Just been thinking about this and read an article from a US AF journal I didn't fully understand, so thought I'd check people's experiences here ???
Anyone know about AF scarring from Fi... - Atrial Fibrillati...
Anyone know about AF scarring from Fibrosis and scar tissue from ablation. How they differ and how the heart may re-model back to normal?
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Turquoise19
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Hi
They are different as you say. Ablation scars are normal healing tissues after being burnt/ frozen. Fibrosis comes with age and then worsens from AF. Also the LA muscle gets thicker with AF. After ablation or other treatment to restore NSR the fibrosis can revert and the LA get smaller again which is good news. Scarring from ablation also shrinks but this can mean gaps open up and let the errant signals through from the PVeins so sometimes a touch up is needed after ablation if this occurs
Thx very much Rosy, v clear reply. I am now 6 weeks post ablation N so far only one episode of AF x2.hrs so far, 2 weeks ago. Know I have a dilated LA, and still not feeling as fit as I was pre ablation in AF, so just thinking about my recovery. Makes sense what u say that the ablation scar tissue shrinks allowing gaps for repeat AF, hence some people with good recovery get a repeat at a year mark, or something like that. I thought fibrosis was caused by the AF itself, n Praps aging as well. Hence now out of AF, will the fibrosis heal/soften the LA muscle n reduce it to normal size ? I am 54, n was pretty fit before AF.
Yes you’re right. Those things should reverse now in SR. As you’ll know, it’s very early days and your heart has been under pressure so ignore things at present as often temporary. If touch up is needed it’s often very minor extra work to be done.
That's very reassuring Rosie, how do you mean by minor, do you know how it is different to the first ablation ? Mine was persistent AF btw ? Really useful for me to be forewarned, forearmed as they say. Though obviously the ideal would be no more !!🥰
If the scar heals and let’s a gap occur then only minor touch up would be needed. If they haven’t managed to shut off all pathways fir the errant signals at the first ablation then amount of work needed would vary with the individual. But you seem to be doing well if only had one episode so hope all goes well for you. Consultants who’ve talked to our support group often say 2-3 ablation may be needed. BobD is probably best on this As he’s very experienced. You could message him if he dies t see this post. Good luck
Yes thx for that Rosy. I have read as well that it's often the case to need 2-3 ablations. Do you mind if I ask how many you have had or how long now out of AF you are, if this is the case for you ?
I haven’t had an ablation as have PAF and since increasing potassium in diet it has been very infrequent. Have been to loads of clinical conferences so pick up a lot but BobD is best on ablation.
Well thx very much for your responses. Very helpful. I am only picking up on PAF in bits on here, do u mind telling me how it differs ?
Hi
PAF is paroxysmal AF - starts for awhile and then stops. I noticed on third trip to A and E that potassium low on each occasion upped potassium in my diet and episodes much reduced. ( jacket potato, tomatoes, bananas, salmon, cod corvettes. All good sources! )
Ah yes of course did know that. I was thinking the P was for pulmonary.. I went very quickly into persistent, not completely sure what makes us differ, or is it the nature of fibrosis. ?
I don’t think any one knows really. Once the electrical pathways get going they spread if the substrate is suitable!!! Won’t hurt to make sure you have enough potassium and magnesium each day
Yes I am taking magnesium taurate now 600mg at night. Plus banana a day for potassium, sweet potatoes etc. Heard it's more easy to overdo potassium supplements , so not supplementing on that, similar with calcium. I have constantly low/borderline iron re heavy periods, so have to supplement a lot of iron. I think this may have been a factor for me
I can't add much to what Rosy has said but just had my fourth ablation though this one for atrial tachycardia and experiencing all the things we say in our fact sheet on recovery. lol
At your age things should be pretty good for you as the left atrium should return to a more normal size in a few months. Regarding any gaps it really depends on if it were cryo or RF ablation. Cryo tends to be more effective around the four pulmonary veins than RF but limited in that any other areas may need subsequent RF to touch up.
Hope that helps.
Yes thanks Bob, golly didn't know u were going for a 4th, hope u are recovering well?. Mine was RF, though box technique for persistent AF, so not only around the pulmonary veins I think that means ? I am feeling like they did a v good job, just the unknowns of watch n wait n not overdoing things.
At my age... Helpful comment, re shrinking back to size, tho not sure if this makes it more likely to come back in a few years .... Hey ho.
Really helps to come in here for the thinking space N reassurance.
