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How long do ablations last?

Posted by Socalsteve 
How long do ablations last?
June 28, 2018 11:49AM
Hi all,

First time poster. Thank you all in advance for your great knowledge and generosity!

I had an ablation for Afib 7.5 years ago. It was 100% successful in keeping my heart beating normally until about a month ago when I started having episodes back into Afib. But kind of felt like Afib lite. Not nearly as intense and the episodes didn’t last nearly as long. Got scared, went to cardiologist and he ran a plethora of tests on me. EKG, heart X-ray, blood work, stress test, holter monitor, echocardiogram and the biggie, an angiogram. Everything came out normal.

What’s weird is that just before I started having these episodes, I turned 60 and rode my bicycle 60 miles on my birthday. So, pretty healthy for being 60.

Since my cardiologist put me on metropolol ( 50mg twice a day ) my heart is back to normal. He said that the max norm for an ablation is 5 years and I’m lucky that I got an extra 2 years of being Afib free.

I guess my question is ( maybe more like a poll, actually ) how long did you stay in normal heart rhythm after your ablation? I’m just curious.

Again, thank you all in advance,

Steve
Re: How long do ablations last?
June 28, 2018 12:17PM
It depends on who did the ablation. Operator skill level matters. Some fail after the 3 month blanking period, others go a decade or longer.

Mine was 3 years ago. I had a breakthrough in April this year, which I would also describe very much as "a-fib lite". Nothing since then. No drugs at the moment. Honestly, if I had to guess I'd say this is what a pulmonary vein reconnection feels like. I'd be surprised if it were another focus in the left atrium. I think that would result in more episodes especially without medication.

Wow, your cardiologist certainly cashed in on that episode. Angio? Never heard of that for AF, certainly not recurrent AF. The holter and echo would belong to perhaps an initial diagnosis of AF, but if you know you've had it already, why bother with all that? You must have good insurance! smiling smiley

As for the 60 mile ride, go for it! Summer heat means electrolyte depletion. That's sticking out like a sore thumb in the causation analysis here. What do you do for rehydration? There are plenty of threads about electrolytes on here. Basically, watch the sodium and calcium and add the magnesium and potassium (healthy kidneys, of course). Lots of fluids. Water or alkaline water. Nix the sports drinks like Gatorade or its ilk.
Re: How long do ablations last?
June 28, 2018 12:54PM
Quote
wolfpack
It depends on who did the ablation. Operator skill level matters. Some fail after the 3 month blanking period, others go a decade or longer.

Mine was 3 years ago. I had a breakthrough in April this year, which I would also describe very much as "a-fib lite". Nothing since then. No drugs at the moment. Honestly, if I had to guess I'd say this is what a pulmonary vein reconnection feels like. I'd be surprised if it were another focus in the left atrium. I think that would result in more episodes especially without medication.

Wow, your cardiologist certainly cashed in on that episode. Angio? Never heard of that for AF, certainly not recurrent AF. The holter and echo would belong to perhaps an initial diagnosis of AF, but if you know you've had it already, why bother with all that? You must have good insurance! smiling smiley

As for the 60 mile ride, go for it! Summer heat means electrolyte depletion. That's sticking out like a sore thumb in the causation analysis here. What do you do for rehydration? There are plenty of threads about electrolytes on here. Basically, watch the sodium and calcium and add the magnesium and potassium (healthy kidneys, of course). Lots of fluids. Water or alkaline water. Nix the sports drinks like Gatorade or its ilk.

Thank you for the response!

The doc who did mine said it looks like he ablated a tic-tac-toe-toe board with my initials to boot. I guess I’ll never know if he was joking or serious. But it seemed like he was very aggressive.

I have Kaiser ( HMO ). All the testing is in house. The angiogram was because he saw something he thought might have been blockage when he read the stress test ekg. Glad I had it though. One less thing to worry about!

I am probably a bit guilty of not hydrating enough when I ride. I use NUUN electrolytes in my water bottle. [nuunlife.com]. Nothing like Gatorade.

Steve
Re: How long do ablations last?
June 28, 2018 02:06PM
Good day Socalstev,
I had my first ablation 10 years ago with Dr. Natale and it was stable until this year. Since March I had 3 episodes each lasting 1-2 hours. Yes i would also say it is Lite version of what i had before. I decided that I do not want to live (I am active and in September turn 47) with it and go for the second ablation with Dr. Natale in August.
Re: How long do ablations last?
June 28, 2018 02:40PM
The question isn't really how long an ablation lasts. A well done ablation lasts forever. However, what can happen is the atrial myopathy that underlies afib can progress, and a new source of ectopy can develop later that's outside the areas isolated by the ablation. If that happens, afib can return. So it's not that your ablation wore out somehow. Rather, your afib progressed and a new source developed that's not within the isolated areas.

Knowing this speaks to the importance of lifestyle factors even after a successful ablation. Keeping the weight down, keeping exercise levels reasonable, and treating known causes like sleep apnea and hyperthyroidism all remain important to remaining free of afib.
Ken
Re: How long do ablations last?
June 28, 2018 03:33PM
Mine has lasted 11.5 years, and still counting.
Re: How long do ablations last?
June 28, 2018 07:02PM
Quote
Socalsteve
I turned 60 and rode my bicycle 60 miles on my birthday. So, pretty healthy for being 60.

So there can be several paths to afib, in my opinion. One is with a lot of co-morbidities (BP, CVD, obesity, diabetes & etc). The other is chronic fitness.

Over the years a lot of those who are chronically fi and end up here, wonder why their heart is having issues. I note that while fitness will reduce the incidence of co-morbidities (which is a plumbing issue) it may not be good for the electrical system (though it may be beneficial for those with the co-morbidities)..

I came here 14 years ago and my path was chronic fitness. One of my choices to stay in remission was to avoid excessive endurance activity. I remain very fit, however, high intensity with long duration is a trigger, so I avoid it. I can to 8x20:10 Tabatas, military fitness training on the TRX, strength training, rock climbing for 6-7 hours at a time, skiing off-piste non stop for 7 hours. However I won't join my young friend who will skin up and ski down at the beginning of the day - too much endurance. I'm 63.

George



Edited 1 time(s). Last edit at 06/28/2018 08:39PM by GeorgeN.
Re: How long do ablations last?
June 28, 2018 08:24PM
My first ablation lasted 5 years before I started having AFFIB light. For several years after that I would usually convert on my own within a half hour. If not I used flecanide as a PIP.
Things really deteriorated this past December and I ended up in the hospital in January.
My EP happened to be doing proceedures that day and did my second ablation. This one did not last at all and I am currently taking Ticosyn as the flecanide no longer works for me.
Thinking back I should have held off on the second ablation and thought about what I wanted to do.
I have my third ablation scheduled for this coming July with Dr Natale.
Re: How long do ablations last?
June 28, 2018 08:38PM
An EP who has immediate openings, as rocketritch has told us, is a telltale sign of an inexperienced or otherwise less-than-stellar practitioner. An EP worth his or her salt will have a waiting list up to 6 months long. Buyer beware!
Re: How long do ablations last?
June 28, 2018 08:39PM
Quote
GeorgeN

I turned 60 and rode my bicycle 60 miles on my birthday. So, pretty healthy for being 60.


So there can be several paths to afib, in my opinion. One is with a lot of co-morbidities (BP, CVD, obesity, diabetes & etc). The other is chronic fitness.

Over the years a lot of those who are chronically fi and end up heret, wonder why their heart is having issues. I note that while fitness will reduce the incidence of co-morbidities (which is a plumbing issue) it may not be good for the electrical system (though it may be beneficial for those with the co-morbidities)..

I came here 14 years ago and my path was chronic fitness. One of my choices to stay in remission was to avoid excessive endurance activity. I remain very fit, however, high intensity with long duration is a trigger, so I avoid it. I can to 8x20:10 Tabatas, military fitness training on the TRX, strength training, rock climbing for 6-7 hours at a time, skiing off-piste non stop for 7 hours. However I won't join my young friend who will skin up and ski down at the beginning of the day - too much endurance. I'm 63.

George

I’m very confused. You think rock climbing and skiing for 6-7 hours at a time is not chronic fitness? Makes my 60 mile bike ride seem like a stroll in the park. Please explain. Thank you!!!
Re: How long do ablations last?
June 28, 2018 08:40PM
Quote
Ken
Mine has lasted 11.5 years, and still counting.

I’ll have what he’s having!!! Congratulations, what’s your secret to success?

Thank you!
Re: How long do ablations last?
June 28, 2018 09:04PM
Quote
Socalsteve
I’m very confused. You think rock climbing and skiing for 6-7 hours at a time is not chronic fitness? Makes my 60 mile bike ride seem like a stroll in the park. Please explain.!

Steve,

I have a sense of how much is too much for me.

I'll give examples. A year or two ago it was a powder day (I was skiing in the Rockies at 12,500'). I can do laps all day without issue. However this day, I decided to add hiking for extra vertical to each lap. That turned out to be a trigger. I was stupid to push it.

Another day, a year or two before that, I decided to see how many laps I could do in a day at A-Basin on their Pali lift. It is 1,340' vertical and steep - 37-40 deg and off piste. I managed 33 laps, plus a few others for a total of 48,000' vertical. That was a trigger. However I've done 62,000' vertical where most of the day was on groomed trails. That was not a trigger and was easy.

A lot of my day rock climbing is spent belaying.

I look at it as a combination of exertion and time in exertion. A ski run only takes say 10 minutes at most. Then you stand in line for a bit (which I try to minimize) and ride the lift up. Rock climbing also isn't continued hard activity. There may be a few physical moves on a route, but it is not continuous.

Early in my afib career, I snowshoed in with a 70 pound pack in 3' snow, breaking trail. I then proceeded to construct a 3 person snow cave. My helpers weren't much help. That was a trigger.

A set of Tabatas is very hard and high heart rate, but only lasts for 4 minutes.

I also make sure I can do everything I do breathing through my nose.

What is a trigger for someone else may be very different. I know that if I push myself hard for a long time, it is a trigger. My non-afibber friends do things like "Ride the Rockies." I avoid stuff like that.

One time I was in a class and we had to do a coulior climb (steep asent of a snow packed gulley at 13,000' with ice aze and crampons). I know it was a big risk. I overloaded my magnesium to the max, both before and after. I managed to avoid an episode.

Pre afib- I used to compete in a race up Pikes Peak. In fact, my first afib episode came with a several day delay after a training run on a 14er.

I'm fit, I can do a lot, but I do have this subjective line that I try not to cross that I think will be a trigger.

Again, for me, using the nose as a limiter (have to breathe through my nose), seems to work reasonably well.

I realize this is squishy, but it is how I try to balance wanting to do more with not triggering afib. My non-afibber friends to all kinds of endurance cardio all the time. I don't join them for that stuff.
Re: How long do ablations last?
June 29, 2018 03:41AM
Hi, Steve,

I'm in So Cal too, and with Kaiser. If you don't mind, who did your ablation, and at which facility?
At this point, I'm gathering information about Kaiser electrophysiologists, and while I'd love to have Dr. Natale, that's not possible with Kaiser.

Thanks!
Sue
Re: How long do ablations last?
June 29, 2018 06:34AM
Think I might be the longest - 15½ years. I had an ablation and touch up 3 days later in Bordeaux after years of paroxysmal AF and 18 months of longterm persistent AF. Get a fluttery feeling now and then but it feels like runs of ectopics not AF.

Most crucial thing is to choose a maestro to do the job - I had Prof. Haïssaguerre, assisted by Dr. (now Prof.) Jaïs.

Gill (female and pronounced ‘Jill')
Ken
Re: How long do ablations last?
June 29, 2018 10:22AM
socalsteve,

Good doctor, excellent fitness, good health (no prescriptions), age 73, plus magnesium, potassium, and taurine to prevent ectopics, but in lesser quantities than most commonly recommended here. I had afib for 11years (5 undiagnosed), with two to three episodes per month.
Re: How long do ablations last?
June 29, 2018 10:34AM
Quote
GeorgeN

I’m very confused. You think rock climbing and skiing for 6-7 hours at a time is not chronic fitness? Makes my 60 mile bike ride seem like a stroll in the park. Please explain.!

Steve,

I have a sense of how much is too much for me.

I'll give examples. A year or two ago it was a powder day (I was skiing in the Rockies at 12,500'). I can do laps all day without issue. However this day, I decided to add hiking for extra vertical to each lap. That turned out to be a trigger. I was stupid to push it.

Another day, a year or two before that, I decided to see how many laps I could do in a day at A-Basin on their Pali lift. It is 1,340' vertical and steep - 37-40 deg and off piste. I managed 33 laps, plus a few others for a total of 48,000' vertical. That was a trigger. However I've done 62,000' vertical where most of the day was on groomed trails. That was not a trigger and was easy.

A lot of my day rock climbing is spent belaying.

I look at it as a combination of exertion and time in exertion. A ski run only takes say 10 minutes at most. Then you stand in line for a bit (which I try to minimize) and ride the lift up. Rock climbing also isn't continued hard activity. There may be a few physical moves on a route, but it is not continuous.

Early in my afib career, I snowshoed in with a 70 pound pack in 3' snow, breaking trail. I then proceeded to construct a 3 person snow cave. My helpers weren't much help. That was a trigger.

A set of Tabatas is very hard and high heart rate, but only lasts for 4 minutes.

I also make sure I can do everything I do breathing through my nose.

What is a trigger for someone else may be very different. I know that if I push myself hard for a long time, it is a trigger. My non-afibber friends do things like "Ride the Rockies." I avoid stuff like that.

One time I was in a class and we had to do a coulior climb (steep asent of a snow packed gulley at 13,000' with ice aze and crampons). I know it was a big risk. I overloaded my magnesium to the max, both before and after. I managed to avoid an episode.

Pre afib- I used to compete in a race up Pikes Peak. In fact, my first afib episode came with a several day delay after a training run on a 14er.

I'm fit, I can do a lot, but I do have this subjective line that I try not to cross that I think will be a trigger.

Again, for me, using the nose as a limiter (have to breathe through my nose), seems to work reasonably well.

I realize this is squishy, but it is how I try to balance wanting to do more with not triggering afib. My non-afibber friends to all kinds of endurance cardio all the time. I don't join them for that stuff.

Thank you very much for clarification and a great explanation!!!
Re: How long do ablations last?
June 29, 2018 10:45AM
Quote
SueChef
Hi, Steve,

I'm in So Cal too, and with Kaiser. If you don't mind, who did your ablation, and at which facility?
At this point, I'm gathering information about Kaiser electrophysiologists, and while I'd love to have Dr. Natale, that's not possible with Kaiser.

Thanks!
Sue

This gentleman: [healthy.kaiserpermanente.org]

At Sunset, which I believe is their biggest ( maybe their only ) EP department in SoCal. His English is broken and he has a strong accent, but he did an amazing job!!!

Good luck,

Steve
Re: How long do ablations last?
June 29, 2018 10:47AM
Quote
Ken
socalsteve,

Good doctor, excellent fitness, good health (no prescriptions), age 73, plus magnesium, potassium, and taurine to prevent ectopics, but in lesser quantities than most commonly recommended here. I had afib for 11years (5 undiagnosed), with two to three episodes per month.

Thank you so much! Sounds like you have a winning formula! Good luck!

Steve
Re: How long do ablations last?
June 29, 2018 11:55AM
Thanks for the info & the link!
Re: How long do ablations last?
July 08, 2018 10:10PM
Mine were always 2-3 years and I've had more than my share hopefully this last will go forever, fingers crossed
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