AF outside the PV

[Lenlec]

after my follow up ep appointment today he suggested I go on the list for a 3rd ablation this time more in depth and to look for triggers outside the pv. Whats this involve ? Anyone had the same ?

Thx all

[BobD Volunteer]

Same technique different area and usually done by RF not cryo. Very common for second ablation.

[Buffafly]

I had an extra thorough first ablation and my discharge notes mentioned ablating the ‘top line’ and a ‘box’ as well as PVI. It worked for two years after which AF crept back and now I am having episodes of persistent AF 9 years later, generally slower than before. I don’t mean to be discouraging but I think a lot is down to luck. As I expect you’ve noticed there is a lot of excitement about mini-maze type procedures for AF. Best wishes!

[Thomas45 in reply to Buffafly]

Can you define "episodes of persistent AF" please?

[Buffafly in reply to Thomas45]

Lasting 7 days or more.

[Buzby62 in reply to Thomas45]

Types of AF

Types of AF

[Thomas45 in reply to Buzby62]

Thank you. The use of the word "episodes" usually means paroxysmal AF. Persistent. AF is not normally paroxysmal. I have permanent, though asymptomatic, AF. I don't have any Apple or other watches or even a Kardia. I feel fine, apart from the results of a fall lengthways on Sunday just gone, when I forgot to raise my leg from the knee. I have Foot Drop in that leg, which is probably worse than AF has ever been.

[Buffafly in reply to Thomas45]

I take your point but don’t know how else to describe AF that lasts longer than 7 days but returns to NSR without cardioversion? Perhaps periods of AF? I also have ‘conventional’ paroxysmal AF!

[Buzby62 in reply to Buffafly]

It’s a persistent episode, that’s the thing with AF, we understand our own version and always learning the complexities of the condition for others.

I just reply for everyone to read not just the poster.

Best wishes all.

[Buzby62 in reply to Thomas45]

Sorry about your fall, you’re lucky you can almost ignore your AF as it doesn’t affect your QOL much but then not so lucky with other ailments. We’re all different and many struggle with the ups and downs that Paroxysmal or Persistent episodes of AF bring.

Best wishes

[Thomas45 in reply to Buzby62]

I've had AF about 29 years, 22 of which it was paroxysmal. Years 9 to 11 were the worst years for AF, when it was very frequent and uncontrolled. I was then prescribed Flecainide which reduced the episodes to 1 or 2 ten minute episodes a year, I til I was found to be in persistent though asymptomatic, AF 7-8 years ago. I am now 78 and taking only warfarin because of AF.I've also been asthmatic at least 50 years. Last exacerbation was in December 2023, the first since before the Pandemic.

I have a benign prostate problem. I also have below the knees lymphoedema on both legs and feet. I wear compression socks which work well.

In 2021 while going downstairs I slipped on some cat-sick, and went down 7 treads on my bottom, with one leg riding above the treads, and the other hitting each tread hard. I had fractured my right fibula, and damaged my right peroneal nerve. The bone healed, the nerve hasn't, resulting in foot drop of the right foot.

When I am stood my right foot stays where it is, unless I get it off the ground by raising my leg from the knee. When I walk outside I have what's called an ankle foot orthotic which fits under my insole and fastens to my leg, around the shin, which helps me to walk. I can no longer drive as I can't pull the front of my foot towards me, for example I couldn't take my foot off the accelerator.

Of all my ailments foot drop has the greatest effect on me. When I fell I pulled a muscle under my thigh. I live alone with my two wonderful cats. I have to keep well for them, so have rested this week.