Do ablations work for persistant AFib?

[Kennyb1968]

I get conflicting advice about this- any thoughts?

[BobD Volunteer]

Nothing is impossible. As I said recently the usual way forward would be a cardioversion (DCCV) to see if you can be put into NSR and if so ablation may help but equally may need several procedures.

[Jalia]

I'm assuming you mean persistent and not permanent as people often confuse the two. Persistent meaning that the episodes last for 7 days or more and require assistance by chemical or electrical means to revert to sinus rhythm.

The answer then is yes, they do work but may require more than one attempt. I've had mainly persistent AF for nearly 30 years and had my 4th ablation 12 months ago.

[Kennyb1968 in reply to Jalia]

Thanks - and if it was permanent?

[Hidden in reply to Kennyb1968]

There is always a degree of confusion between the definitions of persistent and permanent AF. As I understand, someone has permanent AF when both the patient and their medical team have decided not to pursue any further treatment for returning to normal sinus rhythm…….

[Jalia in reply to Kennyb1968]

I understand that it is more difficult and a straightforward Pulmonary vein isolation is not normally sufficient.

Maybe those who were in permanent AF and returned to NSR successfully will post on here with an answer, straight out of the horses mouth , so to speak! ( what an odd expression...I've never written that down before

🐴🐎😄 )

[mhoam]

Hi,I was really pleased with the effect of my cryo-ablation. I was very symptomatic when in AF and it had become persistent when Flecainide and Bisoprolol seemed to stop working.

It is only 3 months but I have had only one short episode since and am feeling a lot better.

Of course it is not a "cure" and everyone is different but it certainly helped my QoL a LOT !

good luck

[jeanjeannie50]

I can't help but think there should be another description for continuous AF other than persistent, which is why I say I'm in constant AF. To me persistent doesn't always describe something that never stops for even a few minutes.

Would be interested to hear the views of others here.

Jean

[Jalia in reply to jeanjeannie50]

Constant sounds a good word Jean !

Aren't you in permanent AF though ?

[jeanjeannie50 in reply to Jalia]

Yes, I'm in constant permanent AF. Don't constant and permanent mean the same? I'm starting to confuse myself now!

Cardiologist looked at my ECG last month and told me to stop taking Flecainide as it wasn't helping my heart and could be making things worse. Now just taking 2 x 25mg Metoprolol. Trouble is with this unbearably hot weather it's difficult to say how you feel as the heat is unbearable.

[Jalia in reply to jeanjeannie50]

I suppose one reinforces the other!Hope you get on OK minus the Flec.

I'm still on my anti arrhythmia drug 12 months post 4th ablation. I had a short but nasty burst of AF last week just to remind me that it was still lurking. I seem to have gone bradycardic over the past few weeks with a few 40s ( non resting) which pulled me up sharply! Will be speaking to EP next week, hopefully.

[jeanjeannie50 in reply to Jalia]

There's never any peace with this AF is there? Just when you thought it was safe to go back into the water - wham!

[mjames1]

Short answer is "yes". As long as you are not in "long term peristent" or "permanent" the odds should be exactly the same as someone with PAF.

I go into it more in detail in this recent post here:

healthunlocked.com/afassoci...

Jim

[mjames1]

I also want to add to my first post in this thread, that in order to be in "persistent" afib, you need to have a single episode lasting more than seven days. Unlike what some think, persistent afib doesn't mean you have had short episodes for a long period of time. Major difference in classification. From what I've read in your posts, you are in PAF.

Jim

[Buffafly in reply to mjames1]

Good point, I think Kenny is interpreting persistent as AF that doesn’t self revert quickly and /or many small episodes?

[CliveP]

Ablation certainly worked for me.I never had PAF, I went straight to persistent (constant) AF. Apart from a few days after a cardioversion I was in AF all day every day.

Despite being generally asymptomatic I had an ablation as soon as I could rather than risk any deterioration in my condition.

I had the ablation in Sept 2016 and so far it’s been a complete success. Pretty much 7 years without any sign of AF.

I have been very lucky 🙏

[Kennyb1968 in reply to CliveP]

Brilliant

[CliveP]

I realise my maths is a bit off. It’s obv almost 6 years not 7. I’m optimistic that I’ll reach 7 though. 👍🙂

[MummyLuv]

Depends on how you define persistent and how long you have been in that stage.

For those in constant (like that work Jean!) afib for 12 months or more the likelihood of catheter ablations being successful falls dramatically and with 2 catheter ablations the likelihood of success is 30-50%. If you are less than 12 months or you are able to convert with the help of a cardioversions your odds will be between 50-85% and for those in PAF odds are great at up to 90% success. These figures are from various research reports and generally these reports are NSR 12 months out from ablation.

When you are in long term constant afib then IMO surgical ablation or hybrid procedures should be considered where success rates are still as high as 85%. There are research reports now saying this although accessing these procedures can still be tricky.