Hi everyone,I have waited 15 months for an appointment to discuss an ablation. The doc told me there was a 20% success rate because I've been in afib for 4 years. I told him no it has been 2 years, with one failed cardioversion and that I'd waited a long time. He did not adjust the % even though he clearly had not read my notes / forgot ! He then said a pacemaker with an ablation may be the solution. I was abit floored. I thought ablation were more successful than 20 % and a pacemaker was a last resort ? He did not explain anything but told me I would be put down as urgent on the waiting list but would be at least 4 months. I was very optimistic and thought I could get back to normal but now I feel really anxious and that it is a worse prognosis than I thought. I am 60. Anyone got any advise or views on this.
Ablation success rate ?: Hi everyone,I... - Atrial Fibrillati...
Ablation success rate ?
You're quite a youngster at 60! I must admit that pace/ablate at your age does sound a bit drastic on the face of it. You are being offered an ablation so wait to see how that goes and keep positive
I'm think I'm right in saying that success rate for ablations in general are around the 60% mark for first attempt. No doubt I'll soon be corrected if I'm wrong! Depends on alot of factors of course , particularly your own history.
I've had 5 ablations, the first in 2009 and the last . and final one in June this year. If this fails it will be pace/ablate for me but then I'm just days away from my 80th bday......
Thankyou Jalia. They kept telling me before that I was relatively young and that they needed to act quickly but that just didn't happen. I am going to speak to the cardiac nurses at BHF. They might be able to reassure me. Fingers crossed your ablation keeps it at bay.
I had 3 ablations to try to eliminate an inordinate number of PVC’s and they eventually gave up and gave me an ICD. Following that, after about a year, I started getting AFib. My EP started me on Eliquist and “watched” it. It began with incremental bouts that lasted a few hours. But after while they came more frequently and lasted longer, (24+ hours) so he recommended an ablation- and that put an end to the Afib! I had to wait about a week 😊
15 months for an appointment? Wow. That's ludicrous. And for your prognosis, any chance of a second opinion? This sounds too harsh and not right. Is he an EP or just cardio?
He is an EP. I am going to speak to a specialist nurse at BHF tomorrow. I will go from there. Not sure if I can get a second opinion ?
I'm surprised an EP would be so conservative, had it been a GP (with due respect) I would actually not have been that surprised. I had a cut on my knee sutured by a young GP, and told her that it was bleeding a lot because I had PAF and was on an anti coagulant. Her repose was 'Then you have a pacemaker I presume ?
Omg....!
And these are the people you are supposed to trust and have faith in!!! bloody hell.
🤣
Difficult to really comment without full medical history but there is no doubt hat early intervention by ablation stands the best chance of success. Leaving it so long will have reduced the chances of success and if there are other factors at work he may well be correct.
Yes, it would have been helpful if he'd explained it further. It was literally a 5m call.
I do find the consultants spend very little time explaining anything and I always seem to think of questions afterwards I have just had my second ablation going back into AF after 3 years from my last one, I don't how long I was in AF originally but it must have been a while as I was also diagnosed with HF
Both times the Cardiologist/EP have said the success rate is around 60% and that they will have a better idea once they are doing the procedure.
It's a very common procedure these days with lots of great technology so try not to get too caught up in the percentages although I appreciate that's easier said than done.
Good luck and if I can answer any questions about my experiences please feel free to message me
Yes, That's what I read. Maybe he works on worse case scenario 🤔 lol. Doctors are suppose to reassure their patients even if the odds are stacked against then. However, that's abit difficult when you are only on the phone for 5m. All the other cardio specialists have been great.
From what you've said, to be honest, I'd find myself a different EP or at least have a discussion with another one about what they think can be done. Have you any copies of ECG's you've had that you could show them? I've had AF for 19 years and never has a pacemaker been mentioned. My EP did 3 ablations and I was better after the 3rd but am now in constant AF
As Bob has said it's difficult to comment without knowing your full medical history.
I'm going to speak to the specialist nurse at BFH and the hospital. He was only on the phone for 5m and I know there's huge waiting lists but they are suppose to reassure you. All the other consultants have been great.
It may be the factor of the failed cardioversion that is affecting the EP’s gloomy prediction. Usually a successful cardioversion is a predictor of possible ablation success. So he could feel it’s a waste of time trying an ablation. However, I agree that 60 is pretty young for P&A. I would be looking for the best EP you can find if that’s a possibility.
As Jean says, it’s difficult to comment without knowing more about your symptoms and medication. It sounds as though accepting permanent AF is not an option for you?
Thanks for the comments. How do you find the best EP. Do you mean going privately ? I haven't won the lottery yet 🙃
I meant by getting recommendations. You can have a private consult for about £250 but ask to go on their NHS list. That would lead to more delay though. I see your cv was actually successful for 6 weeks so that is good news. A failed cardioversion is where three shocks don’t achieve NSR. Maybe go with the EP you’re got but expect to have to find someone better if he fails?
Do your research, find the best EP, experience etc travel if need be. An initial consultation of up to at least , an hour, may cost £250-£300 you will probably get an appointment within a week or two. Then they can then transfer you to their NHS list. wait times can vary from hospital to hospital, was quicker for me than my local hospital. Best thing I did, felt so reassured after finding my EP myself. I traveled 3.5 hours for who I wanted. Good luck
Did you have your ablation at Bournemouth hospital?
Yes, I had PFA there, a lovely team, all went well. Can recommend Bournemouth.
Where are you? I am in Leicestershire UK and have one of the top EPs in the Country. He is a Professor and President of the British Cardiovascular Society and very experienced. He did my ablation in March this year which was successful. 🤞It holds. I did see him privately though but the ablation was done on the NHS and he performed it.
Given how long you've been in afib, you might have a much better chance of success with a surgical ablation versus cathether ablation. I've tagged MummyLuv who has had one and can provide more information.
Jim
Easier said than done in the UK though!
See post by "4Chickens" below. I believe it was Dr. Hunter who did her surgical oblation under NHS.
I had AF for at least seven years before my ablation, probably more like ten.
Have you had an echocardiogram? If the EP is relying on other information and not explained it to you then that might be why he is coming back with a very low % success rate and a fairly drastic solution at your age.
You can always get a copy of your echo and if , as in my case, it indicates an enlarged Left Atrium then that would definitely be a reason for the low % success rate that your EP has given you.
The notes on the Echo would say ‘dilated LA’ and usually mention its severity.
Of course, this is just one possibility, but I really think you should find out why the % is so low so that you can make informed decisions.
Good luck
I think you’re quite right in what you say!
My left atrium became (and is) very large and I also have HCM.
Bristol refused to give me an ablation because they said they only had an 18% success rate, but luckily St Bart’s did it for me.
Hello. I can see from your posts that you have had a number of other complications as well as AFib and it’s great that St Bart’s took on you case. Have they ever explained why?
You say in other posts that you had nose bleeds so I can understand the doctors wanting to get you off anticoagulants but I’m pretty sure an ablation on its own wouldn’t do that. Was that a reason?
You didn’t mention how successful the ablation was though? I’m progressing a different route, surgical ablation, hopefully in the next few months.
Hello! I may not have been very clear Goosebumps!
Since 2020 when AFib first visited I have been on Apixaban (temporarily on anyone, but switched back.
Bristol said no to me because their success rate was only 18% for ablation for someone with HCM.
St Barts cured the AFib (🙏) but unfortunately that then triggered ATach.
Second ablation cured that, but may have triggered VTach!
I think this getting better and the runs are short.
I hope all goes well for you!
Last month I was referred by my private appt. cardiologist to a private appt. EP. Before meeting the EP my GP surgery agreed my cardiologists suggestion that I have an echocardiogram on the NHS. Total cost of private appts. was £450.
Yes it's expensive and you do need to make sure you are not pressured and have all your Q's written down and the answers before leaving the consultants. Still worth it IMHO as likely to get better advice and reduces anxiety.
💯 agree, I did the same
It does not sound correct. You did not say if you were in perm AFib or paroxismal. I have had afib for 40 years but had an ablation at 65 as advised 85% success. It was a success but needed another at 72 and although still get breakthrough's, I consider my decision absolutely the right one. I am confused your Dr advised 20% pct success rate unless it was particular to your condition. Hopefully you will get the best advice xx
get a new cardiologist. One who listens and cares.
my husbands stopped working at some point which caused his stroke, he wasn’t out on blood thinners afterwards which I believe could have prevented his stroke . They did tell us he may need another one after his ablation but as he had no symptoms and wasn’t wearing an Apple Watch at the time had no idea it had stopped working . Good luck . We still havnt seen a consultant over a year after my husbands stroke . It is being controlled with a concoction of meds at the moment . He is also in stage 2 heart failure from his echo last year with his ejection fraction at 33% so we’re hoping when he eventually had another one it had improved slightly . Take care .
Those odds sound unusually low. My EP offered a 5th ablation or pace and ablate at about 60 years of age. That’s why I started to look at other options, which lead me to Sheffield northern general hospital and a hybrid mini maze. Search on this site under minimaze and hybrid minimaze to see if this is something that might be worth you considering.
I had 3 x ablations done in 2022 at age 47. It was third time lucky for me. I'd had AF for 18 years, 10 years of which was constant/ persistent. I was given 50% chance. I had significant scarring, moderate enlargement of left atrium and was in mild heart failure. I think the 50% was quite generous and I think we all knew it was a long shot.I'm now in sinus rhythm despite going straight back into AFwithin 48 hours of all the ablations and cardioversions. 5 months after the 3rd ablation I suddenly went unto sinus, and stayed there.
I'm so grateful to my cardiologist and EP who persisted against the odds.
I wouldn't rush into pace and ablate. I wonder if you can ask for a second opinion?
This gives me hope, I was a very young persistent too 🤗
I had an ablation 3 years ago, unfortunately, not successful and my EP told me my chance of success was 70% (as I recall).I'm now awaiting valve repair surgery and my surgeon told me he would have personally put my chances at 20% and that, in his experience, EPs tend to be overly optimistic with their expectations. This was at a point where he was offering me a Hybrid Convergent Ablation as they were waiting for scan results about my valve.
The surgeon had given me a 90% chance of success with the Hybrid so perhaps this is something you could discuss with your EP.
MummyLuv and 4chickens have had a similar procedure and are doing very well, so perhaps have a look at their posts for further info. They had theirs done by a Mr Hunter, one privately and the other on the NHS.
Hope you find their information useful.
I was happy to give the Hybrid a go but unfortunately, they picked up that my mitral valve needed to be repaired and intend to now do a Cox IV Maze at the same time.
It sounds as if you could have had a far better consultation. The pressure on cardiologists at present in the UK NHS system seems to be intense. A pacemaker is used only to speed up an over-slow heart, so I guess you must have a history of bradycardia, which I do. It came as a shock when the device was mentioned to me, out of the blue (indeed pace and ablate was also touched upon). There is no option for some people, however, especially if a beta-blocker continues to be needed on an already slow heart.
The evidence for acting quickly with an ablation is slim so far as I can tell and still contentious since no one knows the root cause of why the atria quiver as they do in AF. It is certainly complex and maybe differs between sufferers. Different doctors have their own approaches.
The figure of 20% may apply to you because of your specific history or maybe the doctor was being pessimistic for some other reason. These things are hard to understand out of context. If that is a fair guess, I would stay with medication, I think, but, again, this depends on several factors.
Steve
You could email his secretary with a list of questions. My EP is very helpful with stuff like that.
Hi Sailblue,
I had paroxysmal Atrial fibrillation and flutter. I was very symptomatic. Various meds didn't touch it, and they also caused pauses, which took my breath away. I also had a 3 bolus chemical ablation which actually sped my heart up and dropped my blood pressure into my boots.
I already have a pretty low blood pressure.
After doing research on PVI ablation (70% success rate) which I was offered back in 2019, and pace and ablate procedures (nigh on 100% success rate). I opted for the Pace and abated. I too was 60 at the time.
I personally never looked back. The only meds I needed to take was an anticoagulant, which I was already on.
I am due to have an upgrade to a CRT pacemaker (bi ventricular leads as oposed to one). This is due to having a slight enlargement to my left ventricle and an ejection fraction of 40. This is possibly caused by the one ventricular lead pacemaker. It is called Pacemaker Induced Cardiomyopathy. However, I feel fine in myself. I still cycle, garden and generally keep very active. These I did before and after having my pacemaker.
Obviously we are all different but it is worth looking at all of your individual options in relation to your own health status and your continued wellbeing.
Hope that helps 🙂
For what its worth I have had AF for around 15 years progressing steadily from paroxysmal to permanent, have never been offered cardioversion or ablation but after about five years following faints & blackouts had a pacemaker fitted. Now I'm on my second one (they last 7-10 years) - still in permanent AF - and I keep seeing people on here commenting on multiple cardioversions and ablations and think quietly to myself - what's the point?
I'm afraid you need to go private at least for a second consultation. What you received as medical care assistance is not enough, consider you'll deal with this for the rest of your life and acting earlier has demonstrated to produce the best outcomes. If I were you and I couldn't afford the consultant, I would consider borrowing the money.
If you tell us your area, there will be probably people that know EPs near to you.
I've been diagnosed with persistent in March 2023 and I didn't see any cardiologist on the NHS yet. I received a letter few months ago saying they put me on a list in Cardiff Heat Hospital. I had seen the cardiology nurse the past year, and although she is a brilliant human and professional, I needed a very specialised cardiologist, an EP, as afib is a peculiar thing and in my case quite unique situation. You want someone that thinks out of the box, especially when you are a young patient with this.
I paid myself for 3 different consultant, as my first private one was not good and made me feel like a lost case. He discouraged ablation although I had successful cardioversion, I was 38 and had no other health concern heart or elsewhere.
I suggest you get asap to see an EP privately.
I'm 53, had pace and ablate 28 months ago, now on my second pacemaker in HF and have permanent AF since.I'm hoping I will be offered a cardioversion soon to see if it helps.
Obviously I'm not one of the success stories.
Not hopeful il ever get back to normal now.
Your experience is identical to mine. I'm 52 and got diagnosed with AF about 2 years ago. It took a year to have a cardioversion which lasted 3 weeks and then back into AF. It then took 9 months to get a phone call to then be put on the waiting list for an Ablation. The doctor told me that there was about a 60% success rate with ablation but that because I'd been in AF for several months (wrong it is at least 2 years and I actually suspect it's been for a few years more than that), the success rate for Ablation was still about 60% but only after multiple ablations. As I'm young I was told I would be put on the priority list. That was 4 months ago!
I appreciate that the NHS is under dire pressure but I have zero confidence in my doctor. Every time I've tried to contact him its taken months to get a reply. I'm in the process of moving house and expect to be moving to a new county in Jan/Feb next year which still may be before I get the first ablation. I honestly don't know what to do for the best because a big part of me wants to wait until I move and start afresh with a new doctor. That said, I might be put right back at the bottom of the list again and as chances of success reduce the longer you are in AF the more likely it therefore is that it will fail.
If I had the money I'd go private but that's simply not an option. Ultimately I feel utterly screwed with no meaningful options open to me. I hope that you are in a better position and get treated soon.
I'm sorry you have to go through this. I think I would go with the one you're on the list for and change if that one doesn't work out. A difficult choice. I am considering a private consultation to get a clear picture of the options. I would still have that EP on NHS so probably the same consultant. I don't think I can ask for a different one under the NHS. I am looking unto it.
The wait time is consistent with my recent experience in London where it was 11 months from GP to get to an EP, even though the GP knew at the start that I had been diagnosed with paroxysmal atrial fibrillation. The EP told me that the chances of a successful ablation diminishes after 3 months of constant atrial fibrillation although, as always, the % chance of success depends on your individual circumstances.
Dear Sailblue,
All cases are different and all depends on the full medical history but I would definitely be looking for a second opinion. My experience (and I won't bore you with the causes) was that I was in paroxysmal AFib and heart failure, initially treated with medication. The first EP said wait 2 years and then review, that the success rate was low and there was a significant risk of mortality. Felt like scare tactics. Having read quite a bit about the condition, I wasn't convinced and felt I was being fobbed off. I got two more opinions - both said that the sooner the AFib could be corrected with an ablation, the better the chances of success. I was 60, fit, BMI 21, non-smoker, non-drinker. Both said the success rate was roughly 60%, often with a top-up ablation needed that brought the odds up to 80%. I had two PFA ablations under GA, the second was last December 23. I was up and about the following day, in sinus and have remained in sinus since. It's only been 10 months but I feel strong and very able, running up the escalators in the Underground and not out of breath. I'm so glad I went for second opinions - I'd recommend you do the same. More often than not, the success stories don't appear on these forums as most of us come on here to try and find solutions and support for ongoing problems. Good luck.
Thankyou for your measured response. Yes, we forget there are thousands of success stories we never get to know about. I hope you continue to run up those escalators but don't over do it. I think the worse thing is everytime I do exercise like swim, yoga or a long walk I feel like I've done a marathon and sleep for about three hours. You have to try right.
Success rates for ablation are relevant to time.A 6 year remission could be regarded as 20% while a 2 year remission could be regarded as 60% success rate.
Well I can tell you that here in the U.S. the success rate is much higher!
I would try the ablation. What do you have to lo lose. My ablation saved my life. I think it is worth any risk. It depends on what degree of Afib you have and how much it affects your life. Imop
Hi, this sounds very odd. You need another consultant. According to my friends who are consultants - it is a procedure that is very operator dependent. I would have no confidence in this person.
I had 3 ablations that ended badly and did not “cure” the AFib. I for one think that ablations have been hyped up to sound as if they are the end all cure. From my experience and my research if the ablation doesn’t happen early on and is successful then the subsequent ablations probably won’t be either. I may be a little jaded because of my Experience, but I think way too much hope is placed on ablation as a remedy for a fib. I ended up with a pacemaker and a AV node ablation, which finally helped and I’m now good. My fib is not gone, but it is not affecting me the same way nor am I symptomatic. I wish I could’ve had this done sooner than after three failed ablations and what turned into pulmonary veins stenosis, which is another whole different major problem in itself. Good luck.
Hi Eliza 1. I'm being considered for Pace and ablate again after having the process started 3 3 years ago by putting a dual chamber pacemaker in but not going ahead with the AV node ablation. What has in effectt happened to me is having g to put up with multiple drug trials. It's terrible. I just want the ablation over and done with before I'm to old. I'm 82 and have been a very fit athlete in my time but now I can't excersise because of afib. Thanks for your very welcome comments on this topic.Colin from New Zealand.
I’m so sorry you have to wait. Sounds like government bureaucracy to me. I refused the toxic drug options offered instead of P & A but was given choice thank goodness. Is there anything you can do to get around this?
Yes it does sound like bureaucracy. Just heard today there isn't enough doctors in New Zealand. I see my specialist in 3 weeks and will tell him ive had enough. I sent a message to him this afternoon to ask him what to do with my high bp which has occurred since this morning and the burning sensation in the centre of my chest. I'm sick of it. To me drugs are very toxic. Some people get over them. Twice ive been in hospital after flat lining on drugs. I will let you know and thanks for your listening.Colin.
I have been in Afib for 2 yrs too! I had one conversion and that did not work also! I am on a beta blocker and will that just work for you without the pacemaker and ablation?
oh my goodness, I’d definitely be pushing for a 2nd opinion (or more!) Or at least someone who will explain everything more clearly and answer your questions,
The first EP I saw basically said “oh this isn’t deal, live with it”. I moved on. The 2nd EP immediately jumped to an ablation, all good, but didn’t work, so he did another one. That didn’t work, and he said I was stuck with meds for life. And he was incredibly rude. So once again, I moved on. 3rd EP was much more considered and considerate in his approach. He did ablation #3 that finally got rid of the afib. He also takes the time to answer questions, and is never rude. Find a doc you can trust!
Hi
Persistent AF does mean a lower success rate. 2 years you are young at AF. But even at 2 years with uncontrolled or controlled beats your heart muscles have adjusted.
Ablations often make the heart slow down and therefore a pacemaker is needed.
I cannot have an ablation, heart conversion or Flec as an anti-arrhythmic drug as my ECHO of heart shws abnormality in the left atrium. But thee Calcium Blocker Diltiazem acts like an anti-arrthymic med and slowed my heart from 156 on Bisoprolol to 51 in 2 hours but the reduced 120mg from 180mg is just right for me .. Day avg 69-79 Night my normal 47bpm and I take Bisoprolol 2.5 at night for high BP specially the Systolic Level.
But a friend younger had an ablation after years of intermittent AF and they found two separate rogue stimuli and he was fixed .. well 2.5 years of no AF.
You need the best surgeon to operate so see if you can get the best one with the most successes if you go ahead with it.
All the best.
Chefrio JOY. 75. (NZ)
Hi Joy, it's colin from kerikeri here. I'm back with Brandon Wong again. I'm still taking terrible drugs and yet still have arryhthmia as well as a myriad of side effects. I will be seeing Brandon again in a few weeks to discuss further options I guess because last time hetter off etteretterette showed that he is not in favour of AV node ablation. Because I'm an ex cyclist he explained it this way that im better off having five gears than having only 1 gear !!!!! That's ok if one has no side effect probs . He put me on the treadmill and it showed after 7 mins and 7 secs that my pulse rate of 104 rose to 148 and bp 180 90 rose to 195 90. With excersise i became promptly tachycardia 111 in stage 2 and 123 in stage2 and then became promptly tachycardia with accociated breathlessness. This he says demonstrates poor AF rate control. Can you or anyone explained this.Colin , NZ
Hi
Back from JAPAN last Sunday. Happy but frustrating trip.
Cause walking far was a problem. Loss of energy after 20 yds.
My AF control is 60s. I guess Brandon says POOR AF CONTROL when your exercise makes heart rate go up too high.
Betta Blockers did nothing for my heart rate or very little. But CCB Diltiazem was dramatic! On 1/2 dose from 156 to 51! And in 2 hours.
Brandon will sort you out.
As a patient PRIVATE or under hospital?
I'm back for my CT SCAN re thyroid cancer - left there 2 lymphs and Thymus calcified.
These will need to be removed. Surgeon retiring end December. I have said "I want you to operate if necessary before you leave.
I remain in controlled persistent AF with no symptoms apart from this walking business.
So are you going to BRANDON privately or not.
cherio JOY. 75. (NZ)
I do go to Brandon privately Joy. I'm hoping he can make a case for me to be given atrial node ablation in the public system.it will be 3 weeks before I see Brandon
Hi
Reading up on AV NODE ABLATION is interesting.
It sits in between the Atrium and Venticle Chambers.
If a surgeon abates this it stops ANY electrical impulses from travelling between these chambers..
It sounds serious, very serious. Brandon is warning you about total no electrical help to balance the way your heart beats. You may end up with no beats except for the Pacemaker.
Think very carefully before going down this track,COLIN.
cheri JOY
Pacemaker or Ablation 
2 or 3 lead pacemaker with AV node ablation 
