Afib returned 10 months post ablation

[Irev83]

Hey guys,

I don’t really know what answer I’m hoping to find here but I think I need some comfort.

My husband (30yrs old) had an ablation last June due to his afib, and has ever since been afib free (apart from one minor episode in the first 3 months afterwards). Today he told me that he think afib returned, he can tell from his chest pain. :’(

Im really sad and disappointed. I thought it worked. Maybe even for good. But I guess it’s a very bad sign if it already came back not even a year later.

He also caught Covid last week, but told me afib was there before.

[BobD Volunteer]

At least you both know what to expect from the next ablation. Repeats are often necessary. I had three before my AF was terminated in 2008. Its all part of ongoing treatment as you should have been told.

No point in worrying, just contact your EP after a week or two once the covid has settled if he is still in AF.

[Irev83 in reply to BobD]

Thanks, Bob. We have been told that a second ablation may be necessary at some point. Just hoped for a longer time of no-afib. Going through this procedure was such a stressful time for all of us and you hear about people that were afib-free for much longer.

[pusillanimous in reply to Irev83]

Certainly young athletes appear to be free for longer - my son a competition canoeist and white water raftist, had an ablation 16 years ago and has been completely free ever since.

[lindyloo59 in reply to BobD]

Can you ask if you have pacemaker for when you had ablation? My husband has just had pacemaker fitted yesterday and nurse said you need to have pacemaker fitted before they do ablation he is not having ablation soon but could be a consideration in the future thanks

[CDreamer in reply to lindyloo59]

Different type of ablation Pace & Ablate is where they ablate the AV node making one PM dependent.

Ablation just means to destroy - you can a late all sorts of things.

IRev is talking about a PV = Pulmonary Vein ablation which destroys tissue in and around the veins & the atria to cause scarring which blocks the conduction pathways which cause AF.

The first is permanent and a last resort treatment for symptomatic AF, it doesn’t stop AF but lessens the symptoms whereas the second is an attempt to stop AF but doesn’t always work first time.

[BobD Volunteer in reply to lindyloo59]

CDreamer is apparently a ventriloquist but I totally confer.

[Padayn01]

May I ask how bad was the AFIB before abalation?

[Irev83 in reply to Padayn01]

It was very bad. 1-2 episodes a week lasting from hours to days with up to 160bpm, chest pain, dizziness

[CDreamer in reply to Irev83]

That’s not unusual when it becomes progressive. I went for Pace & Ablate, g to he PM made a huge difference to my QOL.

[opal11uk]

You state that he has chest 'pain' if this is the case then he needs to see his cardiologist.

[Ppiman]

I would either go to an A&E or a GP surgery for an ECG to confirm it is AF, or buy an Apple Watch / Kardia device to enable self testing.

I've read that recurrence rates are quite high but that drug therapy can work well in younger people, with flecainide seeming to be the option mostly chosen. It seems that a second ablation is often more successful than a single ablation, too. My son's colleague is now 76 and has had four ablations over a long period (he must have been one of the early patients as his first was many years ago).

Steve

[Coco51]

Agree that the chest pain needs addressing, but Ive had 2 ablations and a back-up pacemaker. You might be interested to know, my AF came back, for 10 non stop days, about month after the first ablation. Then stopped. Then 9 months after the first ablation it came back again and was persistent- ie it never stopped. So I understand your disappointment.

After the second ablation, I had about 4 months of quite bad attacks with horrible pauses. They said it was the heart muscle being irritated by the procedure ( I was pretty irritated too!!) It then stopped for ages til I tried to cut down on Flecainide. But once I upped the dose again it stopped and I get AF occasionally and mildly now and I seem able to ignore it.

I had a pacemaker fitted for bradycardia but it's only back up and isn't intended to help the AF - although it could if I had the Pace and Ablate procedure that CDreamer talks about above.

Don't feel too down about it. They do say that 3 ablations are necessary for some patients. But EPs that do bolder more ambitious ablations, ablating more multiple trigger points than just the PVs in the heart, do seem to have better outcomes. Maybe you could discuss this with your consultant if you go for another Ablation?

Bon courage ❤

[DKBX]

It’s a journey. Four ablations so far; multiple tries on different drugs; lost track of number of cardioversions. Did all the right things (tea total; down 3.5 stone; daily yoga and walks). STILL occasional blips but getting better (touch wood). Keep seeking out good EPs and medics who’ll listen and explain. Find those who you trust.