Ablation.: Does ablation in any form... - Atrial Fibrillati...

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Ablation.

Tudee profile image
124 Replies

Does ablation in any form actually work, what are the stats.? My Cardiologist says it doesn’t in the long term.

I hope someone can prove him wrong.

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Tudee profile image
Tudee
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124 Replies
wilsond profile image
wilsond

Complex! I have not had one ,but am on a list and currently awaiting latest test results to see if it's still warranted. I asked a lot of questions.My EP Proff .Osman told me that it doesn't actually stop the impulses,but changes our perception of them ,so alleviating debilitating symptoms. This is why the stroke risk remains the same. As far as I can see here,for some the benefits last a long time,several years,others shorter. I'm sure there will be more responses on this question!

Tudee profile image
Tudee in reply to wilsond

Really,? It changes how we perceive AF, forgive me for for my hysterical laughter, so it doesn’t work in the long term, if AF starts and the pathway is found, it will become permanent, that’s my perception.

Many thanks for you prompt reply, and Professors opinion.regards ,Dee

wilsond profile image
wilsond in reply to Tudee

Yep..just about quality of life he said. I really grilled him..paying Private wanted my money's worth..

CDreamer profile image
CDreamer in reply to Tudee

I tend to agree - I’ve had 2 ablation & ended up with a Pacemaker - which has improved my QOL more than anything else.

Barny12 profile image
Barny12 in reply to wilsond

Yes, my EP also told me that any treatment for AF was only ever about quality of life and that an ablation doesn't actually stop the AF, but stops the symptoms. Still not sure what this means...

I wish I'd asked more at the time but I was pretty shell shocked at that point.

wilsond profile image
wilsond in reply to Barny12

Proff Osman told me categorically.

Does not stop AF..stops the symptoms...

Buffafly profile image
Buffafly in reply to wilsond

Maybe the 'naughty bits' (note highly scientific description) are still there fizzing away but the ablation stops the effect?

Tudee profile image
Tudee in reply to Buffafly

Oh brain freeze,! Could you simplify your response please, too technical .......... Dee x

Brad43 profile image
Brad43 in reply to Barny12

"ablation doesn't actually stop the AF, but stops the symptoms. Still not sure what this means..." I think I know what it means. AF starts in the pulmonary veins, and works it's way into the atrium, which then makes the ventricle go arrhythmic. So the symptoms come from the atrium and ventricle. Ablation stops the AF from reaching the atrium. It might still be going on in the veins, but there won't be any symptoms.

in reply to Barny12

No wonder!

jondeanp profile image
jondeanp in reply to wilsond

Dr Osman at UHCW?

He was my consultant through the NHS. After my initial meeting with him i could only ever speak to the arrhythmia nurses when i had concerns.

I had been diagnosed initially with AF but at the time of my latest consultation i was told i was now in Flutter. I was offered an ablation to address both issues, but i elected to just go with the Flutter ablation.

While waiting for my ablation (18 months) i spoke to them twice to express my concerns with having the procedure, as my quality of life was not affected drastically. I went in to the appointments both times with the intention of not having the ablation.

Both times i left being "reassured" to some extent. Even as the ablation date got closer i was still not convinced i was doing the right thing.

Since the ablation (at Rugby St Cross) i have been AF/ flutter free for 20 months so far. I have been able to return to exercise to a similar degree that i was doing before AF/ flutter, and i am not on any medications.

For me it has been a success. I am aware that as i have been diagnosed then there may be a chance that it returns from another direction, but my wife (who also works in the NHS) tells me that at this moment in time i am cured.

This took me a while to sink in, but the reality is that i am cured. A bit like having the flu, once the flu symptoms go away, then you are cured until the next bout of the flu. That's my take on it anyway.

I now take Magnesium Taurate regularly and ensure i stay hydrated particularly using electrolyte tablets after exercise.

All the best

wilsond profile image
wilsond in reply to jondeanp

Yes,that's him! I've seen him twice,once on diagnosis and as follow up . He did say the flutter cycle could be interrupted and hence stopped.But AF would still be there,but not recognised by the brain...I'm waiting to see if ablation is still warranted as I'm much better than 18 months ago when I went on list! Glad you're doing so well. Thanks

jondeanp profile image
jondeanp in reply to wilsond

I forgot to add that my episodes were always persistent.

;-)

Ianc2 profile image
Ianc2 in reply to jondeanp

Electrolyte tablets?

Jalia profile image
Jalia

You are going to get so many different opinions here Tudee!

I've had AF over 26 years with 3 ablations, ( offered a 4th..) and about 20 dccvs. I'm not prepared to say that the ablations did a whole lot of good. I was worse after my 2nd. However here I am AF free for over 12 months albeit on an anti arrhythmic drug still.

I would strongly advise lifestyle changes first ie attention to diet, exercise, stress etc

Tudee profile image
Tudee in reply to Jalia

I agree with Julia, lifestyle changes are paramount, and totally affect ones perception of well being if we are doing everything we can to mitigate attacks.

in reply to Tudee

I was told that how effective an ablation was likely to be varied from patient to patient. AF remodels the heart over time and episodes enlarge the left atrium which will eventually lead to worsening symptoms, such as breathlessness- it isn’t possible to give a timescale for this. If you are in good health and the process has not gone too far then you have a better chance of success. Estimates of the rate of success on a first procedure vary from 60-80%. Factors which give the procedure a better chance of success include not being overweight, otherwise being in good health, being young. Many patients require a second or third ablation as the first one is unsuccessful. Symptoms may return after several years. Lifescale factors *may* make some difference, but when I asked an EP whether AF could be slowed down by a good diet, exercise etc. he replied bluntly, “AF doesn’t care about your diet.” My advice would be to get your EP to spell out clearly the pros and cons of having an ablation - it really boils down to what your *individual* prospects for success are, and what the likely consequences are of *not* having the procedure are.

dleppard60 profile image
dleppard60 in reply to

My EP would STRONGLY disagree that diet doesn't help. If fact he says that is the BEST treatment of all. He says if you avoid the triggers that start the signals there will be no AFIB. His prescription before he ever met me was a whole food plant based diet and absolutely no caffeine, alcohol or refined sugar. Works better than any meds.

Jalia profile image
Jalia in reply to dleppard60

Sounds a bit too ' cut and dried 'to me .

I know that getting over tired and stressed can trigger an event for me but then can get extremely tired and over stressed and nothing happens .

Caffeine or no caffeine makes no difference to me. I can go into fast AF just sitting quietly minding my own business so no trigger there.

Barny12 profile image
Barny12 in reply to dleppard60

Would you mind if I asked who & where your EP is? I'm really interested in the WFPB diet myself & there do seem to be more & more cardiologists/EPs advocating this diet all the time. Thanks.

Turquoise19 profile image
Turquoise19 in reply to Barny12

Sorry what's that diet ?

Barny12 profile image
Barny12 in reply to Turquoise19

Whole food plant based diet. There is a small list of (mainly US based) cardios/EPs here: plantbaseddoctors.org/speci...

but this list is in no way exhaustive - I know there are many others, for eg Dr Uri Benzur in Encino CA. etc.

Turquoise19 profile image
Turquoise19 in reply to Barny12

Ah thx. I have been eating more meat re low iron, as my I think most likely underlying cause for persistent. Don't overdo meat tho.

easygoer13 profile image
easygoer13 in reply to Barny12

yes Dr. Benzur is an advocate for this. He is a good man

allserene profile image
allserene in reply to dleppard60

No coffee or alcohol ? Suspended animation. Whats the point of living ?

in reply to dleppard60

Good diet and lifestyle can help in many cases, but there are no guarantees. Certainly, drinking a lot and being overweight are likely to make AF worse and speed progression. However, AF cannot be cured or eliminated by dietary and other lifestyle changes.

in reply to dleppard60

That was my diet for years apart from the odd glass of wine with an evening meal which I've given up since diagnosis, but I still got paroxysmal AF! We are all different and I am hoping being more positive about things will help too.

Barb1 profile image
Barb1 in reply to Tudee

Not everyone needs to make lifestyle changes. Sometimes AF is inherited and pops up even with a healthy lifestyle.

jeanjeannie50 profile image
jeanjeannie50

An ablation is not generally thought of as a permanent cure, though they can help reduce symptoms.

I've had three and still have AF. My attacks happen a lot less now and are not generally quite as severe, but are longer. I feel I can cope with them to a certain extent and haven't had to be kept in hospital like I used to be. I've also been told I'm not suitable for any more and discharged from my EP's care. His main interest is performing ablations.

We see people jubilantly come on here saying they've been cured by one, but a few months or years later they come back to say it's returned.

Jean x

Turquoise19 profile image
Turquoise19 in reply to jeanjeannie50

Hi Jean J can I ask why your EP says u can't have another one ?

jeanjeannie50 profile image
jeanjeannie50 in reply to Turquoise19

He said some people just aren't helped by having ablations and I'm one of them. Mind you he did say something similar after my second one, then he designed a new piece of equipment and I guess I was a good person to try it out on, it did help.

Turquoise19 profile image
Turquoise19 in reply to jeanjeannie50

Umm, would u want to try another one ? Not sure what the some people means if it helped before ?

doodle68 profile image
doodle68

Hi Tudee :-) when you say 'does ablation work' I guess it depends on what you mean by 'work'. From all the information I have gathered I would say ablation removes the symptoms of AF for some people for varying lengths of time and sometimes indefinitely .

I read an interesting article in Cochrane recently I should stress this is in relation to PERSISTENT AF not the other two types but it raises some interesting points ....

''Should we recommend catheter ablation to all patients with persistent atrial fibrillation?''

evidentlycochrane.net/cathe...

I also read some recent reserch similar to the comments EP Proff .Osman made to Wilson.

I have Paroxysmal AF and according to Cochrane ''The risk of progressing from paroxysmal AF to permanent AF over a lifetime is about 20%'' so I am concentrating on preventing the progression with lifestyle changes rather than opting for an ablation .

My episodes of P-AF unpleasant as they are do not impinge too much on my quality of life at this stage . The main thing is I have a diagnosis which has enabled the prescribing of an anticoagulant to provide a degree of stroke protection and resulted in my making lifestyle changes.

We Afers are all so different it is impossible to take into account all aspects of age, health and lifestyle to provide one definitively reply with regard to having an ablation, we can only try to asses our own individual circumstances to decide what is best for each of us.

wilsond profile image
wilsond in reply to doodle68

Great post....my thoughts and responses from my EP..exactly...xxo

in reply to doodle68

“I have Paroxysmal AF and according to Cochrane ''The risk of progressing from paroxysmal AF to permanent AF over a lifetime is about 20%”

I’m definitely not saying that you are wrong-I hope you are not-but do you have a link to Cochrane’s paper where this is stated? I was under the impression that progression from PAF to permanent or persistent AF was around 20% *per year* with this being correlated with being overweight or moderate level drinking or more. If the figure is 20% over a lifetime that is good news.

Norbu profile image
Norbu in reply to doodle68

Hey there...how often are your episodes as a PAF-er? Have they increased in frequency over the years? Do you take any anti-arrhythmic meds? Thanks.

in reply to Norbu

My episodes increased in frequency so now I am taking flecainide regularly rather than as a PIP when it worked very well. Still got episodes with 50mg morning and evening but none since taking 100mg in the morning (what I used as a PIP, so pretty scary) and 50mg in evening. Early days and getting to grips with the side effects but it has worked so far- 5 days! We are all different though! Good luck with finding what works for you.

doodle68 profile image
doodle68 in reply to Norbu

Hi Norbu :-) I had the odd episode of P-AF over the years but didn't know what it was and ignored it . 3 years ago the episodes suddenly became more frequent at one stage they were every 10 days.

Now I have one every 4 to 6 weeks lasting 8-15 hours .

I take an anticoagulant and a betablocker but no antiarrhythmic medication at this time. Flecainide was mentioned at the clinic by the arrhythmia nurse (who discusses my symptoms with my Cardiologist who is also an EP) and we agreed that if my condition becomes worse eg the episodes become longer and more frequent I will try flecainide but will keep it in reserve for now.

in reply to doodle68

Very comforting to see the statistic you have given that the risk of progressing from paroxysmal to permanent over a life time is only 20%. As I was 73 when I was diagnosed having always been healthy, eaten plant based etc, hopefully, there isn't enough left of my lifetime to reach permanent, or even to "progress" to persistent! I shall think positively as the idea of ablation still seems pretty scary! Thank you!

BobD profile image
BobDVolunteer

Any and all treatment for AF is only EVER about improving quality of life (QOL). The idea of perception is nonsense In my opinion. The mechanics of ablation stop the AF present AT THAT TIME once the scar tissue forms which we know can be many months. The underlying factors which started the AF in the first place may not have been dealt with so it can return if they are not.

Is it worth it? Yes most definitely. The ten or eleven years I have been AF free is testament to that although as I have said many times other arrhythmias then took its place albeit less frequently and less impacting on QOL. I am hopeful that my very recent ablation for atrial tachycardia will be just as successful.

I aslo have mentioned many times that without my last successful AF ablation I may not have been able to persuade doctors that I wanted my cancerous prostate removed and without that operation they would not have discoverd that it had already spead. The treatment I subsequently underwent saved my life so for me there is no argument that ablation is good thing for some of us.

As my old tutor used to say "You pays your money and you takes your pick. "

wilsond profile image
wilsond in reply to BobD

Well...all I can say is Proff Osman disagreed when I grilled him....he will be at Patients Day at Brum in September..let's ask the question...? Be interesting to see what he says? That's definitely what he told me..with a witness..es copper!?

kitzabella profile image
kitzabella in reply to BobD

is atrial tachycardia ablation done through epicardial or endocardial only?

BobD profile image
BobDVolunteer in reply to kitzabella

catheter ablation like for AF through vein in groin.

Turquoise19 profile image
Turquoise19 in reply to BobD

Good to hear you Bob, for me getting into persistent AF so quickly, as first onset, from Dec/Jan this year, no brainer I wanted the ablation. And so far so good 7 .5 weeks into my recovery and counting!! So grateful they were able to offer it to me early in the end. And btw, very glad to know u got the cancer stemmed in the process. N still telling us the tale. Bargain !!🌞

allserene profile image
allserene in reply to BobD

It's geographic apparently. (sarcasm). In the US it can be regarded as a permanent cure, (wiki says it is curative)..... but in the UK it's 'all in the mind ' and it doesn't work.... It's like an eye 'floater' that the brain maps out..lol...... I am working hard loading trailers full of top soil every day and my weight has dropped from 202 lbs to 192 lbs since my April flutter... No breathlessness at all.. I got my prostate Cyberknifed in 2017 and so glad I did as I see celebrities dying from it all the time. It's the second biggest cancer killer of men. Even Fred Dibnah ! Now that my prostate is zapped and after an ablation if ever needed, (I had a 150 flutter), I reckon I will get my 100 telegram from King William.. ps I drink beer and coffee every day, but in moderation.......

estrennen profile image
estrennen in reply to allserene

I'm on the US and my EP made it clear that ablation is not a cure. He says it's a treatment and, if successful, may last for a few years up to 10+ years. Every individual is different and impossible to predict. I have PAF twice/week and am going to do my first ablation in less than 4 works and hoping for a good outcome. Definitely about trying to improve QOL.

allserene profile image
allserene in reply to estrennen

I think techniques are improving all the time... bit like with new valves that are quite routine nowadays.. So 10 years from now, they should have much improved methods.... My EP is one who works on the leading edge of research, so I will grill him more on my next visit in January......

in reply to estrennen

I am in the US too and my new doctor said he has never seen a patient who had an ablation be completely free of AF, and does not consider it a cure. He has however seen some nasty side effects from them messing with the wrong part of the heart. He said many of his patients are worse off after the procedure. Insurance companies are also starting to balk at paying for repeat procedures. He no longer refers patients for ablation. His preference is a lifestyle change including stress reduction, diet, supplementation, and moderate exercise. He said the results have been as good or better than ablation and that more research needs to be done on the gastro-cardiac effect. But, of course it will not be done unless they can figure out how to make $$$$ off it by creating a drug.

HowMyHeartSings profile image
HowMyHeartSings in reply to

‘His preference is a lifestyle change including stress reduction, diet, supplementation, and moderate exercise. He said the results have been as good or better than ablation’ could you share any of his specific advice to you? Many thanks.

in reply to HowMyHeartSings

He specifically suggested meditation for stress relief and walking and swimming for exercise. He is fine with Keto as long as it is not endless plates of steak and bacon. He likes it for the good fats (coconut oil, grass fed butter, avocado, olive oil), lots of low starch organic veggies (broccoli, haricot verts, cauliflower, cabbage, spinach, celery and lettuce) free range chicken and eggs, wild caught fish, and the beef or lamb has to be grass fed and finished. The grass fed meat and wild fish have a different nutritional profile than mass farmed animals and fish. The only fruits permitted are low glycemic berries and I have to take it very easy on the tomatoes. Any cheese or butter should also be grass fed.

As for the supplements, that would be an individualized plan. I have the Spectracell test for micronutrients run every 6 months and currently take Fish Oil, Magnesium, Vitamin C, Glutathione, Vitamin D, Folate and a B Complex daily. I also had nutrigenomic testing and my high Homocysteine levels are due to an MTHFR gene mutation, so I will be on the B Complex and Folate for the rest of my life to aid in the methylation cycle. The other nutrients and doses change every 6 months after we get the Spectracell results.

estrennen profile image
estrennen in reply to

That advice may work for many folks, but doesn't apply to my situation. I am a marathon runner who doesn't drink alcohol, no caffeine, healthy diet with vigorous aerobic exercise. I practice yoga, meditation and mindfulness. I have low BMI, low HR and low blood pressure with no diabetes or any other cardio disease. I likely developed PAF from endurance training for the past 5 years. Tried a few drug therapies to control the PAF with no success. I have 2 options: live with it or ablation procedure. The bottom line is that each person will have to find the solution that works best for them.

in reply to estrennen

Yes, medicine needs to be individualized because we all have different body chemistry.

Are you familiar with Mark Sisson? He used to push carbs for runners, but has changed his opinion and now he and many other runners are doing paleo/ keto as well. Our grandson is a Cross Country Runner and his high school brought in a board certified clinical nutritionist at the beginning of the summer to talk to the team about upping their fat intake and getting fat adapted over the summer so that when the carbs run out they can switch over to burning fat and keep going. It seems to be working for him. His endurance is better and his times are getting faster. He made Varsity in his freshman year because he was able to work his way from the 11th fastest at the beginning of the summer to being in the top 5 in his high school when school started. This week he came in 3rd in a meet with 10 other high school teams there. The only thing he did differently to improve his time was the diet change. Several of his friends who had parents who disagreed with the nutritional advice have been left behind and didn't even make the freshman team and he noted that at the meet so many others cramped up and were unable to finish. The coach told our son that none of those kids followed the nutritional advice and he thanked my son and his wife for being on board with the program.

Our bodies were originally designed to burn both fat and carbs for fuel, but because we went low fat and high carb in the late 1970's many people lost the ability to burn fat, and those born after, like our grandson, were brought up on carbs and low fat everything.

It takes a while to become fat adapted, and my doctor said to fool the body it is good to have a higher carb day once in a while, but to get those carbs from vegetables not grains, cereals ,pastas etc. So, every few weeks I will have a day that is 50-60 grams of carbs, but go right back to lower carbs the next day. If I eat too many carbs I feel sluggish.

My doctor is also a proponent of water fasting for autophagy. You fast for 5 days and during that time any worn out cells, or those not working at 100%, are devoured by the body (autophagy). Then your body makes new stem cells. You stop the fast after 5 days to feed the new stem cells. I know it has made my wife's autoimmune disease improve greatly, and the doctor has suggested it would also be good for the cells in my heart, but it is something I have not yet come to terms with.

in reply to estrennen

Did you try flecainide? I've never exercised as much as you and am no doubt older but otherwise similar. It seems to be working for me so far (fingers crossed!)

estrennen profile image
estrennen in reply to

I did try flecainide, but it did not go well for me. I felt very fatigued and could not run more than a mile before I was exhausted. I know it works well for many people, but I wasn't one of them.

in reply to estrennen

I guess it's because I don't run! I did feel fatigued the first few days but am beginning to feel more "normal" - it's only a few days since I've been trying this regime so fingers crossed and hope you find what works for you. I just want to get back to being vaguely active!

estrennen profile image
estrennen in reply to

Glad you have something that is working for you, that is the key thing. Afib has derailed one of the most important parts of my life, running. I normally run 30-40 miles per week and train for a variety of races. I am hopeful that after a successful ablation, I can return to my normal mileage and do at least some shorter races. I'm not sure marathon races will be possible as they are pretty punishing to the body. I'll hope for the best and be grateful for whatever I am able to do.

in reply to estrennen

Sadly, have just found that though I haven't had an episode of atrial fibrillation, my blood pressure, which had been fine, has shot up considerably- just from going to help out at a charity shop for a few hours and picking up a little shopping! Hardly very active and something entirely new!! Hope things work out better for you - but perhaps it's time to cut out the marathons- after all you have proved that you can do it!! Good luck!

Tudee profile image
Tudee

Thanks BobD, good to hear a positive angle, wishing you continued good health.. regards Dee

Barb1 profile image
Barb1 in reply to Tudee

From personal experience, I agree totally with Bob D.

Tudee profile image
Tudee

Thank you all for your responses, everyone’s experience is so .different from the next, Ive read of success stories and of fearful people awaiting a fourth and fifth ablation on here, so thought

Id just throw it out there for discussion, and of course there is no accepted norm.Dee

cjsabc profile image
cjsabc

Depends what the cardio meant by 'long term'! I know of a few that are 5-8 years into post-ablation and are all clear. I'm six years on and doing fine, but in the successful cases I know of, including mine, I'm sure it's not a coincidence that all adopted a serious lifestyle change. In all but one case this involved moving to plant-based foods (not easy for carnivorous Kiwis!) and plenty exercise. So in my experience ablation alone combined with medication is likely to require more ablations (I've heard of folk having had four) 'long term'.

There are stats out there suggesting a 30% chance of a recurrence for every post-ablation year, based on doing nothing more than taking pills. QED: the sufferer has to contribute some healthy initiatives of his/her own in order to strengthen and invigorate the heart. Physicians who discourage that either never learned about its benefits or have their own agenda. Clients should ask questions as to which it is; it's their long term well-being that's at stake after all.

Live well, and good luck!

Tudee profile image
Tudee in reply to cjsabc

Many thanks, how heartening to hear of successes, my cardios spiel would deter anyone from trying ablation, if symptoms are troublesome. I am lucky as I have always been symptom free, apart from a little dizziness at high rates of AF. Regards ,Dee

BobD profile image
BobDVolunteer in reply to Tudee

Cardiologists are plumbers. EPs (who do ablations ) are elctricians. They don't always like each other and approve of what they do.

Tudee profile image
Tudee in reply to BobD

Ha ha, how true Bob, but saying that to their faces wouldn’t enhance ones chances of a good outcome I imagine. Best Dee

lizardo profile image
lizardo in reply to BobD

Bob. I am one of your best fans. I have worked in Cardiology on and off for many years, nursing, pharmaceutical sales and business developer management. I have always referred to cardiologists as Plumbers or Electricians because that is exactly what they are. I have had many people laugh at my description of them. I am retired now and have been for the last 5 years. I am now victim of the dreaded AF myself and most probably it was there long before I actually retired. You talk so much sense and it is good to hear the differences between British and Australian Treatment and compare them. I have the most fabulous EP. He was trained in Bordeaux (the Centre of Excellence for AF or certainly ablation therapy) and he was one of my naughty registrars, previous to his training that I used to woo with lunches when I was selling a pretty second rate Nitrate patch for angina in the late 90's. Then I was Business Developing in the 2010's+ and he was then a Consultant I was promoting his skills to the GP's in Western Australia. We worked well together and he is now one of the most well respected EP'S in the country and he has people coming from the different states in Australia to Perth to be ablated or treated by him. It was a joint success as we worked well together, I certainly can't claim it was all my work. Just remember the distance crossing Australia is equivalent to crossing the entire continent of Europe!!!! Speak soon.

Maggimunro profile image
Maggimunro in reply to BobD

An accurate assessment of inter professional rivalry methinks!

Turquoise19 profile image
Turquoise19 in reply to BobD

Very silly that. Like a disfunctional marriage. Don't they need each other ?

Barb1 profile image
Barb1 in reply to cjsabc

I am at present 4 years AF free without lifestyle changes.

Kaz747 profile image
Kaz747

My next door neighbour had an ablation 6 years ago (at that stage he’d had AF for 14 or 15 years). He’s had no dramas since, even though his EP said “I’ll probably see you again in about 5 years”. He’s recently retired from the fire service and is fit and healthy.

I’m going well since my last ablation and I’m hoping I stay that way for quite a few years.

sue13hils profile image
sue13hils

Hi I must say my ablation has worked had it in 2017 and I am a new women and have lost 3stone in weight and have a promotion in work so please do not worry.

Tudee profile image
Tudee in reply to sue13hils

How wonderful, Im guessing your own resolve had a lot to do with that outcome, and your abilities, well done. Dee

Buffafly profile image
Buffafly

Bit late I know but it's an interesting discussion. I think because ablation is a relatively new technique and equipment is improving all the time and people are having the procedure younger and sooner any official stats are always lagging behind the situation. My personal feeling is that two goes is enough and that probably many ablations don't last but that isn't based on scientific evidence. I wonder if, with the advent of ever more complex pacemakers if that won't end up being the preferred option for older people with complex problems. I have the feeling there is a little competition going on between cardiologists and EPs. I would prefer 'pace and ablate' to a series of ablations - just as well as it is my next option 😃

Tux18 profile image
Tux18 in reply to Buffafly

I’m interested in your comment about using pacemakers to help with AF. It was my understanding that PM didn’t help prevent AF? In October I had an ablation, but still have problems with AF, which is why I’m up at 3:55 a.m.

Would be great if pacemakers would help.

Buffafly profile image
Buffafly in reply to Tux18

A pacemaker on its own doesn't usually help, though some people do feel better with it, but 'pace and ablate' where the sinus node is ablated and the pacemaker drives the ventricles helps because the AF is still there but you can't feel it much, if at all, even though the atria may be going crazy. It is considered a last solution these days but some cardiologists think it's underrated and should be used more often. I've seen several posts where people have resisted it but then wished they'd had it earlier.

Buffafly profile image
Buffafly in reply to Buffafly

healthunlocked.com/user/Jon...

Tux18 profile image
Tux18 in reply to Buffafly

Thank you for the information . I’d not heard about this. Since it been said I may need a pacemaker in the future I’ll ask about the pace and ablate.

jezzer profile image
jezzer

I'm AF-free after an ablation 2 years ago. No medication, no more anxiety. I know there is a possibility of a recurrence but I'm enjoying every moment of my AF-free life!

Maggimunro profile image
Maggimunro in reply to jezzer

Same here, 2 years post 3 ablations and no AFib. Love it.

But we are pescatarians now and I am pretty active with no co-morbidities.

I also take magnesium both in tablet form and via the diet (almonds in various forms and a large cup of blackstrap molasses in warm water every morning).

Horse57 profile image
Horse57 in reply to Maggimunro

How does the blackstrap molasses help you? My mom took it most of her life. She’s gone now and I never asked her. Anemia?

Maggimunro profile image
Maggimunro in reply to Horse57

It is high in magnesium and taking it first thing in the morning in warm water with a dash of lemon juice not only provides me with a good dollop of magnesium, but wakes up my entire digestive system. Really good for constipation too.

Horse57 profile image
Horse57 in reply to Maggimunro

Ok got it. I didn’t realize it had a good amount of magnesium. Thanks!

Tudee profile image
Tudee

You must be jubilant jazzer, long may it continue. Dee

I would argue that in a small number of cases they could be seen as curative ! For example if you are significantly overweight and have high BP that can cause AF ! If you have an ablation that will probably get rid of it for a period, however without addressing the underlying cause it will nearly always return ! There is nearly always something upstream with AF which I think is just being researched and addressed ! I suspect that if caught early and you address the cause you could in theory be rid of it but that means permanent lifestyle changes for most people and that takes a huge amount of bloody mindedness !

Donkster profile image
Donkster

Hi

Please read my previous posts 👍

pkc05 profile image
pkc05

Hi Tudee, I have had two ablations. The first one lasted two years before my father died and I think the stress of that tipped me back in to PAF. My second is still working after 4 years. I cycle between 75 and 150 miles most weeks without any problems with my heart. The leg muscles on the other hand!

All the best

Paul

Shcldavies profile image
Shcldavies

Not sure about AF but I believe it can be a cure for Aflutter, AT, MAT etc but that is dependant upon how well the ablation burned the pathway and the original cause being fixed. Sometimes the original cause can be something like an electrolyte imbalance (too much or too little sodium, calcium, potassium magnesium and iron in your cells - not blood), if this condition continues then other foci in your heart will eventually break down and the arrhythmia reoccur.

The stats for an Aflutter ablation return a 97+% success rate for that particular problem but if you continue to have the original cause then it is likely to reoccur in another part of your heart. I am generalising but people tend to have too much sodium and calcium, and not enough of potassium, iron and magnesium (people are particularly prone to magnesium shortage).

This is a very brief summary and many other thongs can affect your heart, just as an example, taking PPIs or drinking alcohol will deplete your magnesium levels.

Turquoise19 profile image
Turquoise19 in reply to Shcldavies

Hey what are PpI's. I am now just trying out the magnesium taurate and low dose potassium. Had always taken magnesium for yrs before, to stop cycling cramps. Good to hear u mention iron as I have been fighting borderline iron levels for the past 5+years, being perimenopausal. GP and EP's say nothing when I suggest this as factor for my pre ablation persistent AF. Trouble is they are only licenced to speak on the areas they have researched/Nice guidelines.

Shcldavies profile image
Shcldavies in reply to Turquoise19

PPIs are Proton Pump Inhibitors things like omeprizole or anything that stops acid in your stomach as you will then not absorb much magnesium. Low iron will deplete you potassium levels, you need potassium to ensure your calcium and potassium ions move as they should within your heart cells.

Turquoise19 profile image
Turquoise19 in reply to Shcldavies

Thank you, Didn't know that link between iron and potassium, tho Bloods have never said I was low in potassium. My Ferretin levels are v hard to get over 20/25, tho haemoglobin may look ok, which is all my GP was ever concerned about.

I just know when I did if fleetingly get it over 50, I was so much better and fitter. So hard to get understanding across all factors, but of course they all interplay. Really value coming in here, for all the shared knowledge!

Shcldavies profile image
Shcldavies in reply to Turquoise19

Yes its all very complex, even your blood count may not be representative of your cell count (especially magnesium). I have found out a lot over the years but what I know today does not even scratch the surface of how our heart works. Its normally good that our heart tends to fix itself, however it then becomes more difficult finding out what is wrong and how to fix it, as an example some conditions could manifest because it is too good at fixing itself. Our Docs know much more than I ever will but even they don't know everything about everything.

Turquoise19 profile image
Turquoise19 in reply to Shcldavies

Thanks SD

GrannyE profile image
GrannyE in reply to Shcldavies

You are quite right. The Omeprazole prescription was the thing which tipped me over and gave me anaemia which neither my GP nor 2 private cardiologists picked up on. The anaemia gave me my heart problem leading to AFib. That drug should come with a very large health warning and not be handed out like sweeties by GPs.

Shcldavies profile image
Shcldavies in reply to GrannyE

Sorry to hear that, but its good to find our what caused it. I believe too much medication at the same time I was trying to fix myself (eating and drinking healthy) was the cause of my deterioration as well but I will never know for certain.

KMRobbo profile image
KMRobbo

Get yourself an EP! I had a PVI CRYO ablation 29.01.2018. I have not had AFIB since.

Unfortunately I developed re-entrant A flutter 8 days after this ablation quite possibly owing to the flecainide I was still taking.

So I had an RF flutter ablation on 26.02 2018. Not had flutter since.

I stopped all drugs 15.05.2018. Not taken any drugs since.

I can't tell you this will last forever and it probably won't but I have been very happy for the last 18 months.

What is the "long term" anyway?

If AF does come back I will happily have another ablation.

Tudee profile image
Tudee in reply to KMRobbo

Many thanks Roddo, another positive outcome. Dee

KMRobbo profile image
KMRobbo in reply to Tudee

I think there will be a lot more positives that you wont get as the people who have had successful ablations have moved on and don't regularly look at the forum daily as they feel they are cured. Scanning and replying to all the daily posts takes a lot of time. I am not 100% on this as as I was 6 months ago!.

Horse57 profile image
Horse57 in reply to KMRobbo

Are you in anticoagulants

Cliff_G profile image
Cliff_G

My answer is, Yes it does, but it depends on definition.

I had my ablation (PVI, RF) in 2002 when it was still very new. I went to France to be treated by the top guy. At that time he was quoting a 70% success rate for paroxysmal. Mine had developed to persistent and I feel without drugs would have been permanent; I personally counted it as borderline permanent. The first procedure was incomplete due to some very thick heart tissue and the need to change catheter and he decided to see if what had been done was adequate. It broke down (to AFL) after 2 months so I went back and had the procedure completed / redone as some would say.

I then had 15 years of excellent quality life with one only actual AF attack after a huge Xmas meal, which converted with Flecainide, and ongoing ectopics most of the time. So for me it had indeed "worked". I then suffered an aortic dissection in 2017 and went back into AF post operatively. This converted with amiodarone, and I have not yet had the courage to stop the amiodarone yet (my AF has always been extremely symptomatic). But I have virtually cured my ectopics using Ranitidine (they are gastrically linked).

Ablation stops AF inasmuch as most/many focal initiators are in the PVs and they are isolated from the heart proper. Therefore the circular electrical paths don't get set up to maintain AF and this could be said to have stopped AF entirely, though the PV foci still exist. If however there are focal initiators in the main cardiac tissue, these can initiate AF and it can then maintain itself. So whether it "works" or not depends on where the initiators are and how well they can be isolated. That's where it gets tricky.

Two established factors here are 1. the state of progression of AF - the longer it has gone on, the more established it will be, the more the heart tissue will have remodelled, new foci will have developed. So it has been known from the start that it is very important to ablate early, definitely before permanent (even the top EPs struggle with stopping a permanent AF), and preferably before persistent. And 2. the experience and expertise of the EP, and this is where it's i portant to establish the "success" rate with an EP, based on their experience with AF at the same level of progression as you own.

I read and did all the lifestyle adjustments which are advised to help eith AF. In the end none of these worked and my AF went bad and I got an ablation just in the nick of time. So to me the decision will always be a difficult one - do I wait to see if I can beat it myself, or do I get done early and obviously these are to a large degree mutually exclusive.

The key decision maker to me is - how bad is my AF? If it's really badly symptomatic and tyrannical in your life (which it was for me), go for an ablation, as early as possible, and find the absolute best EP you can.

smwdorset profile image
smwdorset

I was told that the ablation ‘works’ where it is done. But that it is quite possible that anyone who has one ablation might develop a problem in another part of the heart as the first problem might indicate a lower threshold . Also statistically as one ages the risk of abnormal rhythms increases. Bit that’s not a reason for not having one if the symptoms and or the drugs are significantly impacting on quality of life . I had mine three years ago and I can’t tell you how great it is to be off blood thinners and not constantly monitoring my heart !

Good luck whatever you decide

Japaholic profile image
Japaholic

I have had one and it worked, sure I still have AF but have seen a 95% improvement which I will take. Very happy with my EP and cardiologist team. They’re excellent.

MarkS profile image
MarkS

I had an ablation nearly 10 years ago and it worked. However I had lone AF and the chances of success are greater with that.

BorgUK1of9 profile image
BorgUK1of9

Had RF ablation in March for AVNRT (SVT), as the months have progressed so have the lack of flutters to the point I am now off the Bisoprolol. Saw my EP yesterday, straight back in if it ever starts again but he agreed drugs are not a long term solution only ablation. You have to understand your body heals, as much as I would like to think my one in March was my last I know that I could be back in the OT in the next few years having it done again.

6 days off the bisoprolol I feel like a new person, I would choose the procedure over long term drugs anytime.

Dodie117 profile image
Dodie117

I had my one and only ablation in 2013 and still AF free. So works until it doesn’t!!

I have kardia and check from time to time if I feel any suspicious beats but so far so good🤞

bobbydb1 profile image
bobbydb1

I had an ablation January 7th 2016, three years and seven months ago. Since then I haven’t had any Afib symptoms. A year and a half ago my doctor took me off Xarelto 20mg, prescribed an 81mg asipirin a day (which I still take every day) and told me that I knew how to find him if I needed him.

I haven't needed him.

I did lose twenty pounds that I watch closely to keep off. I was careful the first year or so after the ablation to not overexert myself. Since then, as far as exercise goes, I do what I want to do. I do twenty minutes on an exercise bike five days a week, and ten minutes on barbells three times a week.

My doctor said that I couldn't ever consider myself completely cured of Afib but the longer I go without symptoms the better it looks for me.

So I would say that although I knew I was taking a chance that the ablation would not be successful it was certainly worth the risk for me.

You will have to do your part after the ablation by keeping you weight down and taking your meds.

I was seventy two when I had the ablation. I am seventy five now.

Turquoise19 profile image
Turquoise19 in reply to bobbydb1

Very inspiring thx Bobby. I am 7weeks post first ablation for persistent and 54, I am taking return to exercise steady. Did lots of sports cycling before. Back on my bike only for comuting one way from Monday, then go on from there. Building up the days. Also getting my weight down to my best weight. Not only motivated by fitting into the jeans now. Intend to keep it down too. 5/2 diet has been good for me.

Goalnsr profile image
Goalnsr in reply to bobbydb1

I absolutely love this reply. Ablations are not cures, but with commitment to a healthy lifestyle and a skilled ep in the lab, ablations offer a chance for a robust, active life without medication. You’re my role model, Bobby!

Mine didn't, but here is something that did and was free...

---------------------------------------

After 9 years of trying different foods and logging EVERYTHING I ate, I found sugar (and to a lesser degree, salt – i.e. dehydration) was triggering my Afib. Doctors don't want to hear this - there is no money in telling patients to eat less sugar. Each person has a different sugar threshold - and it changes as you get older, so you need to count every gram of sugar you eat every day (including natural sugars in fruits, etc.). My tolerance level was 190 grams of sugar per day 8 years ago, 85 grams a year and a half ago, and 60 grams today, so AFIB episodes are more frequent and last longer. If you keep your intake of sugar below your threshold level your AFIB will not happen again (easier said than done of course). It's not the food - it's the sugar (or salt - see below) IN the food that's causing your problems. Try it and you will see - should only take you 1 or 2 months of trial-and-error to find your threshold level. And for the record - ALL sugars are treated the same (honey, refined, agave, natural sugars in fruits, etc.). I successfully triggered AFIB by eating a bunch of plums and peaches one day just to test it out. In addition, I have noticed that moderate exercise (7-mile bike ride or 5-mile hike in the park) often puts my Afib heart back in to normal rhythm a couple hours later. Don’t know why – perhaps you burn off the excess sugars in your blood/muscles or sweat out excess salt??

Also, in addition to sugar, if you are dehydrated - this will trigger AFIB as well. It seems (but I have no proof of this) that a little uptick of salt in your blood is being treated the same as an uptick of sugar - both cause AFIB episodes. (I’m not a doctor – it may be the sugar in your muscles/organs and not in your blood, don’t know). In any case you have to keep hydrated, and not eat too much salt. The root problem is that our bodies are not processing sugar/salt properly and no doctor knows why, but the AFIB seems to be a symptom of this and not the primary problem, but medicine is not advanced enough to know the core reason that causes AFIB at this time. You can have a healthy heart and still have Afib – something inside us is triggering it when we eat too much sugar or get (even a little) dehydrated. Find out the core reason for this and you will be a millionaire and make the cover of Time Magazine! Good luck! - Rick Hyer

PS – there is a new study out backing up the above observations. You can see it at

cardiab.biomedcentral.com/a...

Barny12 profile image
Barny12

I can't quite believe that there is such ambiguity around ablations. It does appear that the experts themselves can't seem to agree, so I guess we have no chance!

However, I just watched our fave doc Sanjay Gupta from York Cardiology discussing "To have an ablation or not..that is the question"

youtube.com/watch?v=3VOq9BL...

and he categorically says that an ablation:

a. does not reduce the risk of stroke

b. will not necessarily prolong life as it's the potential stroke that does the damage

c. it is anti-coagulants that reduce stroke risk

d. if a pulmonary vein ablation is done the PV continues to fibrillate after the ablation, however the impulses do not travel to the atrium.

Not sure if this helps anyone or not but is certainly interesting!

Goalnsr profile image
Goalnsr

That is simply not accurate. I’ve known two people personally who had ablations and have not had recurrence for over twenty years. My 87 year old father had an ablation for vtach (very serious) at age 80 and not a single recurrence and that was after 20 years on meds that gradually caused other health issues and became ineffective). I had an ablation in February and I’ve had no recurrence of my svt. My cardiologist also tried to steer me away from ablation and convince me to take meds but after 6 months I felt horrible and was already on triple the dose of my second medication to control my arrhythmia. Ablation is considered a first line approach these days to many forms of arrhythmias, and I think some cardiologists are simply wary of recommending them, as it is permanent damage to the tiny portions of heart tissue affected. Meds also cause damage, so you’re picking your poison. But if you don’t want to be dependent on meds or have difficulty tolerating them, ablation is a wonderful alternative treatment with very good outcomes. There are many many studies out there confirming this. Just google!

Bob002 profile image
Bob002

Your Cardiologist is a idiot. Worked fine for me with the help of life style change, I was miserable before the ablation. Worked fine for lots of people I know. Everyone is different but I believe 100% that it helped me.

Jumper profile image
Jumper

Of course it works but invariably not 100%. EP' s employed by the NHS don't do procedures for AF, without it being acknowledged through research and the improvement in QOL that the patients have as a result of the procedure, just for the fun of it, never mind the cost of around £20,000.

It is not a question of just the long term. What does that actually mean?

Without the procedure Long term - Heart Failure due to left atrial enlargement will invariably follow never mind increased stroke risk.

Rate control drugs don't impact on the AF burden, rhythm control drugs long term can have serious side effects.

I had an ablation some 10 years ago as a result of my PAF being present some 50% or more of each day. My EP indicated first time success was around 75%. In my case it reduced the PAF to around 1%. So has it worked? Of course it has. From being only just holding down my job, difficulty in relationships because it made me angry, confused and stressed to being normal again albeit with ectopics and minor AF I had my life back.

There is currently no cure as the signals that invariably start in the pulmonary veins are only stopped by the scar tissue created during the procedure and with time other pathways may develop and bring on other AF and possibly other arrhythmias.

Ask your cardiologist to be referred to an electrophysiologist who can give you a more nuanced view of how to treat AF.

Barny12 profile image
Barny12 in reply to Jumper

He's not my cardiologist, I only found his channel on youtube through recommendation on this forum. But last time I saw my EP a few months ago he also told me that any treatments for AF are only about improving QOL and that an ablation only treats the symptoms and that it does not reduce stroke risk.

I'm glad it worked for you and works for many others, too. But I think we all need some real clarity on what is actually happening to our bodies after ablation and what "worked" actually means. This question has now had around 100 replies so far and I'm not sure we're really any nearer to an answer.

Jumper profile image
Jumper in reply to Barny12

This is a link afburden.com/ that revolves around research regarding stroke risk and AF burden. It cuts across Sanjay's comment that ablation does not reduce stroke risk . ie Stroke risk increases with the time ones heart is in AF.

You will find it interesting.

Tudee profile image
Tudee in reply to Jumper

Thank you Jumper.I am now in persistent AF, well controlled rate, on Apixaban and Bisoprolol 2.50mg .

Barny12 profile image
Barny12 in reply to Jumper

Yep, makes complete sense to me. I never understood why stopping the fibrillation thereby reducing the risk of blood pooling/clotting in the heart wouldn't reduce stroke risk - however, I think we must be missing something as there is obviously some debate out there amongst the experts, and I, for one would love to understand the reasons for this.

Jumper profile image
Jumper in reply to Barny12

My AF is not accompanied with other co morbidities such as hypertension, mitral stenosis, diabetes etc. As I understand it these other conditions , and others, act to increase the likelihood of stroke and are not mitigated by ablation. So one would retain the risk of stroke even when the ablation has been ‘successful’ and the AF has gone and one remains in SR.

It follows, to my understanding, that in order to mitigate the other morbidities, as best as one can, is to reduce weight, eat a balanced diet take exercise etc one may be reduce the effects of blood pressure, diabetes. Perhaps when the clinician says it doesn’t alter stroke risk it is based on their observations that most patients have these other morbidities. As Bob says it’s not AF it’s the company it keeps.

Tudee profile image
Tudee in reply to Jumper

That is a small relief, but a relief. I have never seen an E.P, when I asked my G.P. if there was such in the group, she replied “A what “? Thus my question about Ablations, which brought over 100 responses. .... and for my next question, watch this space. Dee

Tudee profile image
Tudee in reply to Jumper

Wow, although informative, you do seem to still have some residual anger there !!!

I was under no illusion about EPs having a laugh at our expense., temper your response please.

Jumper profile image
Jumper in reply to Tudee

Not anger but frustration that your cardiologist would appear to be dissuading you from what could be a major improvement in QOL. I spent some 8 years with increasing periods of AF until I went to an appointment and had a consultation with a stand in cardiologist who asked if I had considered ablation. At that time my profound ignorance of the offered alternatives to drugs had never been discussed. I had an ablation at a specialist hospital a few weeks later and have never looked back. There is a measure of professional ring fencing and now I know that gathering information about ones health is a powerful tool when in discussions with medical professionals.

I trust my experience/information was useful and I wished to express an unmoderated view so as to get a point across. At least I didn't call your cardiologist an idiot as another contributor did (although their response was right!)

Tudee profile image
Tudee in reply to Jumper

Wow, although informative, you do have some residual anger there. Temper your responses please.

GrannyE profile image
GrannyE

bless his little heart! At the moment my QOL is not too bad and I am def into carpe diem and will be an ostrich as long as I can. Not looking forward to more ablations and dementia further down the line. Seeing my cardiologist on Friday (long overdue should have seen him in May).

Tudee profile image
Tudee in reply to GrannyE

Oh Granny E, I think love you. Dee

GrannyE profile image
GrannyE

Thank you. Isn’t this site great? Have a virtual hug

Tudee profile image
Tudee

All the better for you here Ithink., thanks for the hug, same back. Dee x

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