For those who have had to have a second ablation did it work? I had my first in June and it literally didn’t help at all. I am still getting a fib every week for minimum of 10 hours. My 3 month check up is coming up and am just looking into my options going forward.
Flecainde helps but cause extreme weight gain and just didn’t feel well on it… so I don’t really want to go back on that. I’m 37 just trying to get my a fib under control. I am conflicted as what to do atm.
Cardio version also didn’t work I’ve had it done 2x.
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Afib_girl
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If cardioversion doesn't even put you back into NSRregradless of for how long then ablation may not succeed either.
I had three ablations for AF over a four year period. My first made things ssightly worse, my second was great for about 9 months before AF returned and my last on 2008 left me AF free. We are all dfferent but I would seriously ask your EP what he thinks are the chances of success bearing in mind the failed DCCVs.
I had Paroxysmal AFlutter and a CV 4 mths after diagnosis. AFlut came back worse after CV. 1st Ablation 3 mths later partially successful, 2nd one another 22 mths later was successful although I did then developed AFib!
So the 2nd Ablation worked for me, and I understand the success rate after the 2nd Ablation is in the region of 90%. It’s all probabilities though and not much comfort if you are in the 10%. For me I thought the benefit of trying, way outweighed any risk / discomfort.
I’ve been on Flecainide 50mg 2 x daily since the last Ablation, the only impact I can identify is that my episodes are much reduced. Flec has certainly not caused me any weight gain, in fact I have lost a little over the last 6 mths. and judging by a recent thread on this site, the vast majority of people don’t have any weight gain issues with Flecainide.
All I can suggest is you take advice from your EP but recognise that there is no certainty how each person will fair or react so tailor the advice to your own circumstances.
I had a 2nd ablation in April 2022 which only held me in NSR for a week and then I went back into persistent afib. I rang the arrhythmia nurses and they contacted my EP who suggested a cardioversion which I had in June. I’ve been in NSR since then and my resting heart rate is 58bpm. I was diagnosed with persistent afib approx 3 years ago and I’ve had 2 ablations and 4 cardioversions at St Thomas’ hospital in London. I take Bisoprolol and Warfarin.
interesting… that’s what I’m concerned about esp since cardio version didn’t help me either… I don’t want to do ablation again and end up in the same boat
Yes I had a 2nd ablation about 2yesrs later with a different Doctor.It worked.No side effects like I had after the 1st either.Im glad I got the courage to go through it again.Its been 3 years now and it seems to be holding things steady.
My 2nd is working well so far. Almoat 5 months in NSR. But still early days. Never heard of weight gain on Flecainide. I didnt find this. Bob's comments i think are the most sensible.
I had to have a second ablation in 2017 four months after the first attempt and so far five years on I’m still absolutely fine. I too couldn’t handle flecanide.
Good morning from a wet southwest of England, yes, I had two ablations which neither held more than a few days each. The medication of Bisoprolol did not agree with me as it made me very tired and out of breath. Finally, I have had a pacemaker fitted with the AV node ablated in 2021, now I am back to my old self {golf three times per week} with only a blood thinner to avoid strokes.
The decision to become dependent on the pacemaker did take some consideration, but it has worked out pretty good.
When you say you have about 10 hours of Afib a week does that mean you self convert to NSR in between ? I am a bit confused about you saying your cardioversions didn't work which suggests persistant Afib .
I had my ablation about the same time as you and my heart went a bit bonkers after so I am on Amidarone started 3 weeks after ablation ( to be taken for just under 3 months) to give my heart a rest. Since I have been on it I have had no Afib or Flutter but I think in the USA it is only given fot VT?
I come off all meds in 3 weeks and 2 weeks after that I will have a 3 day Holter to see where any rogue signals are coming from. I think I have Flutter so pretty sure I will be having a 2nd ablation. Just hope my Afib will have improved or better still will have disappeared.
Just a comment on amiodarone use in the US. It is widely used here, not just for VT but for various arrhythmias. My mother has been on it, low dose ie 100-200 mg daily, for over 22 yrs for simple paroxysmal atrial fib with no structural heart defects. At low dose it can be very effective and has few if any side effects in most people, but it is used very cautiously at high dose and only for specific cases, due to worse side effects at the high doses. My GP says some of his AF patients for whom nothing else worked are using a fractional dose of amiodarone, and it is keeping everything steady, so that’s good to know… and if amiodarone doesn’t work, there is also dronedarone here (without the iodine component). Both are options in many cases.
Thanks for your message. My cardiologist won't put me on it for longer than 3 months. I asked if we could halve the dose to 100 mg but she was adamant that I had to come off it. My heart feels like it did before I ever got Afib - really a miracle drug! But I would be worried about the effects on my lungs long term so obviously I respect her expert opinion. I live in France.
I'm pleased it has worked for so long for your mother. That's a good story to hear.
Yes, Lilypocket, mom has never had another episode of AF in almost 23 yrs! Hers (like mine) was very symptomatic, until she went on amiodarone. She gets regular tests and checkups, no issues with liver, lungs, eyes, etc. And amio seems to “agree with you”, also. I was happy to hear that your heart feels so good on amio. With regular testing and check-ups to catch and halt any bad side effects, I wonder why your cardio wouldn’t at least let you go 6-12 moths at 100 mg and let experience be the guide… esp since that’s the dosage that causes the least side effects.
My family members from 150 yrs ago were French, from Strasbourg! Have never been there, but hopefully someday. Better and best health to you! Diane S.
Hello, I had 2 cardioversions one lasted a few days one a few weeks. Then first ablation lasted a few months. Second ablation lasted around 6-8 months . Third failed completely and I’ve now had Pace and Ablate which feels just wonderful.
In my opinion going for the second is worth a shot as I did get quite a few months of feeling really well which was wonderful and for many people it is more successful.
For me, diagnosed with parox afib about 4 years ago - within last 23 months have had 3 ablations. 3rd about 3 weeks ago for lots of ectopics and increasing frequency of afib. Would say that that 2nd ablation was only partially successful as had to remain on flecainide (but with the flecainide did help reduce freq and intensity of afib episodes for about a year).
Not sure how the 3rd one will take (still in blanking period) - but fingers crossed that I will be able to come off the antiarrhythmics in a few months and gain some longer term heart stability.
Hope that your heart settles down post ablation and gives you some peace for a good long while
2 cardio versions.....held for around a day. 1st (PVI) ablation held for about 3 days. Took them a couple of months to decide it wasn't AF any more but flutter. 2nd ablation (for flutter); job done !
it took four ablations for me. Still on flecainide and metoprolol and, of course, the anticoagulant. Gone tea-total, moderate exercise outdoors in sunshine, sensible diet, lots of yoga and conscious breathing, cognitive therapy for stress, Let’s see how long it lasts.
I've had 2 ablations and recently a hybrid convergent ablation am due a follow up ablation which apparently works hand in hand with the hybrid op. It's taking me about 8 weeks to get back where I was before my operation ,and yes I've been back in A/F since about a week after operation . Not confident that the next follow up procedure will work . Pacemaker has been mentioned ,but not sure if I want to go down that route . Meeting with the consultant end of October so may have more information to share,for now for all the breathless folk out there keep smiling and keep taking small steps at a time .
That's correct you do need the second op,for me it's been a long hard slog to get where I am today but let's hope after part 2 I get back to my normal self . I realise how lucky I am after reading what people go through on this forum .
since you are in the States, please do your research of the most experienced ep who did already thousands and thousands of ablations already . There are only 10 + only ep like that in the States. It means it requires some travel and lodging for a week for the ablation. The success of the ablation relies 100% on the skill set of the ep . I don’t know your medical history but at your age I guess it would be a lone Afib, which means no underlying heart issues.
a successful ablation will give you back a normal size of the left atrium. The dilation of left atrium means your rhythm control treatment does not work well given the frequency of the episodes as well as its duration. Please see with your ep , a new one preferably to adjust the treatment while waiting to find a highly experienced ep for your second ablation. For a remote patient , you contact them and they will ask for your medical records and they will let you know if they can take your case or not. Your case is not a complicated one. With their highly sophisticated mapping tools to detect all the rogue sources of Afib, you will be ok. With thousands ablations under their belt, Pulmonary veins isolation is not only the source of Afib since there are more rogue sources, which I don’t go into details here. Cleveland clinic or Texas Austin cardiac institute are the two best places to go.
Yes, good advice. I had two ablations locally, one for afib and one for atypical flutter. Both ablations help for a while - 14 months and 2 years. I recently had ablation #3 at the Hospital of the University of Pennsylvania in Philadelphia by Dr. Santangeli. He was trained under Dr. Natale who is a world famous top notch EP. Dr. Santangeli is now at Cleveland Clinic which is #1 for heart here.
I had 2 ablations for AF . They were 6 years apart. Both isolated the pulmonary veins. The first was RF and only partially successful and stayed on high dose of flecanide. Second was a cryoablation but pretty soon after( 2 months) went into SVE and flutter so had third to deal with this. I have had 6 weeks with NSR then out of the blue I had some intermittent AF which triggered flutter for 36 hours but then self converted. If it happens again my EP wants me to go on Amiodsrone to get over the healing period. I have been dreading this drug and so far resisted but I will go on it for a short time if necessary as I would do anything to make this work and if it does it will have been worth the hassle.
If it fails it will be a pace and ablate for me without any more ado.
Hope this helps in your decision making. It is not an easy choice.
I’m 60 and had paroxysmal afib for 6-7 years before getting first ablation in July. At that time I was having afib episodes roughly once per week and they lasted a couple of hours after taking 3 100 mg flecainide tablets. Prior to the ablation I had one cardioversion that was successful in the short term but didn’t change my overall pattern.
As you probably know, most folks who have afib are in their 50s or older. It seems like most (especially with parox afib) do convert when electrically converted. Your case is unusual in those respects. I’d recommend looking at the experience of folks<40 who don’t respond to cardioversions for the most relevant guidance.
I’m also nearing my 3 month checkup. After my ablation, I was in NSR for about 24 hours until I started experiencing all sorts or arrhythmias (almost continuously) that I’d never had before. Discovered that my heart didn’t respond to flecainide the same way after the ablation. Ended up in the hospital with severe tachycardia for a couple of days while cardiologist switched me from flecainide to sotalol. Eventually most arrhythmias stopped occurring and I stopped the sotalol. At this point I just get atrial flutter episodes about every week but they go away on their own after a couple of hours.
Our hearts do seem to continue to change/heal after three months so hoping you see improvement soon.
Your experience is similar to my own. I'm nearly 3 months post ablation and had many different arythmias after (all medication had been stopped day after procedure). EP put me back on Flecainide but it gave me Bradycardia. Strange. Now I am on Amiodarone which works perfectly.
My first ablation was a complete botch job by my EP. The second one was much better though I've had a few mild blips. I gained weight too on Flecainide, but immediately lost it when I changed meds.
I am 48 and have been in persistent afib for a year now. I am on anticoagulant but no other meds. By the sounds of it I think your quality of life will be better if you accept your afib is here to stay and get off the flecanide.
I have a stenosis of 2 valves, which we think is the source of the afib - but otherwise I am healthy. So my afib restricts me when I exercise, but otherwise it’s not really an issue.
Edit: The bit above was written on my phone and I am on my laptop now. I will add that if I had the choice, I would obviously much rather be in NSR. I do not know if this age or afib: but I am finding that I take longer to recover after a massive "workout" - like yesterday I did a 2 hour hike (my dog was even tired) and today my body told me it was not ready for a session of resistance training.
At least you’re keeping healthy and exercising. I just walk and cycle to try keeping the cogs turning.? I’d like to do abit more but the 10mg bisoprolol doesn’t fill me with energy.!!!!😳
my second which was an rf was great for a year and a half. My first was cryo and only good for six months. My third in April has not helped in fact I feel worse. It was a much more aggressive procedure fyi. It isn’t always that the procedure failed it is that a new a fib spot has appeared. My first two are still holding. My third seems to have missed the mark even though it was multi and VOM
we are all so different with this there is no right or wrong answer. I know that doesn’t help. I have been in tachycardia since May
I am now having #16 episode of afib in the past 2 years. I had an ablation in 2020, but it didn't seem to help, or obviously it didn't. I don't know. Every time I've been in afib, cardioversion has worked for me.
Current cardiologist has me scheduled for ablation 10-25, first available opening. He feels confident about doing another procedure.
Current afib now on day 7 and med changes have lowered heart rate, though sometimes it does got into 130s+, even at a normal heart rate if feels nothing like normal. I'm in a dismal situation now, but you may be fine, and whatever your decision, I wish you all the best.
Yes, I would recommend a second ablation procedure. I had my 2nd procedure 5 years ago and I have not had a AFIB episode (knock on wood) since this procedure. I changed my eating habits by cutting out caffeine and alchohol and I have started swimming again and I feel like my old self again. I would say go for it. What do you have to lose?
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ablation or no ablation, that is the question
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Ablation - Second Procedure
