I am curious: how many ablations have folks had until the afib was finally stopped?
Thanks in advance and wishing good health to all!
Jim
Most ablations?: I am curious: how many... - Atrial Fibrillati...
Most ablations?
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One.
BobDVolunteer
I had three till 2008 when my AF was terminated. Then in 2019 had ablation for atarial tachycardia.
I've had 3 RF ablations, but still have AF which is now constant. However it's now low rate AF between 60-90bpm so I can get on with life fairly well.
Jean
One
Two. Though it's not totally stopped, when I get it, the AF is short and infrequent and never very fast. My QOL is 100 % better than when I had the AF constantly.
that’s great to hear. Thank you for replying.
I see from your bio that you live in the US. I do as well.
Studies show that the best ablation results are from very high volume centers. These are most always major teaching hospitals like Cleveland Clinic, John Hopkins, Mayo Clinic, etc.
Here is a good resource: health.usnews.com/best-hosp...
If you don't live near one, consider traveling if feasible. The initial consultation can often be done via video remote.
Don't know how much of a rush you're in, but if you have time to wait, Pulse Field Ablation (PFA) should be available at many of the centers in 1-2 years. It's a quicker and safer type of ablation.
Jim
Thanks for your reply and for these very helpful suggestions, Jim. I actually did meet with an electrophysiologist at Hopkins in January, and I was a bit underwhelmed by the interaction.
Jim
"I was a bit underwhelmed by the interaction" Yes, I've run into that myself with ep's, even at those high volume centers 
But at the end of the day, you want a good ablation, not a good friend. Doesn't mean you should go with someone who doesn't listen, so try another center then. I spoke to half a dozen ep's -- all at major centers -- before I decided to go with someone. The majority of them were via remote video.
Jim
thank you, Jim, for your advice and support. I really appreciate it!
Geisinger Wyoming Valley. Wilkes-Barre, PA Pearsall heart hospital is part of facility..Dr . Vijay...excellent care..ablation in 2017...1 and done.
I had chosen Cleveland clinic..my PCP said geisinger was his choice...Glad i trusted him.
Very helpful, and I live not so far from Wilkes Barre.
I now live 3 hours from Wilkes-Barre (clearfield county) I still go to pearsall..Dr Vi Jay (Pugazhendhi Vijayaraman) for yearly check ups...He is wonderful, his entire team is professional and caring...I dont know about other drs. there...
Jim, more support for high volume. There is a positive correlation between case volume and treatment results and an inverse correlation with complication rates. heartrhythmjournal.com/arti...
mjames, I traveled from NM to Ohio to the Cleveland Clinic and saw the top-rated specialist on ablation shortly after my diagnosis. Because I was symptom free he said no to ablation, mentioned early ablations were typically more successful than later. What I didn't expect was how specialized he was and wasn't willing to talk about meds. He did give me referrals. Overall I was very sure I didn't need an ablation and that is why I chose him.
Thanks, Jim. So helpful!
I considered waiting for Pulse, but there is no guarantee when it will be available.
I understand you decided not to wait, that was my decision as well. But for others that can wait, Pulse Field Ablation (PFA) is available now in the UK and Europe at few centers and no doubt will expand. In the US, should be available within 1-2 years.
Jim
Makes a change for the UK to get something before the USA medically speaking.
Personally I wouldn't wait as if the ablations are sooner rather than later the results could be a cure , mine was not done till 6 years after diognosis but a friend the same age as me had a cryoblation after just a short time and has been fine ever since.
Thanks for the advice!
What is the success rate for PVA for a high vol. hospital?
All trials PFA trials were done at high volume hospitals, but too early for any ep to have done a high volume of this procedure, so results may get better with experience
Below is a link to study results for a one year follow up. Same as success rates for RF or Cryo. 66.2% for paroxysmal and 55.1% success for persistent. However, keep this in mind, they have a very high bar for success.
So, if someone has one afib episode of over 30 seconds (after blanking) during the year, by trial criteria that ablation considered a failure. If I had five 10 minute episodes of afib during that year, I would consider my ablation a success
You would have to do a deep dive into the study -- full text, etc. or beyond -- to break down the actual afib burdens of each participant, assuming they will share that data.
PFA is relatively new, so I don't know if stats past one year exist.
ahajournals.org/doi/10.1161...
Jim
Worth bearing in mind that PFA has so far not been proven to be more effective at treating AF only potentially safer than cryo or RF.
Safer is a big deal 😄
Interested to see your comments on Pulsed Field ablations. Any more information as to why they're better than Cryo or RF? I'm waiting for my first ablation and EP has said I can chose.
"Traditional thermal ablation (rf or cryo) may be complicated by adverse events such as esophageal injury, phrenic nerve injury, and pulmonary vein stenosis.3 In contrast, pulsed field ablation creates lesions in cardiac tissue nonthermally and within milliseconds through the mechanism of irreversible electroporation"
ahajournals.org/doi/10.1161....
Thank you for that . So am I right in thinking that it is just as effective/ more effective? as Cryo and RF but safer?
Correct. Equally effective but safer. Only downside is that not that many centers offer it yet.
Jim
Thanks Jim
I agree. PFA doesn't use heat and is faster so less possible damage where you don't want damage. Has it been used long enough for us to have any data on long-term success rates?
No, there are still many unknowns regarding PFA though I would prefer it to cryo or RF.
1, but I just had it in April. That said, I only had 3 episodes of AF.
I had 3 ablations within 18 months and each one improved my life but not entirely cured my Afib.I only take diltiazam now and warfarin and have had a good quality of life since then in 2010.
If your offered one then jump at the chance.
hi jim, Iv had three pvi ablations, but I still get AFIB only very rarely though. 👍
Thanks, Jetcat. I hope the episodes become rarer and rarer!
I thought at first it had been unsuccessful because I had quite a lot of little episodes and I was in the process of being placed on the list for another but covid emerged.!!! but as time had gone on they have really decreased. I think it was last October I had a 2 hour episode and that was the evening I arrived back home after a foreign holiday and the lack of sleep.!!
I have however been taking magnesium supplements for a couple years now so I don’t know wether that has helped.? I think it has to be honest.👍
Thanks for the reply. I take magnesium supplements, too. Hope it goes well!
thankyou.👍
Which Mg supplement do you take?
I take TriMag Supreme.
one. Not tempting fate but so far so good.
Fingers crossed!
When is finally? That's the question behind your question. I've had 2 - first not successful due to being sedated only and apparently moving around. Today marks 12 months for me in NSR. In December I asked my EP what to expect long term. He said I'd already show a predisposition to AF. So no guarantee that it won't return. Stress, illness, shock etc could all trigger it. But, it should be fleeting and less acute. I'll take that.
Best of luck to you!
I've had 4. The first one worked for 5 years. Numbers 2 and 3 weren't that successful. With number 4 I think the EP got a bit carried away and I ended up with a pace maker but no AF so I'm happy.All the best Tim
Wow. Glad to hear you are feeling good!
I thought pacemakers were only given where the heart rate is too slow, not fast?
we are all so different and many folk not on this forum because ablation successful - and maybe AF never “finally” stopped as the rogue responses may sneak back in the future. My one ablation kicked it away for now
I am sure it is true that, like with most things, once a problem is resolved one tends to leave the pathway behind ...
I've had one ablation which helped a lot, but the af is back but under control n ow.
Under control by using which meds, if you don't mind my asking?
dilitiazem and edoxaban
TY, I am on diltiazem, too, and it seems to work well--much better than the beta blocker I was on at first. Good luck!
I couldn’t have a beta blocker because of asthma so never knew this 😊
I was actually on a beta blocker for a while DESPITE my asthma (MD should have caught that ...), but it only exacerbated the breathlessness and dizziness.
That's why we're not supposed to have them. Your doctors should have known that!
Totally. Very disappointing.
I’m currently awaiting the results of my 4th ablation
Fingers crossed you remain in NSR!
My son's colleague, now still teaching in his mid 70s has had, I think, 4, maybe 5 over his life! His AF (now with AFl) has returned, but he's coping well and been told no more ablations. I have a suspicion that the scarring from the ablations themselves might predispose to eventual conduction issues.
Steve
Steve, that has been my concern as well.
To be fair, I’ve read no scientific evidence of that, only read comments and added two and two (probably making five). I have read that when PAF becomes permanent, as is its pretty-much-often natural course, then people often report it to be much better than intermittent PAF so long as the heart rate is fairly low.
Steve
After 2 years of continuous AF, 90-150 bpm, I had 4 femoral vein heart catheter procedures between Feb '20 and Jan '21. 2x PVI ablations (one halted mid procedure due heart instabilty, 1 successful) 1x internal cardio version (unsuccessful) 1x flutter ablation. UK NHS.
NSR since Jan 2021. (apart from 3 reoccurrences of AF on 3 days when I had covid in 2022.....each bout of AF stopped within 30 minutes of 1x Sotalol 80 mg, 'PIP')
Fingers crossed that NSR continues.
2 For A Flutter, Jan ‘20 & Nov ‘21. Seem successful but now developed AF & A Tach!
Oh, shoots! Well, I hope you are able to resolve those!
One. Dec 22. The only possible afib since was for 1 minute and it resolved itself. Huge difference to ten hours of rvr every three days. Long may it continue
Hear, hear!
I am in constant afib and never feel it. (cardiologist diagnosis) . How do you know you only had one possible episode? Do you mean only one that you felt? ( am just trying to understand why many of you seem to know when you are in afib.)
If like me your heart is beating at 200bmp in a episode, you'll feel it. Feels like your heart is trying to escape your chest. I felt it. I caught it on my kardia on ecg and did a repeat ecg three minutes later and it was gone and I knew it was gone. Sent off ecgs to arythmia nurse.
Thank you! That clears up what was a mystery to me. Higher heart rate, more likely I would feel it. Honestly, I was a tiny bit concerned I was missing out on something.
You're definitely not missing anything by not having AFib rvr (rapid ventricular response). It's like running a ten hour marathon every three days, then having two days of being absolutely wrecked tired and running another marathon on day 4. It didn't matter what meds my first ep prescribed nothing helped unfortunately. Ablation it was.
WOW you are clearing more fogs for me. I thought all afibs were atrial. And I am probably right. But the rest of the heart joins in with its moves as well. So there is more diversity within afib than I realized. I asked my cardiologist if the techniques described in this forum, like holding on to my nose and blowing, would help me reduce afib episodes. She said: "No, you don't have that type of afib." I've read it in this forum: not all afibs are created the same.
MaryCa, your description of the exhaustion following your type of episodes definitely leads me to not miss - at all- the pounding of my. heart. Have you tried any strategies for interrupting the episodes?
Once a cold shower worked... anything else never. The ablation did the trick. 5 months nsr on the 21st. The rvr part means the ventricle just joins in the party, the atria is still quiver pumping so there's where the risk of clot comes in. Long may my nsr continue because I didn't realise how awful I felt until I didn't feel awful
Oh, I hear you. Who ever thought it would feel wonderful just to be normal?
Just a comment regarding types of afib. My EP, (for afib), and my cardiologist, (for heat pumping), sometimes disagree on my EKG as to whether it shows afib or something else. We can all agree on the symptoms, eg, excessive fatigue.
The Nurse Practitioner I just saw emphasized symptoms over test results. I see her point and it supports what you, your EP and cardiologist agree on!!
Quality of life should be the result we are chasing. Whether that be meds or surgery is up to whether a person can tolerate the meds and if they work. I couldn't tolerate the meds. Brain fog, fatigue, bradycardia, conversion pauses coming out of AFib episodes, one about 7 seconds caught by paramedics after I took extra Sotalol and Bisoprodol as instructed by EP to shorten an episode. The brain fog felt like I had cotton wool in my head, very weird feeling.
Look for the missing p wave...loads of examples online
Thanks for responding.
Me, again, Mary. I'm the lucky one who doesn't feel my afib. Does that suggest my BP and HR are not a concern? And thanks again for all that you have helped me understand.
I'm afraid I don't know the answer to that one. I assume that well controlled AFib and BP are much better than what my situation was. Have you read the AFib cure by Dr John Day and Dr Jared Bunch available from Amazon, excellent information in it?
I will order the book.
I agree with MaryCA. Very helpful!
Good to hear. I already have it on my Kindle.
I had 3 and none worked, but I was 18 years in and persistent before I was offered it. So, it was always a long shot!
Sorry to hear that. Thanks for replying. Are you getting along ok now?
Well, still if AF. Medium to long term plan is for pacemaker but cardiologist not keen quite yet due to my age (47). Going to start heart failure meds and try new rate control drugs and see how I go with that in the short term. Doing ok for now. As I say it was always a long shot for me, but I don't regret trying and I'm grateful to the cardiologist and EP for giving it a good go. I had 3 in pretty quick succession last year. I'm not a typical example in terms of ablation efficacy as I'd been in AF for such a long time. Others, as you can see, have far more positive results.
I will keep you in my thoughts. Good luck!
Are you suitable for the mini maze procedure?
I sure it is not a record but I have had 7 ablations. One for Atrial Flutter, one for Atrial Tachycardia and 5 for AF.
The last one was for AT and was in 2017 (first one for flutter 2009.
I am sure it was worth persevering as I have now been AF free for over a year and I am sure it is a result of having the ablations.
I was lucky that I live very near a centre of excellence for Cardiology because I think in the UK otherwise it can really be a post code lottery in that the further away from a Cardiac unit you live the more difficult it becomes to get the attention that the condition requires.
Pete
Thanks, Pete. Fingers crossed that they are all behind you now!
One, 13 years ago.
What great news.
If I read right you still get AF but it does not bother you? So you would not come into the category of the initial question of how many ablations until AF stopped?
I get AF about 0.1% of the time (i.e. for about 20 mins every month or so). It used to be 80% of the time. I call that stopped for all intents and purposes!
I would call that stopped, too! Fingers crossed it continues.
The goal of an ablation is to reduce or eliminate episodes of afib. If a reduction is achieved that improves quality of life then that ablation can be considered a success. I had my ablation in Dec, nsr since.
One. 5 year 4 months ago
One ablation about 6 years ago gave me my life back. I highly recommend my cardiologist and EP in Spokane Wa. Good luck. DICK
Wow! At Sacred Heart?! I’m from there, but in Kansas City now, getting 1st ablation end of August.
Thanks, Dick! and congrats!
I have had 4 ablations with no positive results. Finally had av node ablated and pacemaker implanted. All is well now.
Thanks for replying. I wish you well!
Two ablations and three cardioversions. I’ve been in NSR for about a year.
Thanks, ChiMan. Hope your remain in NSR indefinitely!
Hi, interesting post as I am on list awaiting my first ablation.
hope it goes well. Best of luck!
I was told by my electrophysiologist that Pulse Field Ablations would be available in the USA by the end of this year, or the beginning of the next. He wasn't sure they would be available at my Provider at that time.
fingers crossed this happens! Really looking forward to this being available in the US!
One - a cryo PVI ablation in August 2018. It's coming up on 5 years, with no AF whatsoever and no PACs - just blissful NSR. 😀
Best wishes,
Richard
OOOHHHH, fingers crossed that you remain in NSR!
I’ve had four. Last one was Sept. 2018 at Cleveland. Haven’t had any episodes since. I do take a blood thinner but nothing else.
Thanks for that reply! Good luck going forward.
I might add I try to play Pickleball at least three times weekly. Usually we play 1 1/2 hours and don’t have any problems. I am 72.
Great to hear! I am 71 and have never tried Picklball, but it looks interesting.
I have had 2 Jim. The second a year after the first. The second Ablation was for Flutter. My EP told me that he was going to go over the lines on the original Ablation and it did make a big difference in the way my heart was acting after the first Ablation. Got rid of the Flutter, and I had a couple years of freedom, but it came back and now I get episode of afib every month for about 3 hours. I'm fortunate that I convert. Thank God! I'm done with the Electrophysiolist and going to take another approach. I look at it this way if I have to get it done 4,5,6, times then it's not the best option. How many times do you have to burn your heart before you have permanent damage?
I totally hear you, Brandue. Are you in the UK?
I'm in the United States..
Have you investigated Dr. Wolf's mini-maze at the Debakey Center at Houston Methodist?
I have already seen him and I am having surgery on Sept 20th. I spoke with my cardiologist after doing a lot of research on Dr. Wolf. My doctor agreed with me and said it's a great option. I have done years of research on afib since I have had it on and off for over 10 years and before that I was plagued with PAC's since I was in my early 20s. I'm 61 now. I feel Dr. Wolf is my final chance to rid myself of this horrible condition. I will say this I'm in the best shape of my life and want to go into surgery this way. I can't emphasize the value of diet and exercise when it comes to afib.
I have been paroxysmal for a year and a half. I also researched like mad and decided on Dr. Wolf. I had the procedure on May 3. I am in and out of afib now in recovery, and with hope I will settle into NSR. I left the Debakey center in full confidence in them and my decision. With the Linq device embedded in my chest, Houston is now monitoring me 24/7, so they are aware of what's going on. I'll keep you posted.
Thank you for sharing and please keep me updated on your progress. Heal well.
I’ve had 3 ablations. I’m not sure I ever really noticed the afib symptoms, it was tachycardia that drive me to an EP. But there was afib and aflutter as well. The 3rd ablation finally banished the afib. A 4th attempt at an ablation to target the atrial tachycardia failed as it would have done phrenic nerve damage. Hoping for pulsed field ablation tech to reach the US and that it will solve that problem.
Thanks for your reply. Good luck!
one...in 2017...recurrence of afib when i had pneumonia, but less than 2 days....none since
Thanks, Kathie. Hope you continue on this path!
Five … and hoping this one 1.5 months ago holds. Had to get a cardioversion just a few days ago to set me straight again after it “failed” after two weeks. (It was during the ‘blanking’ period so use of the word fail is inappropriate … someone else can come up with a better word.)
Hopeful that this lasts. The last two were for atypical atrial flutter btw
Two ablations, (on amiodarone prophylaxes but will be switched back to Multaq). I would not be surprised if another ablations is needed.
In my life I have worked as an engineer on a lot of really cool things, eg, space lasers, airborne laser communications. When I retired, I became a decent eye surgeon. I mention this because I believe the brilliant people who do ablations are among the best of the best. To me it's pure magic.
I was experiencing a BPM of 308. I had flutter and Fibrillation. I had one ablation at Papworth (the old site) which was very successful. I still experience elevated BPM from time to time but no where near 300BPM and have angina. I have severe calcification of my coronary arteries and an enlarged heart, signifying some heart failure. I know others who have several which didn't completely solve their problems.
Thanks for your reply, and good luck!
Thank you, I have several other problems now, I have lung PE, two lobes of my lungs have atelectasis, I have oedema in my legs and feet, Furosemide 40mg is helping that, My usual left axis deviation on ECG has now switched to right axis deviation, probably bad news for me, but maybe not. At this time my two real problems are Bronchiectasis and tracheobronchomalacia, just spent 18 days in Papworth on multiple antibiotics I had a pseudomonas infection, then found myself in my local hospital in SDEC, where I got the very best treatment and several more diagnosis' I hope your treatment has proven successful and you are feeling much better.
I've had 4 - 2 of them redoes and one for flutter. Unfortunately Im back in rapid AFib again since 4th April and no sign of it stopping. Not a happy bunny!!
On highest dose of bisopralol, so feeling awful and was on digoxin, but have had to stop taking it due to increasing bouts of diarrohea!! Hoping I may get a cardioversion or another ablation before I balloon to the size of a 'house end' Due to the bisoprolol! God knows how long it will take thanks to the government demolishing the NHS.
Oh, I am so sorry to hear of your plight. Thanks for taking the time to respond, and hang in there! Maybe a few minutes of meditation with regular breathing each day?
I was lucky, my first ablation in 2009 was successful. I get the odd ectopic, mostly when stressed. But otherwise I consider myself 59% cured.
Glad to hear that. Thanks for responding!
What a good question! I’ve been wondering about that too! 🤨
3 ablations in the last 2 1/2 years and still trying to stop the afib. Episodes do get better for a while after the procedure but over 3-6 months more pacs/ tachycardia start to occur once I come of the meds and then afib episodes begin to occur. The battle continues - thankfully daily flecainide still helps with reducing frequency of episodes (though wonder how long that will last....)
Gosh, I hope you can get it under better control. I wish you the best. Are you in the UK?
Yes hope to get things more under control in the future, though as a realist I think this will require more ablation procedures. We will see what the health system thinks. Btw I am in Canada - similar health system to nhs but without the private options that seem to be more prevalent in the UK. Keep safe
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