Slow Build up

[lilmikeb77]

I would like to preface this by saying that i know no one is a medical professional, and that this is just me thinking things through and looking for opinions to help me clear my head

I had an ablation almost 3 years ago, and from the start my AFIB never totally went away. For the first while after the ablation my episodes were extremely short, maybe 1-3 minutes and I was almost completely free of symptoms, the episodes were also spaced far apart, 5+ months apart. Over time they have really come back to "full strength", longer episodes at shorter intervals apart, i am having a second ablation in September to hopefully "fix" this once and for all. Does this sound more like a case of tissue not scarring over properly after the first ablation, or more of a potential that the signals are not coming from the PV, and my electrophysiologist will be looking in more locations?

[mjames1]

It could be everything you mentioned. For many, ablations do not last forever.

Jim

[BobD Volunteer]

Incomplete scar tissue most likely if you had RF ablation or more areas if cryo which can only deal with pulmonary veins. Repeats are very common and I needed three over a four year period to 2008 when my AF finally departed.

[lilmikeb77 in reply to BobD]

Yeah, my line of thought was that because there was a drop in episodes and severity, there was probably a spot that healed instead of scarred, and overtime the pathway has "widened". My EP thinks so as well, but did mention it may be triggered from another area, which made me start thinking more critically about it

[Singwell in reply to lilmikeb77]

Only 1 way to find out! I had to have a touch up as my EP called it and fingers crossed 2nd time around it's much better.

[Snowgirl65 in reply to lilmikeb77]

My first was cryo, done by an incompetent EP. The second was much better by a different EP at the renown Cleveland Clinic. But after 5 months, I had a massive AF episode that necessitated a third ablation in Dec. 2022. It was thought the problem was coming from a different area of the heart, but when my EP "went in," he discovered it was just an errant growth over the scarring done 5 months earlier, so that was touched up as Singwell also mentioned. So far so good at this point!

[Cookie24 in reply to Snowgirl65]

Who was you ep at Cleveland Clinic?

[Snowgirl65 in reply to Cookie24]

Tyler Taigen.

[mjames1 in reply to BobD]

Actually Bob, at least in the US, most first ablations are only PVI's and there is study data to support ablating elsewhere can be counter productive first time around.

Also, ep's who do cryo PVI's also use RF during the same procedure where needed. At least with all the ep's I've spoken to in the US and to the several ep's I've spoken with in the UK and Europe.

Jim

[Ppiman]

Only your specialist will know this. The usual ablation, I gather, is to "isolate" the area around the pulmonary vales, where the foci for AF generally originate. This is a sensitive area, so the ablation is always conservatively carried out. Hence the up to, what, 40% failures or partial failures? A second ablation is safer, I gather, as it's clearer where the foci now are. It should be more successful.

Steve

[GrannyE in reply to Ppiman]

I have only had 1 ablation which lasted 4 hours. I came out 1stone heavier than when I went in (I am well under 8stone). and was leaking and leaking from the holes in my groin. Apparently I had cooling liquid round my heart and all over the place. I was discharged and then had to be taken into our local hospital as an emergency that night. They had no idea what to do with me and I was taken back into the Royal Brompton where I was for another week. Did not feel ‘right’ again for approx 3-6months. A/F came back every now and again but more mildly and is now rather more than less. For obvious reasons am terrified of having another one. The dreadfully strong ectopics that I had before the ablation are now not nearly as bad.

[Ppiman in reply to GrannyE]

I can well imagine your fears. Fear can be awful, can't it? I wouldn't look forward to a second ablation at all. My first was for atrial flutter, though, so I am truly hoping that the AF which has developed following that stays manageable.

Steve

[GrannyE in reply to Ppiman]

Will keep my fingers crossed for you.