Keys to a successful ablation?

[Lenlec]

Hi all. What would you say are the main things to consider for a successful ablation?

Skill of the ep ?

Rest after procedure?

Age of patients?

Severity of Af pre ablation?

Pot luck ?

[Physalis]

Interesting.

Skill of the ep? Mine wasn't one of the well know surgeons at a big hospital, I only know his name because I googled it. Never met him but I did see him looking round the curtains later when my bp dropped.

I should mention the skill of whoever put the catheter in my groin. I had absolutely no problem afterwards from this.

Rest after procedure. I didn't do that much before the op and I didn't do much afterwards so I didn't feel that I rested particularly.

Age of patients. Well I was 84 so I guess that isn't a factor in a successful outcome.

Severity of AF before ablation. I would guess that this is the singular most important factor. Maybe the worst someone's symptoms are pre ablation the longer the op will take and the more chance of needing a second ablation. I hope I am wrong on this.

Maybe there are other conditions that people have like, obesity, high blood pressure, diabetes, not to mention problems with their actual heart which come into play.

[Elli86 in reply to Physalis]

How long has It been since your ablation physalis?

[Physalis in reply to Elli86]

Fourteen months.

[Elli86 in reply to Physalis]

Going strong then 💪 do you still take meds?

[Physalis in reply to Elli86]

No, only anti-coagulants. I don't understand why some people are still taking meds after their ablation. Are they afraid that, if they stop, it will come back?

[Elli86 in reply to Physalis]

No idea on that front physalis but for me personally the reason I had the ablation was to get off meds. If I have to continue taking them then I will ask myself what was the point

[dedeottie in reply to Physalis]

In my case the ablation was deemed to be a success but only in that it kept my AF at bay whilst still taking the meds. Previously the meds had stopped working. I was very disappointed but learned to be grateful for any respite I could get. I should add that my AF was paroxysmal but getting much more frequent and troublesome. In all other ways I was healthy. Good weight, Bp lifestyle etc so just bad luck I guess. I am 65. X

[Buffafly in reply to Physalis]

Usually because their EP wants to be sure the heart stays in NSR, then reduce gradually. My meds were stopped on the day because the anti arrhythmic had become dangerous for me. And some people still have AF after ablation 😕

[Physalis in reply to Buffafly]

I suppose that makes sense but only if the EP or the cardiologists follow it up. Left to my own devices I could still be taking the bisoprolol because no-one told me to stop.

[CDreamer]

All you mentioned are factors but a few others

Experience of EP as well as skill -

Equipment -

The sub-structure of your atria and the amount of ‘re- Modelling’

Your fitness and lifestyle - eg: weight, diet, sleep, stress management

Other conditions

Age maybe a factor, not our chronological age but our biological age which is a new but very important science to do with how our body regenerates and what happens when cells start to age and therefore malfunction.

Mindset I believe also has much to do with recovery. If you are constantly worrying and stressing at every small symptom it may have a negative affect.

Luck? Don’t believe so other than equipment working on the day. I had 2 catheters fail.

[BobD Volunteer]

Yes skill and experience. A good EP with a track record of success helps. He/she should be doing a lot more than one or two a week.

Rest and recuperation post procedure are vital to allow the heart to recover gently.

To my mind the most important factor, however, is the patients themselves.

Too may people expect the world to do everything for them and refuse to change those things which caused the problem to start with. Diet and life style have been shown to be the most important factors in controlling AF. Obesity, poor diet, alcohol intake, over exercise etc all need addressing if the hard work and skill of the EP are not to be wasted. We see more and more that people who refuse to or for other reasons are unable to change are often refused ablation treatment simply because the medical staff know that it will not work.

Lastly yes mental attitude. The mind is a powerful thing and properly controlled can do wonders. You can have the best diet, the healthiest body and still be ill if you are not positive. Controlling worry and anxiety and chanelling inner strength often succeeds where drugs and other treatment fail. We regularly hear of people who, having had AF asymptomatically for many years with no knowledge and then have a diagnosis by chance, perhaps duringa simple examination for another complaint, suddenly they become ill. Nothing has changed other than knowing they have AF.

Moving sightly to the side here I doubt that I am alone in feeling that the medical profession should change their approach to treatment to include help for people to address their mindset . When I was a patient representative on a committee developing the arrhythmia nurse role my aim was to include psychological help as I knew from personal experience just how disturbing a diagnosis of AF could be. Whilst everybody agreed it was important I am still waiting !

[Lenlec in reply to BobD]

Thanks Bob. Wise words

[bassets in reply to BobD]

I absolutely agree with all you say, Bob. The shock and fear of finding you have a diagnosis of AF.

[Fibber222 in reply to BobD]

What a wise reply Bob. I soo wish I could overcome my anxieties and be able to deal with them positively instead of dwelling on them. I believe that Anxiety is definately my trigger 90% of the time. I had gone nearly 5 months this time without an episode and ‘bang’ a 2 hr episode followed swiftly by a 9 hr episode yesterday. This was preceded by a worrying episode that I just couldn’t seem to deal with.

[Buffafly in reply to Fibber222]

Yesterday we had some very bad unexpected news about my husband’s health. My first worry was how things would turn out quickly followed by my second that anxiety would tip me into AF 🙄 You’re not alone 💜

[Fibber222 in reply to Buffafly]

Oh Buffafly I’m so sorry to hear that. I’m sure we all will be here for you. My anxiety reason was nothing to your news. I will be thinking of you. I hope you are back in NSR now x

[Buffafly in reply to Fibber222]

Thank you so much, fortunately my heart has behaved so far. About 25 years ago my husband was found to have a very large abdominal aortic aneurysm which was operated on but it was touch and go. Last week he had investigations for suspected cancer because of abdominal pain but the CAT scan showed that he has another big aneurysm. My first diagnosed episode of AF came after weeks of anxiety waiting for the operation so I got a feeling of deja vu 😨

Anxiety is anxiety, mine doesn’t trump yours, no one can say what situation pushes someone else’s buttons but with AF it’s doubled 😬

[Fibber222 in reply to Buffafly]

Hi Buffafly, I’ve just gone into AF again- that’s 3 days in a row. Take meds again in an hour so hopefully will stop this evening. What a pain. I’ve had upset tum for the last 3 days so maybe my meds aren’t working as they should. I do hope they didn’t find cancer and that they can deal with his aneurism.

[Buffafly in reply to Fibber222]

That’s right, I was told that - not enough is absorbed…..

[Eliza2 in reply to Fibber222]

Afib is extremely anxiety provoking especially for us folk who have struggled with anxiety before ever having afib. I totally understand what you are saying. Then the anxiety goes up knowing you aren’t supposed to be anxious cuz it may bring on the afib again or certainly make it worse. Quite the struggle. I remember thinking when I first got afib “this is my HEART!!!” After 3 ablations and a pacemaker my heart anxiety is greatly diminished but for 4 years going through it it was a real struggle.

[UkeMan in reply to BobD]

Your spot on, Bob. This is one of the best comments and advice posted. "AF Community" take note.

[Adalaide2020 in reply to BobD]

Hello Bob. I just wanted to add that I realised many years ago how anxiety was affecting me and my af but no one made mention of this fact. I told my cardiologist and he didn't respond. This is 20+ years ago mind but as a worrier I knew I was not doing myself any favours with my mind set but what was I to do? I read everything I could on the subject . I we t to counsellors and did CBT. I did yoga and meditation. I have had 3 ablations and went in each time with a positive attitude. I'm heading for a 4th but I still have the same attitude. I'm not afraid. I do know my af is a difficult one (EP told me recently). But along with keeping a healthy mental attitude I keep my weight down, I eat a very good diet, I could do more exercise but walk every day and run upstairs if my knees allow 😬. Fear is what keeps us sick a lot of the time. I'm not suggesting we ignore our fear but accept that it is a part of life along with all the other emotions. Recognise it, work to get around it, breath, express gratitude, get proactive to find out all you can about af. I wish the cardiology departments had psychologist to help with this but the NHS probably would not fund that. I asked for it all those years ago but there was and is too much fire fighting going on. Long rambling reply sorry 😁

[Eliza2 in reply to Adalaide2020]

Yes I agree with the need for emotional help that the EP and cardiologists don’t seem to even acknowledge!! There is a great deal of fear and indecision with afib and how to deal with it. No clear road map here. Research for the best EP you can find and get different opinions. In my case after being so I’ll from the heart medication that I could not tolerate ablation was my only go to as I could not deal living with my constant afib. Still very stressful times trying to cope with the process.

[dedeottie in reply to BobD]

Great post Bob. I would’ like’ it but my phone won’t let me. 😠

[CJB5569 in reply to BobD]

Very interesting thank you

[TracyAdmin Partner]

you may find it helpful to view some of online patient resources and videos on the A F Association website heartrhythmalliance.org/afa..., you will also find it very helpful to join us for our HRC2021 A F Association Patients Day taking place Sunday 3 October, follow the link to view the full agenda and details on how to register heartrhythmalliance.org/afa...

[Lenlec in reply to TracyAdmin]

Cheers Tracy

[greyarmadillo]

Hi,

I had an ablation on 12th August and it all seems to have worked.

My only comment is, while the clinical team will undoubtedly work hard on all factors within their control, the patient (i.e. us) needs to work just as hard on all factors within their control.

By this I mean be as fit as you can be on the day, most people wait a number of months for the operation so follow guidance on managing your condition to the letter prior to the procedure.

For me it is Afib - I follow a vegan diet, no more alcohol, no caffeine, no refined sugar (terrible trigger for me), exercise daily and focus on weight loss. I make sure I take all my meds exactly as prescribed and with consistency, pre-ablation even a slight variation resulted in Afib.

I also read all information about a catheter ablation on the AF alliance, BHF and NHS. This prepared me for surgery and how to manage after it.

I suppose, what I am saying is if you do your homework and work as hard as the cardiologist and their team will for a successful outcome you increase your chances of a positive result.

I hope that helps.

[BRHow]

1. Skilled Dr. 2. Beat up to date high tech surgical equipment. I work at numerous hospitals. 2 hospitals have old out dated medical equipment. I feel so bad when I see patients being wheeled into the OR. The Docs request certain stuff and the hospital makes them use whatever product is on contract.

3. Someone to show you some tender loving care after the case and when you go home.

[Elli86]

I agree with all your suggestions and as a few others have mentioned I think a lot of it comes down to the patients lifestyle changes pre and post ablation. Exercise, diet, sleep, stress management etc.

Also massively agree with Bob on the mental health aspect. This is huge in my opinion. Your outlook on the success of the procedure I think can have an enormous baring on the actual outcome. Mental outlook is key. Meditation is superb for this 👍

[Ducky2003]

All of the above 😁.

[Geoffa1]

The old adage, 'what you put in is what you get out' and to quote Churchill 'never give in, never give in, never give in' are most important in getting the best out of the ablation procedure.

Top it off with Einstein's opine 'insanity is doing the same thing over and over again and expecting different results' confirms the importance of some semblance of life modification after ablation.

I have been recovering from a total knee replacement concurrently with an ablation. Recovery for both is a long-term journey. With a knee replacement the trauma is obvious not so an ablation. This obvious TKR scar belies the internal carpentry that was performed. Like an ablation how you manage the internal carpentry defines recovery!

[dedeottie]

Skill of EP performing ablation.Severity of AF

[Mjlarson11]

The items of importance to me were

1. Experience of EP

2. Assurance that the EP was doing the surgery vs supervising a student

3. The experience of the surgical group operating as a TEAM. In the unlikely event something goes wrong you want a surgical team that has worked together

[KMRobbo]

All yours plus fitness, and possibly most importantly lack of comorbidities.

[wilsond]

Not had one . We are told time and time again that it is very important to research the skills and experience of your EP.I agree.

HOWEVER...after doing just that ,at my last virtual appointment I was told "Oh it might not be me on the day , depends on the list"(!!!)

So that fills me with great confidence that I may see someone approaching me in scrubs that I have never set eyes on before,to fiddle about with my heart!

Actually I have had time to reconsider after breaking my shoulder and several ribs.

Hope you are able to come to the decision best for you, but I am stable (🤞🤞) on meds and lifestyle changes .

Good luck

[Jimmy37]

Skill of the ep, pot luck