Ablation efficacy

[Anonymouskd]

my sister had 4 ablations. None helped. In fact made it worse. My cardio keeps pushing me to have one. My GP (regular doc) knows of no one who has had one that worked more than a short time. Even after having several. Is there ANYONE in this forum who has had an ablation(s) that worked and I’d Afib free??? ??????

[CDreamer]

Not me - had 2, first made it worse - 2nd I had 3 blissful AF free years. At AFA Patient Day an EP was asked this question and WHY? The answer - EP’s burn or freeze and some patients heal so the pathways reappear.

[Physalis in reply to CDreamer]

I'm not sure this is right. I think that the existing pathways get zapped but whatever caused the AF in the first place can allow new pathways to develop.

I am very careful now to avoid stresses. Or should it be stressors?

This is also true of falls. Having had two falls in 2018 and 2019 I am super careful now to avoid it happening again. A moment's carelessness could mean I end up in hospital again.

[CDreamer in reply to Physalis]

Just quoting what was said……there are always more than one truths.

[Physalis in reply to CDreamer]

Maybe in time they will have machines which will be able to track every tiny little nerve in the heart. They might then be able to see if the old nerve pathways have been repaired or if the signals are travelling on new pathways.

[CDreamer]

Those for whom ablation did work 1st time tend not to linger on this forum so please take this into account.,

[Guitar335 in reply to CDreamer]

Absolutely agree. I think this exact point is a real risk in terms of us possibly seeing a distorted view. Whilst I have a huge appreciation of the people on this forum if an ablation removed my AF I would want to forget all about it and not read a forum that no longer applies.

Therefore we all get to hear of the failed ablations far more than the successes?

[BobD Volunteer]

Been AF free since 2008 but did go on to develop other arrythmias. As CD points out few success stories linger here as they are too busy enjoying life.

[jeanjeannie50]

My first 2 ablations made my attacks worse, the third helped but I'm now in constant low level AF at a rate of 60-90. Can cope with that and life is fine.

[Gertsen in reply to jeanjeannie50]

hi Jean How do you keep your rates low? I am getting longer snd longer episodes and I am m trying to control my rate with bisoprolol. I was on Donedarone but it did not stop the AF. I can’t take flecainide. I am not very symptomatic and go through my life as normal, I am caring for my husband who is bedridden and has Alzheimer’s, but I can only get the rate down to the 84 -100. I am speaking to my EP again in a couple of months, he want me to have a PA but it is not really practical for me given my situation. Sorry for the long message. Thanks Britta

[jeanjeannie50 in reply to Gertsen]

Hi Britta, what dose of Bisoprolol are you on? I take 2.5mg twice daily. Don't forget I've had 3 ablations. Have you had any?If I eat too much sweet stuff. Like a donut and lots of chocolate, my heart lets me know it's not happy. That's what I've done today and can now feel heart bumping around. I feel cross that I've had a weak day and eaten rubbish when I've been so good. Went shopping over the lunch period and they do say not to do that without eating beforehand. Oh I had two packets of crisps too - well there's so few in each pack these days. Honestly I deserve to be fat!

Jean

[Gertsen in reply to jeanjeannie50]

Hi Jean when not in AF I take 2.5 bisoprolol in the evening when in AF I take extra ones either 1.25 or 2.5. I have not had an ablation. I expect my AF to become permanent at one stage at the moment it seem to be 3 to 4 days AF 2 - 4 days NSR. I get anxious about going back in AF when in NSR but fine when it happens. I to get over 100 bpm when I go for a walk especially in the start of an episode. It seems to calm down later.

Thank you for responding. I am off to have a massage when the person who will look after my judo arrives. I do have 2 carers 3 times a day to do the personal hygiene for him I do the rest.

All best Britta

[jeanjeannie50 in reply to Gertsen]

The trouble is every case of AF can present differently. Before my third ablation I felt disabled when I went into long periods of AF and was unable to walk far. I had an unknown underactive thyroid and thought that the extreme tiredness I was experiencing was all part of AF - it wasn't. Taking meds to right that has really helped my energy levels.

Hope you find a solution to your attacks. Do you avoid artificial additives in food? That's an important thing that may help.

Jean

[wilsond]

I would challenge your Drs opinion,its specious! Yes ,ablations can and do work,sometimes for many years. Yes,some do not work for various reasons and for varying lengths of time for some people.In the UK,our system means that no nhs dr can benefit financially,directly or otherwise. Some people abroad have felt their medics were keen to do proceedures for other reasons than purely medical.

Given the cost of ablation( circa 15,000) the fact that they are offered widely to suitable candidates,and repeat 'touch ups' if need be,it indicates that it is a viable proceedure.

Many on here have them,and then leave as they have no episodes.

I had mine June 2022 ,for both Flutter and Fib and in nsr since. Touch wood!

Perhaps it might be that after a sucessful outcome,people take more care than ever to maintain nsr.

No proceedure is perfect of course

Wishing you the best.x

[Buffafly in reply to wilsond]

I am not quite sure how access to ablation works. I suspect that EPs have a set number of slots and try to fill them so they can show there is sufficient demand. If only five people turned up desperately needing an ablation when there are 8 available slots I would think that three others would be offered an elective ablation. I wish we could hear from an EP how the system works. As others have said we may, some time in the future, discover we have inadvertently been Guinea pigs in a giant ablation trial, which may lead to more ablations, or less, or a different kinder procedure.

[Speed in reply to Buffafly]

I suspect that as waiting lists are so long, there are plenty of patients requiring the procedure and so no need to “find” patients. I was fortunate to get get cancellations for both my AFlutter ablations and so avoid s 6 mth waiting list. The last was 15 mths ago and since A Flutter free. I have since developed PAF but the EP is in no hurry to do an ablation as I am currently managing it through a combination of daily meds, meds, limiting my exercise routine and when necessary PIP Flecainide. My EP certainly doesn’t appear to be pushing likely candidates.

[Buffafly in reply to Speed]

My point is that as AF is not generally a life threatening condition many people are offered an ablation to improve their QOL. Last time I saw a cardiologist about my AF (etc) he said I could have another ablation if I wanted one but agreed with me that I didn’t actually need one and it might not do much good having one because of my other heart issues. So what I’m getting at is that there is extra capacity for those who opt for an ablation over those who need one for health reasons. I needed my first ablation because I was having pauses when I reverted so it was dangerous to continue taking the required amount/type of medication I was on at the time. I have just had three days of AF but apart from the first few hours it didn’t bother me too much but many people would feel that was unacceptable. So the long waiting list reflects demand rather than clinical need. Those with the highest clinical need at the time will/should be treated first but maybe slots are divided between urgent cases and elective cases. I don’t know but I’d like to!

[Buffafly in reply to Buffafly]

And on the basis of your comments you’d be an ‘elective’ case if you were keen to have an ablation.

[Anonymouskd in reply to wilsond]

we have universal health care in Canada so ablation would not cost me anything. Thank you all for your replies.😊

[CDreamer in reply to Anonymouskd]

UK has dual system so you can access through NHS or privately.

[CDreamer in reply to CDreamer]

The problem is that there are too few EPs world wide for the number of arrythmia sufferers.

[mjames1]

They do work in the majority of cases, but in some cases they don't and even can make things worse. It's really a matter of risk versus reward. I've put off having an ablation for the past four years hoping to manage via lifestyle and then medications. It got to the point where I am willing to take the risk of having an ablation versus the benefit of being afib free without medications I don't tolerate very well.

Jim

[Achant1]

At the time I was diagnosed with Af in2016 one my good friends wife’s was also diagnosed, she had an ablation early 2017 and absolutely no Af since.

[A_fi_bR]

Had my first one in Aug. Next up, EP study for tachycardia. Just need to find put where it's coming from. Had it alongside AF. I think everyone is different and it's a good idea to think about an ablation not being a "cure". Tricky decision, I know I considered it for many months beforehand.

[bassets]

I had my first a year and a half ago. I was AF free until I dropped flecainide and the af returned but much reduced. After a consultation I had the option to have another ablation or stay with my meds which now have given ne almost a year af free again. I am in a quandary as to whether to have another ablation or stay with the meds as I have got to a point where I am feeling about 70% of normal and enjoying life now .

[MarkS]

I had an ablation 12 years ago when I was in AF 80% of the time. I still get very occasional bouts, may be 0.1% of the time, but to all intents and purposes I'm AF free. I think the secret is to find the best EP you can.

Also, to try to find whatever caused the inflammation that caused the AF in the first place and fix that. For me that was excessive exercise which I have since moderated. That could include weight, fitness (not too much but certainly not tool little), diet, drinking moderation, no smoking, oral hygiene, etc).