I had a private ablation recently under professor Gupta in Liverpool . The procedure was smooth , my first experience of GA which was magic . I am 44 years old . The recovery was ok . 5 days of taking it slow and about 2 months of no lifting etc . At first complete solution then for 4 weeks my heart was like a roller coaster . Then settled . I reduced 10 mg bisiprolol to 5 and then 0 . Then 3 months post ablation it came back (afib) shorter bursts every couple of weeks 5 mins or so per time . So it’s like the ablation has partly worked. As previously I could be in it for a few hours at a time. Prof Gupta wants to go back in and ‘tidy up’ as he says most likely some of the blasted rogue veins survived . I’d like to ask the group :
1 - is it possible I have a longer blanking period than most , the prof said I had particularly strong muscular veins . As currently I’ve had a couple of weeks with nothing though I am back on 5mg bisiprolol
2- can afib be caused by anything else other than these rogue veins that the ablation blasts ? ( my fear being the second one won’t work either ).
I should also add that the procedure was less of a pain than going to the dentist . Anyone fearful of the procedure should not be it was very very routine .
many thanks friends x
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Chesterghost
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I would go with the professor for a touch up. The more time that goes by from ablation to episodes, the less likely the ablation will hold. At 3 months, the "blanking period" starts to become more of a wishful thinking period. If you trust the professor, let him try and figure out where the rogue waves are coming from with his ep study prior to ablating. Hopefully, he will nail it this time but no guarantees. Great you sailed through surgery and recovery and I'm sure your relatively young age had a part in that.
Firstly did you have cryo ablation or RF? Cryo (freezing) is often used as a first line attack as it is faster and easier to do than RF(Heat).
The problem is that the four pulmonary veins may not be perfectly shaped and the tiny balloon can miss areas. In addition there can be other areas firing off than the four veins so finding those and creating scar tissue to block the signals requires an RF ablation.
Is three months long enough? Well if you read our fact sheet on recovery we talk in terms of three to six months and also make the point that many people are still improving at nine months or a year. Personally I had three RF ablations before my AF was terminated but I waited at least a year between each.
By the way I have always said I would rather have an ablation for AF than root canal dentistry.
I hope that helps adn will come back and edit to include our fact sheet.
I see Chesterghost has not replied as yet, but as this was a recent first ablation under Professor Gupta at Liverpool Heart and Chest Hospital, I suspect they actually had a pulsed field ablation (PFA) - as did I in September 2022. I can't see any background on Chesterghost in terms of whether their AF was paroxysmal or persistent, but from my own experience I know Prof Gupta was very positive about PFA, including for early persistent AF. I asked him at my initial follow up what he would offer if needed a second ablation (I am still in sinus rhythm at present with only occasional spells of palpitations so hopefully that will not be necessary for a long time yet) and he did say a different technology would be used at that point.
I guess it depends who your dentist is. I had root canal with a specialist recently and hardly knew I'd had it done .....apart from a lighter pocket . And my heart was untouched by numerous burns !!
My EP’s at the Brompton are reluctant to stop meds at three months. Easily took me a year for my first ablation to really work. Three years later Af returned, I’m nearly two years post 2nd ablation and still taking beta blocker but having pvcs and tiny snippets of fast heart rate. Listen to your ep though, he knows way more than us lot 👌🏻
Hi. as you were a patient at Liverpool where the latest in ablation technique is being performed, did you have the new pulsed field ablation, Chesterghost?
I think you are confusing Dr Sanjay Gupta Cardiologist who presents those so helpful videos with Professor Dhiraj Gupta a highly esteemed electrophysiologist
It's a shame your ablation didn't work first time but I have seen one study that showed a full year or more can sometimes be needed for the full effects to be apparent. If your symptoms are mild, I think I would wait and see, although your EP will know best. My understanding is that ablation is an imprecise "science" and there are various safety reasons, also, why certain areas of the heart cannot be ablated.
Out of interest, I didn't think AF was "caused" by veins (the pulmonary veins, I guess your doctor means), but by aberrant heart muscle cells called cardiac myocytes (cells that transmit electrical signals throughout the heart). The myocytes that create AF are commonly those clustered around the pulmonary veins, but the cause is not the veins themselves (indeed the EP has to avoid going too close to the veins for fear of damaging their walls; also the heart wall in this region is very thin, adding yet more fears of ablating there).
Why these myocytes become aberrant still isn't known, I gather, but is being actively researched. I have read that inflammatory processes are a likely culprit, perhaps an autoimmune response associated with issues such as obesity, hypertension, diabetes, sleep apnoea or genetics. "Stretched" heart muscle and cells have also been implicated as the myocytes have been shown to react to being distorted, so issues that involve heart size, such as obesity and direct heart conditions are also being looked at.
How are you feeling now? If you would like any support advice, please do not hesitate to contact our patient services team on 01789 867 502 or info@afa.org.uk.
Thanks for the post. It's very timely for me as I am currently 7 months post first ablation (cryo) and still experiencing occasional afib episodes. During the month of November, I had no episodes. December, I had five episodes, each lasting 2-3 hours. During January, I only had one episode and it only lasted an hour. I'm not taking any medications and the only thing I "did" in response to the episodes was to lie/sit down to rest.
I would suggest you consider whether any other lifestyle changes you've made since the ablation may be impacting your recovery. My afib has often been triggered by exercise. There is data that indicates exercise is helpful in recovery but not too much. I started riding my e-bike in October. After a positive visit with my ep cardiologist in late November, I switched back to my regular bike in December. My December episodes did not occur during my exercise but typically occurred 1-2 days later. After noticing the trend at the end of December, I switched back to my e-bike and had no episodes for most of the month of January. Only episode I had was on a long overseas airline flight where I was awake for almost 24 straight hours.
I'm hopeful that over the next few months my heart will continue to heal and the episodes will become less frequent and I can slowly increase my exercise level. If not, a second ablation may be in my future also. Best wishes on your recovery.
I’m afraid I can’t answer your query because I don’t know but if I were you I’d definitely have the second ablation because it seems to have been almost completely successful. I wish you well and please post again and let us know how you are. All the very best wishes.
I had such a bad time with anesthesia from my first one, I was dreading a second, but really wanted to be a-fib free. I soldiered on, got it done and haven’t had an episode since - coming up on 11 months! (It was one year between ablations). Good luck with your decision.
My first ablation was wonderfully successful. Then I had two Pfizers, immediate shortness of breath after the second and after that my AF came back, worse than ever. I'm on a list for a second ablation. Cardiologist said no boosters.
Your post and profile does not give your background, for example was your AF paroxysmal or persistent? Or what sort of ablation did you have (as others have queried)? However, if recent I would anticipate you had the relatively new pulsed field ablation (PFA) procedure as I know from my own experience at LHCH that Prof Gupta offers these at present and was very positive about the procedure (I had a PFA done by him in September 2022 at LHCH when I was in early persistent AF). I am fortunate that my ablation appears (so far at least after almost 5 months) to have been successful and I have only had occasional spells of relatively mild palpitations to deal with since September. I did ask Prof Gupta what he would offer if I needed a second ablation within a shorter rather than longer period of time and he said a different technology would be used. In your case and as others have said, things may still settle down, but otherwise I personally would go for a second ablation if offered.
I’m so grateful for all the positive comments . I had AF episodes that would kick in about 3-4 times per month and last for hours afib and flutter resulting in 160 bpm at worst . Prof Gupta is amazing in my opinion I had the latest technology combined with RF ablation for an area that he said was safer to use RF on , though he suspects it is this area that has recovered and needs treating again . Currently I’m in a AFIB free period of about 2 weeks so I’m hopeful . However I will not hesitate to get the second one done it feels like I’m 3/4 of the way there . Many thanks
Yes, I was very happy with Prof Gupta, who I understand is one of the UK’s leading EPs - I had three opinions in total before deciding to go ahead with a PFA by him at LHCH. As you may be aware a reported advantage of PFA is a typically shorter procedure with a lower risk of complications. I hope your AF does still settle, but if not and your symptoms remain problematic good luck with a follow up procedure should you decide to have one.
I needed a top up after my 1st. Really glad I did as like you I'd been getting regular outbreaks, though more manageable. Fingers crossed none now since last May.
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