Touch up ablation

[KiwiBlake]

Hi all

1 week ago I had a touch up RF ablation, I thought I would share my experience.

I had my first ablation (a cryo ablation) September 2022. During this first procedure I had all 4 pulmonary veins ablated. At 3 month post ablation, under cardiologist advice I tried to give up the Diltiazem (for rate control) and the Flecainide 100mg/day (for rhythm control). I went into AFib approx 7 days later. Over the past 2 years I have tried numerous times to stop the meds only to slip into AF, 7 to 14 days later. I always revert to NSR within 3-4 hours with PIP flec and bisoprolol.

So I had my touch up RF ablation last Tues at Waikato Hospital (New Zealand). I spoke with the EP post surgery and he was very pleased with how the procedure went, and is very confident he found the area giving the rogue signals.

He explained to me that 3 of the PV's had good circles of scarring from the previous cryo ablation, and he could find no rogue signals in these areas. The PV's are in pairs and he said on each pair the circles of scar tissue should join to form a figure of 8. On the 4th pulmonary vein however the cryo ablation had not been done properly. He said this vein was larger and he could see that the balloon used was too small. The balloon therefore had gone in too far up the vein, so when inflated with the cold freeze substance, the scarring was inside the vein, and not the heart tissue. So using the RF catheter he made a horseshoe shape of burning in the correct area which joined the existing scar tissue on the other PV of the pair.

So here's hoping he got it (2nd attempt). The EP was very confident of a sucessfull outcome.

One week on, and I've had no funny sensations, and have been in NSR the whole time. I feel great. I've been advised to stop the Flecainide at the 1 month post ablation. I am to continue the rate control (Bisoprolol) and the AC (Pradaxa Dibigatran) and have a follow up review at 3 months post procedure.

Note, the EP who did the initial Cryo ablation was a different EP who did my RF last week.

Regards Blake

[wilsond]

Thank you for the detailed post and sounds very positive. Very similar lead up as me, I'm weaning off flecanide 100mg x 2 ready for telephone appointment Aug 20th. My cyro was done June 2022.

There have been 3 appointments since and touch up was mentioned ,so we shall see!

Best of luck to you xx

[KiwiBlake in reply to wilsond]

Thanks Wilsond. Here in NZ our public health system is based on the UK NHS. We don't know who is going to do the ablation until the morning of the operation. Looking back at my first one, the EP looked very young, whereas last week, 2nd time, the EP was older and far more experienced. I've subsequently been told he is one of the best in NZ.

[wilsond in reply to KiwiBlake]

Sounds promising! I met mine on the day,although I was under the care of another. Best of luck x

[Buzby62]

That all sounds very encouraging and a great informative post for others in a similar position. They do tell you before cryoablation that an RF touch up may be required but not everyone takes that information in at the time. I was aware of this but hope I won’t need it.

Best wishes and good luck with the recovery, rest up!

[KiwiBlake in reply to Buzby62]

Thanks Buzby.

It is often quoted on this forum that it can take multiple ablations to 'knock it on the head'. Also everyone's hearts are different, PV's not perfectly round so the cryo balloon not making a complete circle of scarring. With me one being bigger than the others.