Failed Ablation but it’s ok ? Just wondering what they do next

[mjm1971]

Ok so I know I will be shot down and be told it’s still early etc etc .

But I had my ablation 9 weeks ago and for the last 6 weeks I’ve been in AF for 50% of the time and that’s far worse than before the ablation .

The longest I’ve been out of AF is 3 days and on average its 24 hours in and 24 hours out of AF

I always seem to flick in and out of AF over night while asleep so what ever I wake up in is what I stay in for that day .

My heart rate averages 90 when in AF and I don’t suffer too bad compared to most .

So for me the ablation has failed and I have almost got my head around that although very down about it I know it’s a long journey and I’m only 51

but I have some questions .

A) if ablation is working do episodes gradually slow down and stop or do they just suddenly stop ?

B) when I have my follow up appointment in 3 weeks what will they say or do based on my amount of AF I’m now having .

I’m already on 5mg of bisoporol and 200mg of Flec per day .

C) How do they check what the first ablation has actually done to the Veins etc can they screen me to check the scar tissue or something ?

Any advice on what the next stage is after a failed ablation would be appreciated please

Thanks

Matt

[BobD Volunteer]

OK I had to check back your profile but see that you had a cryo balloon ablation. For many people who are lucky enought to have nice neat pulmonary viens this is great but a fair percentage of people don't. For those an RF aablataion is often needed as touch up to sort out the missed areas.

Regarding question C they can check when they aer doing the RF ablation where they need to ablate.

I still think you need more positivity though. SO MUCH depends on your mind set.

[mjm1971 in reply to BobD]

Hi Bob

I just wondered if there was a scan they could do to check rather than only when next Ablation is carried out .

I understand the positive attitude approach but when your auntie had a stroke at 52 and your mum had AF and a stroke at 67 it’s difficult .

Neither of them smoked or drank and were physically fit .

My mum had AF but the medical world still don’t officially see AF as hereditary ( joke )

For my mum to have it and me is more than a coincidence .

So my mind set can’t help but wander and if she had a stroke despite no drink and smoke and being on thinners then what ever hereditary aspects I have got would potentially be the same .

So all the time I’m in AF It’s difficult not to be concerned re having a stroke so that’s the frustration I have .

What are the real odds of a 51 year old on blood thinners who doesn’t drink or smoke and having a stroke from AF .

5 x more likely isnt the stat for everyone who has AF it must reduce dependent on other factors .

Sorry for the rant but feel better now lol

Cheers Bob

[Hidden in reply to mjm1971]

Hi Matt, I think we can all under why you are so concerned, it’s commonly known that AF can be hereditary and that anticoagulants do not guarantee freedom from having a stroke so it’s not surprising that you are worried. The only positive I can offer is that you are at least aware of your condition and the risks associated with it which means you can do everything possible to minimise the risk with medication and lifestyle.

I’m no medic, but I believe establishing the causes for AF in terms of finding rogue impulses can only be determined by having an ablation. There is a term for a procedure where they use catheters to investigate and then only ablate if necessary but I can’t remember what it’s called but in reality it’s no different than having an ablation. The only “scan” that I’m aware of is an echocardiogram which establishes the overall performance of the heart.

Like BobD, I also checked your history and saw that you had a Cryoablation. I had mine in 2016 and was told that they had difficulty in treating one of my pulmonary veins so it was no surprise when AF, albeit much milder, returned and a second RF ablation was carried out in 2018. All was well for about 8 months but then episodes returned but at the time, my thyroid was diagnosed as overactive. After treatment, over time, the episodes reduced and 🤞I have not had AF for well over a year now 🤞

Might be worth having your thyroid function checked as there is a significant connection between AF and thyroid. I know it’s not going to be easy for you given your family history etc but you can only do your best to minimise risks. Of course the fear is real, but somehow you need to find a way of not letting it spoil your life…..easy to say I know!

[mjm1971 in reply to Hidden]

Thanks Flapjack

Your comments are always welcome 🙏

[Jajarunner in reply to BobD]

I find the comment about positive mindset completely offence. I approached each of mine thinking they would work and was devastated when they failed. Positivity doesn't cure Afib because if it did I'd have been 'cured' two years ago and would have avoided eight extra cardioversions.....

[Jajarunner in reply to BobD]

I meant offensive, I meant. Lol

[DKBX]

I am pretty close to being in the same boat as you. So many ablations (1cryo and 4rf), still on beta blocker and flecainide and Xarelto, so many cardioversions … I’ve lost count. I keep the medics busy with lots of questions and appts. HOWEVER, my best friend is a cardioversion, even after an ablation that has “failed”, just to kick the ticker back to normal until it learns the best pathways to take while healing. Be patient but persistent with the EP until you get seen.

[Snowgirl65]

I'm sure you heard it all regarding the blanking period. I had a similar situation to yours whereby my a-fib episodes increased weeks after my (first) cryo ablation. When one episode lasted a day, I was told to go to the ER, my doctor met me there, and I was wheeled down for a cardioversion which did the trick and shocked me back into NSR. As far as screening to check for scar tissue forming, it turned out that my cryo ablation mentioned was not performed adequately. My EP at the time said he attempted to get the vein behind my esophagus but had difficulty. A few years later, my new EP did a RF ablation (successfully) and discovered no scar tissue on the vein the first EP "attempted" -- he obviously lied about that. Can you ask your EP for a cardioversion? Your heart is obviously still healing and probably still inflamed a bit, but certainly something can be done to get you back in NSR.

[Jajarunner]

I have experience of this. Once my first ablation failed I was immediately put on the list for a second, I was then seen urgently after three cardioversions in six weeks. When the second failed I was again put back on waiting list a few weeks later once I'd had my followup six month EP appointment. This too was upgraded to urgent following four cardioversions in three months. My third appears to have failed as I needed a cardioversion just before the three months mark. My late three month follow up us in a few weeks, be interesting to see what they suggest. I suggest you make a list of questions to ask the EP in advance and, if possible, a 'secretary' to jot down the answers. Ask if you can email the EP later with any further questions. I won't be having a fourth at this stage, three ablations in 23 months is enough for now seeing as it takes me four to six months plus to get over each one!