When is ablation successful?

[50568789]

Just curious. Often see quotes from EPs and in literature about success rates from ablations, seem to be anywhere between 60% to 100%, depending on lots of variables. Is there a definition of "success"? Where do the stats come from? Are they from a national database or individual medics / hospitals? Or a guess? How and when are they gathered? In my own case, I wouldn't know what I have been referenced as a statistic , and feel the term "success" is a bit of a moveable feast. I will ask my EP for more information at my next review, for the sake of it, but I don't really pay much heed to quoted success rates. Like I said, just curious how they arrive at the figures.

[BobD Volunteer]

Since any and all treatment for AF is primarily about improving quality of life (QOL) then that speaks for itself. For one person with persitant AF a reduction in events to one or two a year would be considered successful but not by a person who only ever had one or two a year. Years ago the criteria used to be no AF at five years post procedure. but I think that a little harsh.

Caveat, forums like this are tilted towards failures as successful candidates seldom remain.

[CDreamer]

Good question - and one I would ask any EP is at what point in time post ablation would you call the procedure successful, bearing in mind there is blanking period?

My own interpretation would be that I would have sustained NSR for between 1-5 years.

[dmac4646]

Its a good question re sources of success rates - even Dr Schilling results stop at 2020 ....

[Brizzy50000]

I've remained on this forum, had a successful RF ablation in May 2018 after AF became unbearable, I like to keep an eye on this forum to give what knowledge I can that might help other AF sufferers

[M-Lumino]

Hello. My first post on this or any other forum. I had a first ablation (Pulsed field) 8 weeks ago in mid December. It wasn’t an easy decision as I wasn’t very symptomatic with the acid episodes I had. However, I did notice a possible increase in frequency. I managed the bouts with PIP combination of 2.5mg Bisoprolol and 50-100mg Flecanide. This would generally finish the episode in a couple of hours. I was finally convinced when the cardiac nurse I dealt with mentioned that ablation is more successful with paroxysmal afib and they (obviously) couldn’t predict if/ when I might enter a permanent afib state. I’ve also never had a health issue, am a reasonably fit 59 and really didn’t want to take pills. I’m not so sure I made the right decision even if it is early days and in the blanking period.

I’ve read so much of the literature and the papers about PF ablation and blanking period and scarring etc. My instinct (not always reliable, I know) tells me that I’m going to need another ablation and that the dream of first/ early success isn’t going to apply in my case. I know this isn’t unusual, but my confidence in the efficacy of the procedure in my case is shaken. My afib episodes are now more frequent and seem to build over 48-72 hours. Then take isopropyl and flecanide and episode goes in an hour or so. Sometimes they go on their own if I sit differently. The symptoms during afib are worse than pre-ablation. Much more breathless and can be more tachycardic. Is this simply due to inflammation and scar/ repair or has my procedure been ‘botched’. The centre I went to has a good cardiac reputation and they consultants have lots of experience with ablation and PF in particular.

I have stopped drinking alcohol and eat smaller portions. Was a ‘healthy’ weight already, but have lost an additional 7kg so all okay there. I basically feel hyper-sensitive to everything now. The one small glass of wine I had about 3 weeks post ablation possibly caused chaotic ecg (have a little Kardia device). Same with eating too much/ too fast. Almost feels like the slightest change in anything I do could trigger the inflamed heart and cause afib. Aware that this might be a self fulfilling loop.

Told this is normal blanking period by nurses, but my heart feels different. Different thuds and patterns and unpredictability- very lacking resilience. This is the one outcome (if things stay the same) I didn’t want - to feel worse and, with ablation, being irreversible. However, I know I can’t re-write what’s has happened, but can I trust (if required) that a second procedure wouldn’t make it even worse? As I understand it, the first ablation is (kind of routine) in isolating the four blood vessels and subsequent ablations are more targeted at rogue/ missed cell areas. Is that correct?

Also, even if some of the literature (especially related to pulse field ablation) suggests that afib at 0-8 weeks into blanking would suggest a second procedure likely required for improvement, has anyone here been worse (than before procedure) this long after ablation and then started to improve 3,4,5 + months after ablation? Am I really judging ‘success’ too early?

Nurses have suggested I go to daily bisoprolol and PIP flecanide, but they don’t seem to have rationale for that and surely that ‘masks’ the issue and hides the reality of the position - when/ how would I know to come off them? Am on daily edoxaban..

Sorry for the rambling nite, but any words of wisdom or advice gratefully received. I’m very appreciative already of the input on this forum. Wished I’d found it earlier. Thank you.

[ozziebob in reply to M-Lumino]

With all your valid concerns, I think this reply of yours needs to be a Post of its own. Easily done.

[Ossie7 in reply to M-Lumino]

I feel for you , as although early days , you do seem to be more symptomatic than pre ablation . I have always had ‘persistent AF ‘ , only relieved by cardioversion . The 3 ablations i had were always asymptomatic in the blanking period . One lasted 5 months , the second 7 months before the beast came back and 3rd done early May last year still in beautiful sinus , BUT on same meds as EP said i was high risk for a return and the ablation was only partially ( but 75% ) successful .Thats my story , i hope you do settle down and it is indeed just the scarring of the heart not being fully healed .🤞🤞🤞

[M-Lumino in reply to Ossie7]

Thanks Ossie7. Appreciate your reply and words of comfort.

Am new to forums so have also realised I've not posted this in the best place (apologies all) Have re-posted as a separate thread.

Thanks again.

[Ppiman]

I think it's from their own work and from studies online that have been carried out. I don't know how many years they consider "success".

Steve

[DawnTX]

I think that’s a great question as far as unconcern successes when down a bit and you don’t get it as often maybe none at all if they were lucky enough to get the right spot that being said another area can act up. It’s not just one area. It’s unpredictable at best. I am the word successful much too much from is going to honestly tell you it was successful especially as soon as it’s done just healing alone is going to give you some issues if they knew it was they would know if they got exactly the right point and even with the equipment, they are coming out with daily. either that they got the spot or another spot will not act up later. It’s not an appendix that you just pull out and it doesn’t hurt anymore. It’s your electrical system for your the wiring in your house. How many people have had it fixed in the kitchen and then later on the living room has a problem that’s the way I picture a fib, etc..

I say everyone out there that gets a break from any arrhythmia be grateful and if you know a avoid it if you can believe it or not ice cream is one of mine. It doesn’t matter how much one spoon could do it I could ache all night and then it goes away like anything else that is sensitive. It can be irritated. Anxiety and stress are different because it’s hard to control if you find that to be a big trigger, talk to your doctor you may need something for it. My EP spoke to my GP about it he could see what I could not about anxiety even though I had meds it had been take as needed, and I did not think I needed them very often. I turned I was very wrong even though I disagreed with my EP. It turned out. He was right I have just recently stopped taking them and I feel wonderful. There are side effects to the meds I used to say I felt a bit like a zombie, even if I wanted to cry I had a hard time even when there was a good reason unfortunately it seems like everything they give us needs another medication for the side effects. makes me angry because I feel like the makers have done this on purpose because how they make money. But we do need our meds. I have been pretty lucky with side effects and the difference how I feel is amazing. Since the pacemaker after my healing most of the I feel which I never thought I would feel again then again no one feels perfect ever and don’t just blame your heart. You could have something else including gastric. It’s a learning curve as I keep telling people honestly I’m pretty thankful. I have this look around at things that other people have that cannot be helped. Positivity will take you a long way.

[Jetcat]

Hi 505. iv had three ablations but unfortunately I still do get some episodes of afib at night time early hours .! And I still get periods of ectopic heart beats now and again, but my life is alot better than it was and I don’t regret the ablations. I’m still working full time,going on holiday and running around after grandkids.👍

[Madscientist16]

Cryo-balloon ablation in 2018 and no AF or on any meds. Currently 58-year-old female who is still in good health and very active. You are correct, too many variables and everyone is different.