a flutter ablation versus a fib ablation

[jsanta]

I’m a 70-year-old male that’s had four ablations all unsuccessful. Three years ago I had a pacemaker being my pulse rate, went down to 25. I’ve tried Tyson and that worked get me back in rhythm but I had to go off because my QT number was very long and they were concerned about sudden death. They put the pacemaker in put in and now I’m in a flutter. I’ve heard that a flutter is easier to have a success rate versus a fib. However, I also understand that too many ablations can make your heart stiff. I usually can’t exercise more than 15 minutes without getting out of breath my lower chambers are beating around 80 but my upper chamber is between 180 and 200 because of a flutter. I lost 20 pounds and feel better. Just don’t know if it’s worth getting another ablation, I have one of the Top people in Austin wants to try again the first time he did not get rid of the fib that was about three years ago

Any advice?

[wilsond]

Flutter is much more easily treated by ablation than aFib. 95 % effective. Resistant to medication. I had both done June 2022. NO flutter since day 1.

It's likened to cutting an electronic circuit. Flutter goes round and round the chamber in a mad circle. By laying a line across the route,that's it. Done

Best thing I ever did, as felt so terrible in Flutter.

Best regards

Ps mine was atypical flutter but even so...gone

[KMRobbo]

I developed TYPICAL reentrant Atrial flutter ( right Atria) 9 days after my successful AFib cryoblation. My flutter was rate controlled by diltiazem at a fixed 140BPM. I was Very breathless with this. I had an RF ablation 3 weeks after the onset to get rid of it. That was much quicker than my AFIB ablation.

According to my EP, the right atria flutter ablation is 90% plus successful and IF successful flutter rarely returns.

I understood the % unsuccesful was because the errant heart cells were in an area which could not be safely ablated.

The right atria ablation has easier access that left atria ablation.

However please note you can get Atypical atrial flutter in the LEFT Atria, so you need to know where yours is.This is much more rare, but is also more complex but I have no experience of that.

I was 57 when I had my ablations and both were succesful. ( 6 years ago). I am not medically trained , just describing my experience.

Best wishes.

[Cookie24 in reply to KMRobbo]

I have atypical flutter and ablation was successful 2 1and a half years. Then, third ablation for afib and flutter with isolation of left atrial appendage.

[Jajarunner]

I asked my EP about stiff heart and he said it's possible if you have many ablations or the "old fashioned" aggressive ablations (lots of burning) but they don't do it like that any more (Papworth, Cambridge, UK, one of our top centres). This is something to put on your list of questions for your EP. My list is always very long 😁

[Rosie0202 in reply to Jajarunner]

Hi, How do they do the ablations now that doesn't involve lots of burning.

[Jajarunner in reply to Rosie0202]

I think they just burn the pathways that show up rather than loads of burning 'just in case' ?

[jsanta]

TY! I am wondering if mine were aggressive or not..

[Cookie24]

Are you seeing Dr. Natale?

[mike1961 in reply to Cookie24]

Was just about to post the same Q myself.

Natale is held in extremely high regard - verging on God-like status - on the US Afibbers Forum. My take is that he is very skilled at being as aggressive as possible with the burns but at the same time avoiding complications. I would imagine that several of his ablations might cause some degree of stiffening of the heart. Preserving atrial transport/function remains an important consideration. But that said, the main consideration remains getting rid of the arrhythmia !

[jsanta]

yes now in A flutter. Concerned about doing another. Heart is taking a beating especially left Apendsge. I have Stiff heart. Wondering if good ole Vardio version could snap me back..

[Cookie24 in reply to jsanta]

Is your left atrial appendage occluded or isolated?

[jsanta in reply to Cookie24]

Cookie that is a great question and I will ask my doctor! Why is that important? What is the difference between the two..

[Ppiman]

My ablation in 2019 was for AFl. I was told it was much quicker and safer than the left-sided ablation for AF and with near 100% success rate. I would go for it if I were you as the atrium (beating at 300bpm in the usual AFl type) puts stress on the ventricles and valves, as I found.

I’ve not heard about “stiffening” as such from ablation scarring but only your cardiologist can advise on this.

Steve