Cardioversion and ablation

Following an ablation-during which the heart has been deliberately put into AF if it is not already in that state-it is necessary to return it to sinus rhythm. How is this achieved? One way is, presumably, by cardioversion. Does anyone know how frequently this is done during ablations?

[pottypete1]

We are all different but most of the time they use DC Cardioversion.

The last time I had an ablation which was a couple of years ago they DC cardioverted my heart three times. I had a number of ablations prior to that one where exactly the same routine was followed.

Sometimes they use IV Flecainide.

If you have General Anaesthetic then you know nothing about it apart from perhaps a sore chest.

Pete

[Hidden in reply to pottypete1]

Thanks for the info. You mean that they always restore, or attempt to restore, nsr by cardioversion following the induced AF during the ablation?

[BobD Volunteer in reply to Hidden]

The whole point of inducing AF is to see if they have blocked it. Once it stops happening they assume they have got all the rogue bits and stop the ablation. No point in continuing burning bits if there is no need.

[Hidden in reply to BobD]

What I do not understand is whether the ablation *immediately* terminates the induced AF in most cases, (rendering cardioversion redundant), or whether cardioversion is often necessary to achieve the termination of the induced AF. If I have understood him correctly, pottypete1 says that all of his 7 ablations involved cardioversion.

[BobD Volunteer in reply to Hidden]

Just accept that they would not leave you in AF after an ablation. if it were possible to restore NSR.

[pottypete1 in reply to Hidden]

Yes

They would be very unhappy to leave you in AF particularly if you arrived in normal rhythm.

I have had 7 ablations and have always been returned to NSR.

Pete

[Hidden in reply to pottypete1]

I thought that they might at least wait to see if the heart eventually returned to nsr. They never seem to mention this “detail” in any of the descriptions of the ablation procedure.

[pottypete1 in reply to Hidden]

If they didn’t do a cardioversion it sadly could be a very long wait without the intervention.

I don’t think those considered an ablation should worry unduly. As I said in my previous message I have probably had over 20 cardioversions during an ablation procedure with no ill effects.

I have also had about 20 more cardioversions to correct my dodgy rhythm on other occasions.

Still here to tell the story 😜

Pete

[Hellie54 in reply to pottypete1]

I was on Amiodarone when I had my ablation. I went into af which took three weeks to calm down. After I stopped the Amiodarone I went back into af again. The ablation seemed to just make things worse

[BobD Volunteer in reply to Hellie54]

This does rarely happen unfortunately which is why we always make it clear that ablation is part of ongoing treatment for AF and not a 100% cure. My first caused problems which were later sorted by other ablations. We are all different so generalisations are not possible.

[KMRobbo]

I was awake and watching the screen during my ablation they have the AF traced on the screen and i am pretty sure as they did the ablation it stopped the AF. I certainly was not dc cardioverted and I dont remember getting an injection of anything after the 4 cryo ablations. I was taking flecainide and diltiazem at the time anyway.

When I had a flutter RF ablation I had had 140bpm for 3 weeks which was very symptomatic with breathlessness and when he zapped the bit causing the reentrant flutter I felt my heart slow down as I got a noticable heartbeat back! No cardioversion needed there either.

[Jalia]

Sometimes it is done chemically . I remember reading notes after one of my ablations where sinus rhythm was restored with IV flecainide.

[cbsrbpm]

Hi, I have been Cairdioverted after all three of my ablations.