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Does having cardiomyopathy affect how long an ablation lasts?

Posted by tobherd 
Does having cardiomyopathy affect how long an ablation lasts?
July 09, 2018 01:30PM
Hello - I have a friend that has had 4 Afib ablations over the years, and has been in an out of Afib for awhile....which became persistent right before she headed out on vacation. I kept encouraging her to get down to Austin to get an ablation with Dr. Natale, and I would go with her (her husband doesn't understand any of this and is quite frankly, not helpful). She kept saying she would just see a good Dr. up in Massachusetts, which is where she's from.

While she was on vacation, she went into flutter - I believe...her heart rate has been 105 and jumps up when she moves around at all - and she ended up in the hospital in Massachusetts after all. They told her she is not in Afib right now...just a fast heart rate. I was hoping they would control the rate and then we could try to make an appt. for her in Austin to get this done once and for all. However, the doctors at Brigham and Women's Hospital in Boston are planning to do a (fifth!) ablation tomorrow afternoon....they told her that because she has cardiomyopathy, the ablations only last 8 years. She will need another one in another 8 years, according to what she understood them to say.

Have you ever heard of this? I certainly have no say in any of this, but I'm concerned for her as this seems so odd that her other heart condition might affect the length of time an Ablation would last. Personally, I think she needs a LAA isolation ablation, but what do I know?

Anyone?
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 09, 2018 03:37PM
I think she misunderstood them. There is no way for anyone to predict how long an ablation will last, or even to predict with such certainty that it won't last forever.

You might want to have her read this .
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 09, 2018 03:56PM
What Carrey says!

In her case, I would only go to see Dr. N. The Mass guys have had 4 tries to get it done and failed. I concur that LAA is likely in her cards if it is to be fixed properly.
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 09, 2018 06:54PM
RED WARNING SIGN! If doctors are able to schedule ablations in just a few days time then they are not top-notch practitioners. Good ones all have wait times in the 6 month range.
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 09, 2018 07:47PM
Wolfpack...I got in to see Dr. Natale in about 2-3 months, but I agree, they shouldn't be free the next day.....unfortunately, I have nothing to say about this. I'm frustrated, as I am concerned for her - 4 unsuccessful ablations and now another one from some EP...name unknown?

It can be hard to convince someone how important it is to see a top doctor in difficult and/or long standing cases, when their cardiologist insists that the EP in their practice can do the job just fine.....

Barb
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 09, 2018 07:48PM
Carey - I didn't see a link or anything to read, when you said to have her read this....?

Barb
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 09, 2018 07:51PM
Yes...it's hard to convince someone that going to see Dr. Natale in Texas (she's in Mass now but living in NY), when her Cardiologist is saying they can take care of it there and her husband is very close minded and thinks I'm being an alarmist or exaggerating.....

Why would they tell her 8 years? I've never heard of anyone being told how long their ablation should last...If it's done correctly, it should last for a very long time if not indefinitely...unless it just needs a touch up (like mine did).

Ahhh...everyone with Afib should be on this Board!

Barb
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 09, 2018 07:59PM
Quote
tobherd
Carey - I didn't see a link or anything to read, when you said to have her read this....?

Oops, sorry. http://www.afibbers.org/forum/read.php?9,158643,158983#msg-158983
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 09, 2018 08:05PM
Quote
tobherd
Yes...it's hard to convince someone that going to see Dr. Natale in Texas (she's in Mass now but living in NY), when her Cardiologist is saying they can take care of it there and her husband is very close minded and thinks I'm being an alarmist or exaggerating.....

Why would they tell her 8 years? I've never heard of anyone being told how long their ablation should last...If it's done correctly, it should last for a very long time if not indefinitely...unless it just needs a touch up (like mine did).

You know, the first EP who did three failed ablations on me told me every single time he was confident of success. Well, he shouldn't have been. Of course they're telling her they can take care of it just fine but I doubt they can and I doubt they will. She's had four ablations; that right there makes her a complex case.

And I don't know why they would tell her eight years. They're just making that crap up, and that's not a good sign at all. Also not a good sign is what wolfpack mentioned. Being able to schedule her so quickly indicates the EP isn't busy and therefore doesn't do many ablations. That right there is a huge red flag. She's a complex case and needs somebody who can do ablations in their sleep.
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 09, 2018 10:43PM
Thanks so much for that link, Carey. I'm not sure how to save it...can I? I am very frustrated that this happened to her before I could get her down to see Dr. Natale...she got caught up in the system of doctors in Women and Brighams hospital in Boston, and they convinced her they could handle it...BUT she should expect that she will need another one in 8 years...due to her cardiomyopathy....Could there by any truth to that at all?

Anyway, ablation #5 is happening tomorrow, so it's basically a done deal. I hope it does go well, I imagine she might feel good for awhile, and I also expect it will come back again.... how many can a body take before it's too hard to fix even for Dr. Natale?

I appreciate all of your great information...to all who repliedsmiling smiley Barb
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 10, 2018 12:49AM
Quote
tobherd
Thanks so much for that link, Carey. I'm not sure how to save it...can I?

Do you know how to create and use bookmarks in your web browser? Better to just create a bookmark ("favorite"). Then you can send that link to anyone and they'll see the original without you having to email copies around.
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 10, 2018 07:38AM
I was referred to BB&W by my hospitals cardio dept, Dartmouth. Dr Stevenson I believe is the EP who is listed at 97% success rate. I would think after 4 failed ablations, Austin would definitely be in my radar. Is it possible Stevenson doesnt take the higher risk patients?
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 10, 2018 08:19AM
Statistics are very misleading. 97% of what? All ablations, including simpler, right-atrial flutter procedures? Also, what's the definition of "success"? Is it complete freedom from arrhythmia without continued use of AAR drugs or with their continued use?

You have to ask VERY pointed questions to get to the real answers.
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 10, 2018 10:07AM
I flat don't believe a 97% success rate if he takes all comers, it's afib ablations, and "success" is defined honestly.
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 10, 2018 11:01AM
tobherd, It is even harder to convince your cardiologist to refer you to the best EP. I have scheduled procedure with dr. Natale in August. My cardiologist was really frustrated as to why I am flying to Texas. He was trying to convince me that now i could do ablation locally and everybody has the skills to do it right now. The underestimation of the importance of who performs the ablation might be coming from your friend's doctor.



Edited 1 time(s). Last edit at 07/10/2018 11:03AM by dartisskis.
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 10, 2018 02:10PM
Quote
dartisskis
It is even harder to convince your cardiologist to refer you to the best EP.

This can be an issue, yes. I don't think it's necessarily because he or she doesn't mean well. You just might be putting them out of their comfort zone. My cardiologist, whom I like very much, won't talk about anyone other than the local EPs. When my AF returns, I won't be going local. I can already see it's going to be a source of friction. I'd do well to broach the subject before it becomes necessary.

Remember we are the ones in charge of our bodies and what happens to them, or who pokes holes in them. It's not fun to have to argue that point, but no good doctor should ever take offense at a patient asking questions or even challenging an opinion.
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 10, 2018 07:34PM
Wolfpack - why do you write "when" my Afib returns? Why do you think it will?

So she is now seeing a Dr. Paul Zei who is a Director of BWH Comprehensive Atrial Fibrillation program, with a faculty appt at Harvard medical school. Supposedly he focuses on complex arrhythmias and catheter ablations.

I'm going to write a separate post about him to see if anyone has heard of him.

SO much you have to know and be your own advocate when it comes to things like this....

Thanks for all of your input, everyone ~ Barb
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 10, 2018 08:41PM
Quote
tobherd
Wolfpack - why do you write "when" my Afib returns? Why do you think it will?

Because it already has. AF Returns

I’m just waiting now to see when it becomes more frequent. Hopefully that will be some time.
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 10, 2018 08:55PM
Who did your ablation (s)?
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 10, 2018 10:01PM
Duke University. I’ve always felt like it wasn’t “complete”. I had AF in the blanking period and plenty of ectopics since. There’s probably some little area where the lesion set isn’t complete.
Re: Does having cardiomyopathy affect how long an ablation lasts?
July 12, 2018 10:07AM
Obviously there are other EPs performing successful ablations and Natale has some failures also. Could it be those are not as complicated as the cases Natale takes on? Im guessing the majority are simple.
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