I found my way into this very helpful forum because I have experienced Afib following my 2nd ablation for supraventricular tachycardia (SVT). It seems my SVT is gone, but it might have been replaced by afib. I think afib ablation is more complex than SVT ablation, takes longer to perform and also has a longer recovery/blanking period. My understanding is that for afib ablation a 'hole' is made from right to left ventricle, but this is not done in SVT ablations. Afib ablation involves the AV node and therefore a pacemaker is needed. Is everyone who had afib ablation on a pacemaker? Irrespective of any of the above, I believe and feel in my heart that the recovery period (7 days) told to me by the medics is wrong and for SVT it is more like 3 months. And if afib ablation is more complex, even longer for afib ablation. I was told that after 6 weeks one would know if SVT ablation was successful..........I don't agree. Look forward to replies.
ablation - types and pacemaker - Atrial Fibrillati...
ablation - types and pacemaker
Whilst you are correct that the catheter has to punch though the septum you are quite wrong about the pacemaker.
Pulmonary vien isolation (Ablation for AF) goes nowhere near the AV Node and this is a quite seperate procedure .
Yes a few people who have a pacemaker fitted may go on to have the AV Node ablated where all other attempts to control the heart have failed but this has nothing to do with normal Ablation for AF. Why not go to our main AF Association website where there is a wealth of information, fact sheets and booklets on all aspects of the treatment for AF.
Welcome to the Forum - our members will offer great advice and share their experiences with you I am sure! However, please do not hesitate to contact the A F Association for further help and support heartrhythmalliance.org/afa...
7 days for recovery is very optimistic... I had an AF ablation and it took at least 6 months to recover from it and I had an SVT ablation subsequently and it took about 3 months to recover. I was told that an SVT ablation could have affected the AV Node and that a pacemaker would be possible outcome but my SVT was a slow fast AVNRT , not close to the avnode. I do not have a pacemaker...
You say AVNRT or AV Node Tachycardia is not near the AV Node? Is this correct?
I have AVNRT that occurs at the AVNode.
Sorry, I badly worded that, written in a hurry. My EP study showed that I had "a dual AV Nodal physiology with typical slow-fast AVNRT inducible with programmed stimulation ans isoprenaline. The slow pathway was ablated at the usual site and subsequently there was no tachycardia inducible". So my ablation site was not close enough to the AV node to damage it and require a pacemaker.
This is only from what I have read and been told, but I think SVT ablation recovery can vary as can all procedures like it. In AF ablation (mine was for atrial flutter in the right atrium), the septum between the two atria is slightly punctured to allow the catheter through into the left atrium. It's a needle catheter so the hole heals nigh on instantly. The healing period is said to be up to three months but a friend has had three and he's been able to return to teaching very soon after each.
I gather that a pacemaker is sometimes fitted for AF to control the bradycardia resulting from rate-control medications such as betablockers or digoxin, thus allowing larger doses to be given safely.
Steve
It makes no sense to take beta blockers that reduce heart rate and then insert a pacemaker to increase the heart rate to allow one to increase the beta blocker dose.
It does sound perverse, but how else would you treat AF if bradycardia is a problem and more risky drugs aren’t safe?
Steve
You will not get a pacemaker for bradycardia caused by AFib. An ablation would always be done to rid one of AFib. This done then no need for beta blockers.
I disagree.
There are many studies that will contradict your views, e.g.
“Symptomatic bradycardia, often due to sinus node dysfunction, complicates atrial fibrillation (AF) management, often requiring permanent pacemaker implantation. [1–5] Bradycardia may be a manifestation of general conduction system disease or iatrogenic due to medications used for AF rate control.”
And this from the NHS website, “Atrial fibrillation can usually be treated with medication, but some people don't respond to treatment, so a pacemaker may be recommended.”
Correct. The pacemaker is a type of signal generator and not a signal arrestor.
It cannot absorb extra or fast signals. A Pace and Ablate procedure is done when no other treatment for AFib is successful. A pacemaker is then inserted.
This does not stop the Afib in the atrials itself but stops the ventricular response to AFib.
I’m told that pacemakers are also regularly inserted in Leicester Glenfield for allowing increased beta-blockade when symptomatic bradycardia can’t be tolerated.
My neighbour’s sister had one for this reason several weeks ago. She’s doing well but, as you say, her now persistent fibrillation hasn’t changed. She refuses to try flecainide or sotalol.
I disagreed with Palpman’s statement that:
“You will not get a pacemaker for bradycardia caused by AFib.”
I’m afraid the staff at Glenfield Heart Unit wouldn’t be agreeing with you. They told me that pacing is often needed for just that reason.
Steve
It makes perfect sense but a pacemaker doesn't increase heart rate it prevents bradycardia.
I believe it’s job is only to increase heart rate; sadly, it can’t decrease it or it would be wonderful device indeed.
Steve
The rate response function can increase rate if the pm thinks you are climbing a hill or running a race but mine is turned off as it was increasing inappropriately. My pm now purely gives a kick if my rate drops below 60, it doesn't increase just prevents rate going lower.
I've had two ablations, sadly unsuccessful. The recovery period for me was 4-5 months. That was to return to brisk walking, light cycling and an active job as a fitness instructor. I do not have a pacemaker, I think that comes after the Pace and Ablate procedure, others will be more knowledge about that. Good luck
Fabfibber,The real opportunity in the pacemaker is the telemetry they offer so a cardiac scientist can track your heart status 24/7 from anywhere in the world. This takes all the uncertainty out of what is actually happening.
You might read my recovery post.
My experience is: PAF diagnosis, not sure best prognosis. Loop recorder improved fidelity of understanding nature of problem. Pacemaker, perfect fidelity, real time, fully informs experts. After ablation pacemaker shows exactly what is going on.
I get a three month detailed report, albiet a tad hard to understand, showing all the key parameters.
Ablation is not a trivial procedure whilst I had no AFIB after the procedure I really did not start to get my life back until about four months.
Now all good.
Hope this helps.
Geoff
We are talking past one another here so I'll try again.
AFib accompanied by sick sinus syndrome or sinus pauses not caused by drugs such as beta blockers can be treated with a pacemaker.
This pacemaker treats the bradycardia arrhythmia caused by the damaged sinus Node and not the AFib.
Only then can bb be taken to reduce Atrial fibrillation.
A pacemaker is not inserted to enable stronger beta blockers to be used as someone stated.
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