Ablation to back wall of the heart

[Spoiler]

I just had a 3rd ablation at the Cleveland Clinic. My first two were PVI ablations, the reason for two was because my first was unfinished due to cardiac tamponade. I have had persistent afib since last Sept. 11th. On this current surgery they found problems on the back wall of the heart and also the floor of the heart. I was told that the Cleveland Clinic is currently in a

“Trial study” of ablations on the back wall. Since they had no way of knowing that was a problem area for me, I was not signed up for the study. He said 90-95% are in the pulmonary veins. He would not give me ANY percent of possible success other than the fact I converted to NSR when they ablated the area and did not require cardioversion. They also went ahead and ablated a common area for atrial flutter although that was not the problem. Has anyone had the back wall of the heart ablated ? What success for you? Did you have persistent afib? Thank you for any info.

[Buffafly]

Yes, that was included in my ablation I think (referred to as a ‘box’). My paroxysmal AF returned after two years but tends to be much slower so I just put up with it as my medication doesn’t upset me (diltiazem and Candesartan).

[Spoiler in reply to Buffafly]

I dont know if the cardizem (control heart rate) has been responsible for my legs/feet swelling and achy legs or what, but since being off of it now almost a week. Swelling is gone and so is the pain. I know the efficiency of my heart being in NSR after being in persistent afib almost 8 months could also be the explanation. Thank you for the info very much.

[mjames1]

Sounds promising your afib episode stopped when they ablated the back wall. Did they do a typical aflutter ablation (right side) or did they did ablate on the left side for atypical flutter. Good luck and let us know how things go.

Jim

[Spoiler in reply to mjames1]

on second ablation flutter was from atypical side, this time they went ahead with the typical side even though they saw no problem there. They said no more afib ablation, but they will if it is flutter.

[Spoiler in reply to mjames1]

Yes, hopefully and another positive note was me converting without being shocked. they ablated the typical side this time even though I was not having flutter, the atypical side was done on the second ablation because I was in flutter at that time.

[Afibflipper]

Hi there, I’ve had PVI twice then this last time in Nov’22 I believe they were again touched up and the roof & backwall also! For 4 months I still had Persistent AFlutter & some Fib. Got to the point of next step discussions whereby I was told they could try one more ablation but “where” as everything was done now! All of a sudden converted to NSR. Have been having other issues for which no reasons found yet such as high liver enzymes, anaemia, swollen legs & abdomen breathlessness err think that’s it ?rt sided heart failure on all symptoms & bloods but no idea why as echo was good NSR though & Furosemide Looking good just fatigued so hope for you too fingers crossed 🤞 please 🙏

[Spoiler in reply to Afibflipper]

did you ever take Flecainide or a antiarrhymic?.

[MummyLuv]

I had my back wall ablated by surgery rather than by catheter. It follows the Cox maze approach, a very well documented and studied successful approach for afib. I was over 5 years persistent.

[Spoiler in reply to MummyLuv]

are you serious?!!! 5 years? Oh my goodness. When was your surgery? I wondered if it was similar to the maze procedure which is much more invasive.

[MummyLuv in reply to Spoiler]

I had a minimally invasive maze. It was all keyhole done through the rib cage.

[Cookie24]

Hi, What is the Back wall, is there a medical term? I had ablation last August at Penn Medicine in Philadelphia by Dr. Santangeli. He was promoted to Cleveland Clinic

[Spoiler]

after looking it up, it is the anterior wall of the left atrium. From what I am reading when patients have persistent afib, which I did. The last round lasted almost 8 months until they ablated that area. It is not a common area they ablate, my first Dr there passed away April 18th and he had done ablations since 1995 and was a teaching Dr. He told me in the beginning they start out conservative and ablate common areas first, the PVI, but a small percent of people have areas inside the heart and ablations there can create other rhythm problems so it is reserved for further questionable ablations. The Cleveland clinic is on top of it and I am at peace with whatever their decision was as being the best approach to help me. Rather than giving me a success percent, he said he hoped they were able to help me. I went in and out (flutter/atrial tach)of rhythm after surgery, but currently in NSR straight for almost 36 hours. Even the going in and out was a improvement because it was not afib, which made me feel worse than a slow rate flutter. I hope you are doing well.