More FIB and Flutter Tales

I was taking Norpace for AFIB for about 2 1/2 years until August, 2003. I tried flecanide this summer and the FIB switched to flutter. I have since gone back to Norpace, but the flutter remains. Judging by this board, this does not seem uncommon.

I know some folks in this circumstance (e.g. Anton) have had flutter ablations and gone back to FIB. Has anyone ever had a flutter ablation and NOT gone back to FIB? That is, had the flutter ablation fix everything?

I am still moving toward an ablation in the next four weeks or so (At Yale or NYU). I’m wondering if, since I am now in flutter, they will suggest a flutter ablation and waiting to see what happens before doing a fib ablation. My inclination would be to do both at the same time (like Sammy did) – especially if the likelihood of reverting back to fib is high. But since the fib ablation is more complex, riskier, less likely to work, etc. waiting may be a viable option.

Any thoughts.

BillB
48;A

Hi Bill,

A flutter ablation will not stop the fib, however if you take norpace the flutter will be stopped and it may hold you in NSR. I had a flutter ablation(1999) hoping flecanide or rhythmol would hold me in NSR. The flutter was stopped, but I still went into AF. I'm using norpace now, but still have breakthroughs. If it were me I would go for both ablations, but that's just me. Good Luck.

Jim W.

Jim,

I have been told by my cardiologist that sometimes the flutter triggers the FIB, and by stopping the flutter, you could stop both. Sounds good from a theoretical perspective, but I've never had any "real world" confirmation of that at this site.

I just talked to my EP who works with Yale, but doesn't do the ablations. He said whether they would attempt to do both ablations at the same time would depend, in part, on how difficult (and long) the flutter ablation was. He also said they probably wouldn't attempt the FIB ablation if they couldn't stop the flutter. Since I am mostly in flutter now (+- 80% of the time), that could be an issue.

The other issue for me is that NYU might be able to do the ablation in the next week or two. For Yale, it would probably be 4 or 5 weeks. I have already been mostly fluttering a lot since about 8/1/03. I'm concerned about re-modeling issues and whether another two weeks would make a difference.

BillB

I have been mostly in flutter since July 12 this year. I have met with my cardio and Ep. I am now set for an ablation for flutter Oct 30th. Once when I went to ER they said I was in fib. Both my cardio and Ep say that maybe the flutter ablation may keep the fib away. Thats what I hope happens.
They are going to use the 8mm tip. They all say it makes the operation shorter and better at keeping the flutter from coming back. Dr, Nath in colorado Springs CO. is going to do the ablation. He seems to know what he is talking about. I asked all the questions that I read on this board. He said "I was the most informed patient he has ever had". All that I know came from Hans book and all the good people here. I can't thank you all enough. I will let you know how it goes.

Robert P

Stopping flutter with ablation has been known to stop fib but it's rare. More commonly stopping fib with (PVI+) ablation also stops flutter but is by no means a strong chance. One can always hope.

I read good things about the 8mm cath for flutter but didn't know who was technically good with it. My flutter was ablated with 5mm OK (New Haven)but it's unknown if the 8mm would have been better. After completing one "line" a failed test made him go back and burn another.

Most EP's would rather do 2 seperate procedures at different dates than have a patient camped out under anesthesia for hours. When Dr. Natale does his PVI+ he doesn't spend time with flutter. If flutter exists afterwards a separate ablation is scheduled.

-Anton

I have had two flutter ablations at the Univ. of WA, by my EP, Dr. Poole. The first was not successful, and I stayed in flutter, and then after the second one, I went into AF for a few months, and then reverted back to flutter. I did not find this site until after my two ablations, and had I found this BB, I would never have had the ablations, until I exhausted all avenues of nutrition first, and I'm talking hard core nutrition, as I'm doing now, with aminos and cofactors, after my meeting with Dr. Gersten on the 14th. I'm giving it another year. I want my heart fully intact, and hope no damage was done in the flutter ablations. I only have one heart, and I want to try to keep it as close to God's design as possible now, and try to nurse it back to health. I can only hope it's not too late. My wife sat in the waiting room while I was having my ablation, on heart transplant patient day. She didn't know the questions to ask at the time, but everyone of the patients had started out with AF. It probably wasn't LAF, but it still scared her to death.

Richard

Anton,

I believe if you ask Dr. Natale to check for possible flutter problems he will. I'm having an ablation(PVI) done by him next week, and just today I talked with the nurse there to confirm that he would do that. Maybe it is because I have already had a flutter ablation & it has been established that I might have problems. Dr. Wharton at MUSC will do a flutter ablation along with a PVI-it is common with him. IF Natale would not check my flutter situtation, I would not see him, but I am told that is not the case.

Jim W.

Richard,

"I can only hope it's not too late. My wife sat in the waiting room while I was having my ablation, on heart transplant patient day. She didn't know the questions to ask at the time, but everyone of the patients had started out with AF. It probably wasn't LAF, but it still scared her to death. "

Now there's a cheery little mental landscape for worriers like myself!! Surely it wasn't LAF. It's just the "but everyone of the patients had started out with AF." part of the above that's a bit alarmist - surely the AF came about secondary to - as opposed to initiating/predisposing one to - serious heart conditions which in and of themselves necessitated the transplants as opposed to the AF itself??

Mike F.

Mike,

I agree, knowing what I know now, that the AF was a sympton to a much more serious heart condition than ours, but it was alarming, nevertheless. My wife only wishes she would have known the questions to ask, at the time, so we could have had a better understanding of what the real underlying causes were. One woman in the waiting room was only 32 yrs. old, but from what my wife gathered, hers was more to do with a genetic defect. I don't want to scare anyone, with these thoughts, but we all need to be fully aware of what we are doing, and what the consequences in any form, could be, when we have an ablation. I'm still not sure I totally trust the long term results of the procedure, esp. a PVI, as of yet, because it CAN'T be undone. Once it's done, it's done.

Richard