Statistics on Ablation..... ?

I have some questions for the "pros".

How long is a Cather Ablation expected to last? Is it a permanent fix? I realize that is a LOADED question but does certain factors figure into this answer such as going 1 year with no issues after the 1st ablation?

I have been doing really good after my Feb. 27 2014 Ablation. No issues; nothing. I hesitate to say that because of a "little" superstition" I have .

I am just looking for statistics if there is any.

Thanks in advance

The best statistics I have seen is Dr. Natale's 10 year study of ablation outcomes. With a single procedure 59% of people are afib free; with two procedures that jumps to 87% afib free. If you are talking about 20 plus years I don't think ablation has been around long enough to have any meaningful data.

10 year Ablation Outcomes

I had my ablation almost 12 years ago and have been in nsr ever since. When I ask the docs about the long term they say "You ARE the long term". So far so good.

Gill

Alan,
Those statistics from from the stone age 2000-2002.
I would dare say Natale's success rate the last few years since the advent of irrigated catheters is somewhere nearer to 80-85% now after a single procedure.

McHale

When you guys say nsr etc. Does that mean you have perfect heart beat? No pvc or pac or does that mean afib free but with some other hits hear and there?

NSR means Normal Sinus Rhythm.

This to me means NO AFIB and my heart is beating normally.
Personally, I have had no skipped beats etc. Now, I do have some Tachycardia issues when I go to a Doctor; Its called White coat condition.
For instance, My normal resting heart rate is around 60-65 bpm. I have seen it as low as 55 when I am really relaxed BUT when I go to a Physicians office I WHITE COAT with my heart rate.

Yesterday, I went to a normal routine Pain Management visit and my heart rate was 110 bpm with a blood pressure of 125/78. After I left the Doctors office, I "Beamed" back down and my heart rate was 70 bpm when I got home 2 hours later. Hell, I guess I am scared of the Blood Pressure machine and I have no blood pressure issues....... Its a mind game that I terribly loose at. LOL



Edited 2 time(s). Last edit at 11/20/2014 10:34AM by smackman.

When I say 'nsr' I mean no Afib at all. I do get lots of ectopic beats but I take magnesium, potassium and taurine which seems to dampen them down so that I hardly notice them. The EPs say they are a nuisance but not a problem.

Gill

McHale,

You are correct about the excellent 10 year prospective results of paroxysmal ablations done in the year from Dec 2000 to Jan 2002 or the full calendar year 2001 was truly in the dark ages still of ablation technology and understanding and still Natale his 59% at 10 years and off all AAR drugs begging totally free of all arrhythmia after just 1 ablation. That is truly remarkable.

His stats for straight forward paroxysmal AFIB cases have risen over the last few years to just over 90% ... and are up to 80-85% for the most difficult long term persistent AFIB cases when including a second ablation for this more challenging group, then rising to the upper 80s up to low 90% range when accounting for a more rare third touch up, when needed.

This later group includes many people with very enlarged left atriums and other significant co-morbidities and a large number of whom would not even be considered candidates for ablation by most ablationists practicing today.

the very long term we can only extrapolate but the value of having a successful ablation process by an elite level practitioner is clearly a major step forward compared to living in frequent fear of yet another episode and on going underlying remodeling etc. Its a not brainer at this point for those with frequent AFIB and even of not too symptomatic ... see the new large meta-analysis report coming in the next Dec/Jan issue of The AFIB Report that itself is a follow up on the special report on Silent Cerebral Ischemia (SCI) as caused by ongoing AFIB itself, in this last April/May issue, as a powerful motive for finding a solution to one's breakthroughs.

Shannon

Hi Shannon,
Could you provide a link to the latest Natale stats? I can't seem to track them down.
Thanks

JohnBM Wrote:
-------------------------------------------------------
> Hi Shannon,
> Could you provide a link to the latest Natale
> stats? I can't seem to track them down.
> Thanks

These must be taken as anecdotal input at this point until formally published in the coming year. Have it on very solid grounds from those very close to the action in the know.

It also dovetails well with the kind of improvements seen in recent years overall with the advent of better mapping and more robust irrigated catheters among top level EPs.

The thing you have to remember when looking at most Ablation stats is they all are looking in the rear view mirror and often as in the case of the longest yet study published anywhere in the excellent 10 year Natale group prospective results, they extend to much earlier days, in part or in total.

There has been real progress, especially amoung the old timers in the last 5 to 6 years in particular. Yet some of those even more recent numbers can be watered down some when including broad surveys in Europe and else where in the US looking at a large collection of more average experienced EPs, and even rather new ablationists in the mix, who are still climbing up the experience curve. While their path may be smoother and somewhat shorter than was the original case that the pioneers had to navigate, such numbers can still look a good deal worse than the elite level EPs can achieve in present day with modern tech and methodology.

Moral or the story, you still have to be very selective in who you put behind your catheters to expect the best quality results.

Shannon



Edited 1 time(s). Last edit at 11/20/2014 03:11PM by Shannon.

I do believe that on an individual basis taking care to avoid your particular triggers for afib AFTER AN ABLATION is the key to its long term success....and the only way to find out is by trial and error learning what gives you missed beats ect. Alcohol is a major trigger and I suspect that if that were taken out of the equation the "success rates " for an Ablation would increase dramatically. I had an ablation a few years back and had a bout with afib that I was able to convert using the PIP method....something that would not work prior to the Ablation. I determined what triggered that episode and have been able to avoid any problems since then. Now if you feel that you want to do everything you did in life prior to afib and feel ablation is the total answer and getting as many as needed to return you to that former lifestyle is how you want to live...that is a personal choice. I prefer to give an Ablation help with avoiding as many of the triggers as necessary, and adding Magnesium and monitoring Potassium, to me that is much better than going through the pain, the expense and the stress both mental and physical, and the meds you have to use each time you have an ablation. I really don't think that Ablation is the "magic pill" that most affibers (outside of this forum) think it is.

Hi Tom - That's an important observation and I totally agree with your statements. Thanks for speaking up.

Have a wonderful Thanksgiving.

Best to you,
Jackie

Good points TomC,

It's a balance as in most things in life, an expert ablation process is very often the key cornerstone to longer term success, but a person can really help smooth out the bumps in the road that can occur, even post ablation, by making a commitment to taking better care of themselves, before, during and life long after a successful ablation process.

Especially paying attention to those specific areas like electrolyte repletion, and known trigger avoidance or minimization at least, as well as better stress management in one's life and addressing any sleep apnea, hypertension and metabolic syndrome issues.

On the other hand, there can be new active sources that crop up even after a successful index ablation, or due to reconnection of previously ablated lines or focal targets. And when those start to act up and trigger repeatable episodes that are not entirely quelled by whatever life style and dietary/nutrient modifications one attempts with real dedication, then a follow up ablation with an expert EP is most definitely warranted as well .. all the while redoubling one's focus on good heart healthy habits.

It's not wise to settle for just what one considers a half way decent reduction in episodes after one ablation if there is still a modest or greater number of ongoing episodes. The reason it can be a mistake to get too complacent and 'settle' for anything less that excellent control of AFIB, is due to the lack of reverse remodeling and continued ongoing progressive remodeling that will continue on with even a modest amount of periodic breakthroughs, even if that progression may be at a somewhat slower pace.

This scenario most often winds up requiring a more advanced follow up procedure when one procrastinates too long in the face of not having near total control over the beast. A large amount of recent research, including some new reports to be discussed in the upcoming Dec/Jan issue of The AFIB Report, highlight the real and notable increased in SCI (silent cerebral ischemia) that accumulate as a result of ongoing AFIB/Flutter over time with a definite increase risk for early and worse outcome dementia. This issue was not even on the radar when most stats and rules of thumb about AFIB and the consequences of on-going AFIB were established and assumed as good guidelines.

This is another major incentive for choosing the most experienced ablationist one can arrange for oneself as well, as top tier operators have a real leg up on insuring the patient will require the least number of total ablations to get the job truly well done, and we can often significantly help ourselves out in that cause by our own proactive commitment to improving diet, proper supplementation, consistent modest exercise and stress reduction in our lives.

Not only has that been a key step either alone or added to an expert ablation or two, for many of us here who have enjoyed long term success, but it's clear that those who follow such heart calming protocols, post-ablation, most often have a smoother go of the recovery blanking period, and beyond. This relentless condition requires all hands on deck for best long term management results.

Shannon



Edited 1 time(s). Last edit at 11/26/2014 11:22AM by Shannon.