How likely is for AF to come back after succesfull ablation

Hi,

After 13 years living with AF (presently I am 43 years of age) and spending significant amount of this time fibrillating (for the last few years I was roughly 30% of time in AF), three months ago I had ablation with dr. Skanes at LHSC in London, Canada. Actual procedure took 7 hours and according to doctor at the end of procedure they "tried very agressively to trigger AF but heart remained in normal sinus rhytm" so he was confident this was a successful one. In any case, after two brief episodes within the first 10 days after procedure (they told me this is normal in the first few weeks, until heart heals and scars made by ablation properly form) I don't have any arrhytmia problems. Beside this AF ablation I also had two flutter-related ablations in the past (Toronto General in 1997 and St.Michaels in 2006, both in Toronto) so there is no flutter either.

Now my question - how likely is for AF to come back at some point in the future (and I am not talking of period immediately after procedure, I am referring to time after a year and beyond)?

Thanks

Eric

No one has the data needed to answer your question. The vast majority of successful ablations are less than three years old. There have been some a-fib recurrences years after successful ablation.

From a scientific perspective it seem reasonable to assume that there will be more ablation failures soon after the ablation, with the rate of failures decreasing with time. Whether the final percentage plateau of long term ablation success is above zero will be unknown for five to ten or more years.

Eric - I believe Hans had statistics in his survey on recurrence of afib after various types of ablations.

From just reading what's posted here and remembering who has what, I'd say that for single ablations only, it's somewhat rare not to have a recurrence. Many of the afibbers who had the second ablation have enjoyed NSR for quite a few years; others have had many subsequent ablations.

I think it all goes back to the skill of the EP doing the ablation and also the tendency of the individual patient's body to heal overly well and negate the efficacy of the burn lesion. If the burns are not adequate to begin with, the recurrence seems to be fairly quick; but even sufficient depth or quanity some seem to be able to be healed and function again as a driver.

For my way of thinking, I'd rather have the EP be conservative and burn a bit less deeply as a precaution than to overburn or over heat and risk either burning through the heart wall or causing stenosis.

Some people have reported that it takes longer than the 3 month healing time for the heart to settle down and become totally calm so give it more time. I wouldn't be concerned or discouraged at this point based on what you report.

Just think positive thoughts and be kind to your heart while it's healing. Don't push or overdo.

Be well,

Jackie

Hi Eric,

Both Wil Schuemann and Jackie have given you good advice. I had my ablation 10/05 and it took me a year to get off the meds and for my heart to calm down. I feel great now! If Afib should I appear, I now am armed with information on what I will do - I give thanks to this board - I learn something new all the time. Frankie (ablated 10/05 V at Age 65)

Eric: I had a flutter ablation in 2003 by a new E. P. When the fib came back and Dr. Natale did the fib ablation he also did another flutter ablation as he said some of the nerves had grown back across the original flutter ablation scar tissue.

Bodies try to heal themselves and I'd guess that those same nerves will try to grow back yet again.

I hope they don't make it.

Gordon

Eric

I had an ablation in Bordeaux 5 years ago, followed by a touch up three days later. I have been in nsr ever since, though I do get huge numbers of ectopic beats. Magnesium, potassium and taurine make them less uncomfortable so I just ignore them and get on with life.

When I ask my EP what the long term prospects are, he says 'You ARE the long term'. So we just have to wait and see what happens. But five wonderful years of nsr made the ablation worthwhile for me, even if AF should return tomorrow.

Gill

Hi Eric,

I saw your post and had to reply.

I am just one week past my "touch up" ablation, and this is some information I would like to impart to the BB.

As I said earlier, 3 of my 4 veins over healed. What my EP told me after this ablation is that it is difficult to tell at the time of the ablation if a cell is killed, or wounded. A "wounded" cell my not respond to their stimulus, therefore, the EP thinks that the spot has been taken care of. After healing for a while, it recovers. Now, with the new tips, they have a more uniformed depth and burn, hoping that my type of re growth will not happen.

As Carol A. wrote to me, the second time things do seem better. I hope so.

As my dad use to say to me, Life isn't fair and you get no guarantees with it. This holds true of an ablation. But life has certainly been alot better since May of 2004 for me.

My best, Jeanne