Advice on Second Abalation

[Murphy10]

I have always found this forum very helpful in getting the views from those that have probably treaded the path I am heading down.

9 months ago I had my first RF abalation. After 8 months I had a couple of AF episodes that lasted around 3 hours going by my Apple Watch.

Yesterday I went to see the Electrophysiologist that I selected to do my first abalation. He seems very experienced and does approximately 6-8 abalations each week.

What he told me was very surprising and I was not expecting. He said he had reflected on the day he did my abalation and told me that they had major issues with all of the hardware / technology during my abalation and they had to replace the majority of equipment during my abalation. He said perhaps my abalation was not done as good as it could have been. I thought to myself why is he telling me this now and why did he not tell me this when I went back for a check up after my first abalation. You could consider that he is being honest and open and he wants me to do another abalation to fix the first attempt.

He advised on another abalation using pulse field rather than AF. He said he would not be doing any heart mapping looking for new areas to abalalate as he suspects were he first abalated these would just need touch ups. As such the procedure would be approximately 1.5 hours.

I am not too sure whether I should go ahead with another abalation with him or look at seeing another EP. He has all my history and mapping of my heart from the first abalation and if I went with another EP not too sure whether they would know what has been done.

Any advice from forum members that have gone through a second abalation and what you would do I would be grateful.

[mjames1]

Based on only two short episodes, I would not rush into another ablation yet. I had one three-hour episode ( terminated by Flecainide) six months after my ablation and none in the 18 months since. A successful ablation does not necessarily mean zero atrial fibrillation, just a significant reduction in burden.

Should the episodes start becoming more frequent, at the minimum I would get a second opinion from a different ep.

Jim

[Murphy10 in reply to mjames1]

Thanks Jim. My cardiologist put me back on 50mg of Flec and 180mg Diltiazem which also helps with mild blood pressure.

I would like to get off the meds particularly the Flec. I have had two three hour episodes and one episode that lasted about 5 minutes. The one that lasted 5 minutes resulted in another long episode that night.

When I had the episodes ( The 2 3 hour episodes) I took 100mg of Flec.

I certainly don’t want to rush into another Abalation.

[Rainfern]

It sounds like your EP has been very candid and honest with you Murphy. An EP’s high tech equipment is a part of him, and he feels responsible. And now he has even more advanced equipment that can do an even better job than the first. So I’m not sure why you’d not go for this touch up ablation?

[Murphy10 in reply to Rainfern]

Thanks. The only reservation I have with my EP why did he not tell this 3 months on my follow up after the first abalation.

Perhaps he did not want me to worry about something that may not eventuate.

[Rainfern in reply to Murphy10]

I think you’re right, and he probably didn’t want to worry you right after your ablation. But no harm in asking them to clarify - you have a right to know.

[Onkaparinga]

I had a first pulsed field ablation over 2 weeks ago. Not had any symptoms since. Quite a remarkable difference.

[Prawnsalad in reply to Onkaparinga]

Where did you have it dine?

[Onkaparinga in reply to Prawnsalad]

Spire Hospital in Manchester. It was excellent in every respect but I had to go privately as NHS was so slow and uncoordinated.

[Snowgirl65]

I had a somewhat similar experience with my first cryo ablation by my then-EP. I was going to write a long essay about what happened, but the condensed version is, if you aren't happy with your doctor, and if you can change, then do so. I did and was very happy with the outcome.

[Murphy10 in reply to Snowgirl65]

Thanks. It is not that I was not happy with him it is more about whether what he is recommending on redoing the first abalation and not looking for new breakouts.

His reasoning was he was fairly confident there would be no new outbreaks.

Not an easy decision. He is also a lot easier to book than going with another EP. Waiting time for another EP is likely 4 - 6 months.

[Snowgirl65 in reply to Murphy10]

I understand completely.

[stoneyrosed]

I Would definitely go ahead with the second ablation. My first one only lasted a few months too but the second one has lasted nearly two years. I believe you have much more of a chance of a successful outcome with a second ablation.. go with what he is telling you, I don't think you will regret it, but not having it will probably always be a regret.

[Murphy10 in reply to stoneyrosed]

Thanks. He did give me a 80% successful outcome re a second abalation. But recommended not looking for new breakouts and redoing the ones he did last time using Pulse Field.

Interesting he had some comments about Pulse Field and said while early results are promising he said there still is not enough patient history on whether it is better and safer than RF.

[Karendeena in reply to Murphy10]

Exactly what my EP says about Pulse Field

[Jetcat]

at least he was honest with you which is nice to hear. I would stick with a honest person to be honest.👍