - so little is known about it.

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Hi Pete, I was so glad to see your post as I am currently due to have my 4th Ablation in 2 weeks time, and I was getting a bit worried about the lack of overall progress. I have had 2 ablations for AF and 1 for AT, and am now in AF again. I will post the results following my op, thanks again.

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Pete,

Good to hear your AF has improved with the last Ablasion, I wish you a successful Hernia surgery and quick recovery

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My 2nd ablation is tues. 17th. My heart rat at rest is running at 120. I hope the 2nd one is the charm.

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Best of luck for Tues. Let us know how it goes.

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Best wishes for Tuesday.

I hope it all goes well for you. At least you know what to expect.

Remember that rest, rest and more rest is the key to you helping them to help you.

Pete

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Thanks Pottypete. What a great positive post. Annel

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Your history is most inspirational, Pottypete 1. You have probably helped more people than you realise. How wonderful for you to "stick it out" and not go for the "pace and ablate" option even if it was driven by your allergic reactions to electrodes.

I do wonder why your last ablation took 6 1/2 hours since it was for tachycardia?

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They also did some retouching.

In addition to that they were using new state of the art 3D mapping equipment. Much more complex but much more information which in turn led to greater accuracy.

I haven’t had an ablation in under 5 hours.

Pete

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I am curious as to which " new state of the art 3D mapping equipment" was used for your atrial tachycardia. For mine "the Rhythmia system" was used. I did research in :

dicardiology.com/article/me...

and discovered:

"Unlike previous systems, the Boston Scientific Rhythmia HDx Mapping System rapidly and automatically generates 3-D maps of any chamber of the heart to help locate and treat the source of rhythm abnormality. The technology allows electrophysiologists to see the heart like never before, with 20/20 or better vision."

I think this was the same system that was used as my medical report reads:

" atrial tachycardia was perimitral dependent flutter connected through vein of Marshall."

The article goes on to say"

"A recent analysis of patients with symptomatic AFib showed that compared to other mapping systems, the Rhythmia Mapping System produces higher-density voltage maps without increasing overall procedure time.[15] In fact, the technology has the ability to automatically map the heart with a speed that allows physicians greater efficiency in the EP lab and thus, more time to develop a well-informed ablation strategy. "

My procedure took one hour.

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Yes that is the one “Orion Rhythmia”

Sorry I cannot shed much more on why your procedure was I hour and mine 6+ hours.

I was Anaesthetised at the time.

Pete

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