What is the longest you've been afib-free after an ablation? Hello to everyone. I'm considering getting an ablation due to my worsening afib. But after reading this forum, it seems there are so many failed ablations or cases of afib getting worse after an ablation. Has anyone here had a successful ablation that lasted more than 5 years? Thank you https://www.afibbers.org/forum/read.php?9,190350,190350#msg-190350 Sun, 20 Sep 2026 22:57:18 +0000 Phorum 5.2.23 https://www.afibbers.org/forum/read.php?9,190350,190854#msg-190854 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190854#msg-190854 alsass10 AFIBBERS FORUM Thu, 01 Jun 2023 02:20:23 +0000 https://www.afibbers.org/forum/read.php?9,190350,190724#msg-190724 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190724#msg-190724 Not "how many are AFib free after one year"

There are various milestones after a CA.
6 months, 12 months, 2 years, and 5 years.

5 year data is long-term success. If it was not important, it would not be quoted in the study that I referred to.

The only thing that was special about the patients in the study, that you referenced, is that they had two or more previous CAs that failed.
My argument exactly, that 50% of first time CA will fail and will require 2.5 CAs to be in rhythm after five years..

When I said 30% recurrence of arrhythmia after five years, I was erring on the side of caution because it is 50% recurrence.
You said: "I don't know where you are getting your figures from?"

"Clinical Outcome After the Initial Ablation Procedure
Among 161 patients, all PVs were completely isolated during the first procedure. During a median follow-up period of 4.8 years (0.33 to 5.5 years), 86 patients (53.4%) demonstrated recurrent ATa." [ATa = Atrial tachycardia arrhythmia]
[www.ahajournals.org]

(please see attached graph)

Who would be satisfied with just one-year success and to have AFib back after 12 months, and then have a second and third, and fourth CA?

The Cox Maze IV (also thoracoscopically) reports freedom from ATA was 92% (552/598), 84% (213/253), and 77% (67/87) at 1, 5, and 10 years.
[pubmed.ncbi.nlm.nih.gov]

This is exactly the CA dilemma: 20% of folks will never have any success of being AFib-free after many CAs. 27% will require 2.5 CAs on average to achieve long-term success (5 years).
2.5 average CAs means some actually having 3 and 4 CAs inside five years.

If you are interested, there are videos that discuss the electrical mapping of errant impulses, that form the basis for a CA, that show moving errant foci when tested at different times and this, I believe, contributes to the recurrences of AFib every year and diminishing success long-term.

It is difficult to blanket-isolate all foci from inside the heart during a CA.

Be well.]]> saulger AFIBBERS FORUM Tue, 16 May 2023 05:27:35 +0000 https://www.afibbers.org/forum/read.php?9,190350,190723#msg-190723 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190723#msg-190723
Quote
saulger
I will read your reference and will also search for the exact numbers, but one year monitoring is not long-term.
The drop-off (recurrence of AFib post CA) after five years is something like 30%.

Don't know where you're getting your numbers but 1 year of freedom from atrial tachy-arrhythmias without AADs is proof of a successful ablation. Recurrence of afib after that is due to progression of the disease, not a failed ablation. You're sort of setting up an impossible situation here where you're counting progression of the disease beyond the boundaries of the procedure as failure.]]> Carey AFIBBERS FORUM Tue, 16 May 2023 04:27:57 +0000 https://www.afibbers.org/forum/read.php?9,190350,190721#msg-190721 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190721#msg-190721 I hope that you are well.

I will read your reference and will also search for the exact numbers, but one year monitoring is not long-term.
The drop-off (recurrence of AFib post CA) after five years is something like 30%.

Thanks again. Saul.]]> saulger AFIBBERS FORUM Tue, 16 May 2023 04:09:09 +0000 https://www.afibbers.org/forum/read.php?9,190350,190719#msg-190719 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190719#msg-190719
Quote
saulger
Carey messaged me that he will forward a report that shows 90% success, including persistent AFib patients.

I apologize for the delay. I've had a wicked busy few days and more are to come.

I must correct myself a bit on that 90% figure. That was achieved after two procedures, but those procedures were done on the toughest of the tough cases, those who had failed multiple previous PVI ablations and had persistent afib. Many typical EPs wouldn't even attempt ablations on this patient population and most who did would likely achieve maybe 50% success rates at best.

You can read the abstract here.

Quoting the relevant conclusions:

Quote

At 1 year, 90% were arrhythmia free off-AAD in non-PV ablation group, and 72% who did not receive non-PV triggers ablation at the index procedure (P = 0.035). The success rate of empirical LAA and CS isolation was 78.5% and 82% after the index and repeat procedure, respectively.

That last sentence is especially telling. Achieving a 78.5% success rate with one ablation on that patient population is remarkable.

There are other studies showing one ablation results with a single ablation in the 75% range, but I haven't had time to find them yet. I will. (I need to bookmark these things!)]]> Carey AFIBBERS FORUM Mon, 15 May 2023 23:58:49 +0000 https://www.afibbers.org/forum/read.php?9,190350,190678#msg-190678 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190678#msg-190678 If you get a lone AFib patient with a RF (or cryo-balloon) accessible heart, and can create continuous lesions that are transmural, you will have a successful outcome.
I also watched a video showing the the electrical mapping of the heart showed errant foci in a different location, when it was tested again hours later. Stay well.]]> saulger AFIBBERS FORUM Sun, 14 May 2023 15:48:32 +0000 https://www.afibbers.org/forum/read.php?9,190350,190676#msg-190676 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190676#msg-190676 gloaming AFIBBERS FORUM Sun, 14 May 2023 15:34:41 +0000 https://www.afibbers.org/forum/read.php?9,190350,190672#msg-190672 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190672#msg-190672
I am simply trying to get a research paper that confirms a high success rate, long term, no medications, after a single procedure.
.
Carey messaged me that he will forward a report that shows 90% success, including persistent AFib patients.

Should I receive this from Carey, I will stand humbled and will be very pleased !]]> saulger AFIBBERS FORUM Sun, 14 May 2023 06:34:33 +0000 https://www.afibbers.org/forum/read.php?9,190350,190671#msg-190671 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190671#msg-190671 gloaming AFIBBERS FORUM Sun, 14 May 2023 04:21:11 +0000 https://www.afibbers.org/forum/read.php?9,190350,190655#msg-190655 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190655#msg-190655
As I mentioned, I would love to read a paper. either peer-reviewed or even by the EP themselves touting 90% success rate - long term and no antiarrhythmic medications - after a single CA.
I have searched high and low for the evidence and all I ask is that if you quote figures that you link to the evidence.

A large study showed that the recurrence rates after a single CA at 2, 5, an 10 years were:

After years 2 5 10
Paroxysmal: 3%, 11%, 27%
Persistent 13%, 29%, 62%

It stands to reason that some practitioners are very talented and dedicated individuals who are better than the average and are at world-leading hospitals, but a disparity of 90% for some and 50% for others just doesn't exist. It would be medical negligence.

Gloaming cited a study that had 80% success overall. When one looked at the actual numbers of over 6,000 cases, out of a hundred patients, 20 never achieved success, 53% were successful after a single procedure and 27 needed on average 2.5 CAs to achieve success.
This means that 47% (haf of all who undergo CAs) will either not have success at all, or will need 2.5 ablations to be successful.

Very important to realise before going down that route.

The study noted that there are wide fluctuations in the CA outcomes, which I believe are due to the anatomy of the patients, patients age, co-morbidities, obesity etc, and difficulty in achieving transmural lesions with the CA technique to ablate the offending areas that are on the top of the heart, where the nerves originate.

Dr Natale is a star EP in the US. Professor Schilling is a star EP in the UK.
Dr Natale, apparently, doesn't publish results, Professor Schilling does. His results are at average 18 months post procedure:

2020 success paroxysmal 75%, persistent 80%
2019 89% 73%
2018 63% 58%
2017 90% 63%

[londonafcentre.com]

Professor Schillings success varies widely year by year, which I posit is due to the luck of having patients who match the technique.
If it is solely the system and skill that determine the outcome, Prof Schilling's results would be more homogenous.]]> saulger AFIBBERS FORUM Sat, 13 May 2023 08:50:50 +0000 https://www.afibbers.org/forum/read.php?9,190350,190652#msg-190652 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190652#msg-190652
Quote
saulger
Hi Daisy. Can you share a paper for any EP that confirms 90% long-term success rate after a single ablation?
I would love to see it.
S

I can do better than that. I can show you a 90% success rate ablating afib in patients with multiple prior failed ablations, and I will when I find some time tomorrow. But as you probably expect, the study authors aren't average EPs. They're leaders in the field, and as Daisy pointed out, the EP doing the ablation is the most important factor of all.

The real lesson: If you find the average success rates unsatisfactory then don't choose an average EP.]]> Carey AFIBBERS FORUM Sat, 13 May 2023 00:45:06 +0000 https://www.afibbers.org/forum/read.php?9,190350,190651#msg-190651 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190651#msg-190651
Quote
saulger
Hi Daisy. Can you share a paper for any EP that confirms 90% long-term success rate after a single ablation?
I would love to see it.
S

I don’t have access to such a paper though I have seen this discussed here on the forum—EPs who participate regularly in research have their outcomes monitored. I also don’t remember whether it was after one or two ablations. But the point I was trying to make is that general statistics for the success of ablations really don’t have much meaning as success rates vary so much according to who does the ablation. That is why you will keep seeing the advice to go to one of the very best if you are seeking an ablation. Unfortunately, there are not very many truly elite level EPs and, for most, seeing one will mean travel—but the difference in outcomes makes it very worth the extra effort.

Another interesting factor is that the handful of EPs with the best outcome records are the ones who see the most complex patients, yet their skills still bring a very high percentage of success.]]> Daisy AFIBBERS FORUM Fri, 12 May 2023 20:38:20 +0000 https://www.afibbers.org/forum/read.php?9,190350,190650#msg-190650 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190650#msg-190650 I would love to see it.
S]]> saulger AFIBBERS FORUM Fri, 12 May 2023 18:56:42 +0000 https://www.afibbers.org/forum/read.php?9,190350,190649#msg-190649 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190649#msg-190649
Quote
saulger
According to the data that you shared, a qualified 80% of CAs are successful with 20% not succeeding at all, 53% successful after one ablation, and 27% successful after having an average of 2.5 CA.
It's important that people realise that there is a 47% chance that your CA will not succeed or will be successful only after 2.5 ablations on average.

Very different !

You are welcome to share your thoughts. We are a discussion forum after all.
Saul

But the most important predictor of successful ablations is not quantified in statistics like this—who does the ablation. The “elite” top-ranked EPs may have a 90% success rate while an EP who does 100 per year May have a 50% success rate while the majority of “competent” and moderately experienced EPs are somewhere in between.]]> Daisy AFIBBERS FORUM Fri, 12 May 2023 18:35:08 +0000 https://www.afibbers.org/forum/read.php?9,190350,190648#msg-190648 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190648#msg-190648 Gloaming said:
"It's a confounding factor, obviously, because if people get what should be successful ablations, say running 90%, but some go on to eat more sensibly, have other comorbidities fixed, get more sleep, get more exercise, have healthier relationships, or lose bad ones, etc, etc,, I can't help but wonder if it's something WE'RE doing and not something they're (the EPs) are doing wrong, or failing to do."


According to the data that you shared, a qualified 80% of CAs are successful with 20% not succeeding at all, 53% successful after one ablation, and 27% successful after having an average of 2.5 CA.
It's important that people realise that there is a 47% chance that your CA will not succeed or will be successful only after 2.5 ablations on average.

Very different !

You are welcome to share your thoughts. We are a discussion forum after all.
Saul]]> saulger AFIBBERS FORUM Fri, 12 May 2023 17:52:47 +0000 https://www.afibbers.org/forum/read.php?9,190350,190647#msg-190647 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190647#msg-190647
Quote
saulger
...

I had to correct Gloaming's sweeping statement that CAs are 80% successful...

???]]> gloaming AFIBBERS FORUM Fri, 12 May 2023 17:47:23 +0000 https://www.afibbers.org/forum/read.php?9,190350,190645#msg-190645 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190645#msg-190645 I love the afibbers.org site of Dr Larsen.
One of the very best.
I tried the Steven Carr method but it hadn't worked for me.
I hope that you are well.]]> saulger AFIBBERS FORUM Fri, 12 May 2023 17:11:11 +0000 https://www.afibbers.org/forum/read.php?9,190350,190643#msg-190643 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190643#msg-190643 Daisy AFIBBERS FORUM Fri, 12 May 2023 15:04:27 +0000 https://www.afibbers.org/forum/read.php?9,190350,190642#msg-190642 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190642#msg-190642 For me at 76, the thought of having multiple CAs and having to fund them myself is not feasible.

I had to correct Gloaming's sweeping statement that CAs are 80% successful.
The criteria for success are: long term without AFib episodes (longer than 30 seconds), and no antiarrhythmic medications.

Based on Gloaming's own reference to the article, 80% are successful with an average of 1.5 ablations.

Take an example of 100 people with AFib, 80% success (80 people), including multiple ablations.

From the article:
53 people will be successful after a single ablation. 20 will never achieve success however many CAs they have had (1 out of 5).
That leaves us 27 people who require multiple ablations.

If y is the unknown for >1 ablations.
(53 x 1) + (27 x y) / 80 = 1.5 (average ablations for 80 people who achieved long term success)
Solving for y= 2.5 ablations for the group that required more than a single ablation.

This translates to some having 2 ablations and others having 3 ablations, and if a larger number achieve success with 2 CAs, there will be smaller number who require more than 4 CAs - just like Carey?

Having said all that, I may require a CA for atrial flutter, if it doesn't respond to rate control medication.

All the best in beating the AFib misery, Saul.]]> saulger AFIBBERS FORUM Fri, 12 May 2023 13:50:46 +0000 https://www.afibbers.org/forum/read.php?9,190350,190640#msg-190640 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190640#msg-190640 Ken AFIBBERS FORUM Fri, 12 May 2023 12:40:55 +0000 https://www.afibbers.org/forum/read.php?9,190350,190639#msg-190639 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190639#msg-190639
The article mentions, in the first paragraph: "Success rates vary between 60% and 80%, for paroxysmal AF (PAF), depending on ablation strategies, and between 50% and 60% for persistent AF.4,5"

I followed the footnote (4) to the original study:

"Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis"
[pubmed.ncbi.nlm.nih.gov]

For 6179 patients, with a single procedure, the outcomes were just 53.1% overall- made up of 54.1% paroxysmal and 41.8% persistent.

If you read the very next paragraph in the article, the higher success was nearly 80% with an average of 1.5 ablations.
The article also mentions that there was wide variation in the results, so some patients needed multiple catheter ablations.

Quote:
"Data were extracted from 19 studies, including 6167 patients undergoing AF ablation. Single-procedure freedom from atrial arrhythmia at long-term follow-up was 53.1% (95% CI 46.2% to 60.0%) overall, 54.1% (95% CI 44.4% to 63.4%) in paroxysmal AF, and 41.8% (95% CI 25.2% to 60.5%) in nonparoxysmal AF."]]> saulger AFIBBERS FORUM Fri, 12 May 2023 07:21:35 +0000 https://www.afibbers.org/forum/read.php?9,190350,190638#msg-190638 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190638#msg-190638 www.ecrjournal.com]

[www.stopafib.org]]]> gloaming AFIBBERS FORUM Fri, 12 May 2023 06:55:22 +0000 https://www.afibbers.org/forum/read.php?9,190350,190622#msg-190622 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190622#msg-190622 saulger AFIBBERS FORUM Thu, 11 May 2023 10:21:50 +0000 https://www.afibbers.org/forum/read.php?9,190350,190621#msg-190621 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190621#msg-190621
The very first Google search "catheter ablation success rate" states:

"Our group previously reported stable sinus rhythm in 80% of patients with PAF [paroxysmal AFib] after multiple procedures and a follow-up of 5 years on antiarrhythmic drugs.2 Success rates of catheter ablation for persistent (Pers) AF are lower, and reported between 56–70% after multiple procedures and after 5 years.3–5"

[academic.oup.com]

Multiple procedures and with anti--arrhythmic drugs?

You mentioned that "unfortunate Carey had to have 6 or more CAs to achieve success" ?]]> saulger AFIBBERS FORUM Thu, 11 May 2023 09:41:39 +0000 https://www.afibbers.org/forum/read.php?9,190350,190620#msg-190620 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190620#msg-190620
If you factor in persistent cases, 40% is the success rate after five years (as quoted by cardiac surgeon James Cox).]]> saulger AFIBBERS FORUM Thu, 11 May 2023 09:30:14 +0000 https://www.afibbers.org/forum/read.php?9,190350,190619#msg-190619 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190619#msg-190619 Would you be able to point me to a survey showing 75% success rate: no Afib after 5 years, no medications, single procedure.

My figures are more like 50% success rate.
Thank you. Saul]]> saulger AFIBBERS FORUM Thu, 11 May 2023 09:23:05 +0000 https://www.afibbers.org/forum/read.php?9,190350,190600#msg-190600 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190600#msg-190600
Quote
greyhoundgal
Have also been following Steve Carrs protocol.

Here is a search on Steve Carrs protocol here for those who are interested. His most current version. Steve has done a very systematic analysis of the variables impacting his case.]]> GeorgeN AFIBBERS FORUM Tue, 09 May 2023 12:02:40 +0000 https://www.afibbers.org/forum/read.php?9,190350,190592#msg-190592 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190592#msg-190592
Totally changed my lifestyle and keep my Free T4 at the low end of the scale. Have also been following Steve Carrs protocol.]]> greyhoundgal AFIBBERS FORUM Mon, 08 May 2023 03:42:39 +0000 https://www.afibbers.org/forum/read.php?9,190350,190529#msg-190529 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190529#msg-190529 susan.d AFIBBERS FORUM Wed, 03 May 2023 18:51:55 +0000 https://www.afibbers.org/forum/read.php?9,190350,190526#msg-190526 Re: What is the longest you've been afib-free after an ablation? https://www.afibbers.org/forum/read.php?9,190350,190526#msg-190526 Yuxi AFIBBERS FORUM Wed, 03 May 2023 18:14:25 +0000