What exactly does ablation cure?

Post-ablation, what actually happens? I assume it only prevents atrial fibrillation from occurring.

It doesn't prevent ectopics, PACs, PVCs, or the feelings of stress that lead to afib, correct?

I ask because right now I am only having major episodes (2-6 hours) every 2 months or so. Last night, under a period of intense stress I had two afib runs of like 5 seconds each, but they converted immediately.

More frustrating then the occasional afib itself are the periods of intense stress (and digestive issues) that can cause me to feel like I might get an afib. If getting an ablation won't help with those things, it seems silly to get an ablation at the moment just to solve the issue of getting an episode every 2 months.

Am I correct in that:
a) an ablation will only fix atrial fibrillation itself
and
b) Having an ablation when I am only average 5-6 events a year (lets say a total of 40-60 hours of afib load a year) is a bit premature?

-Eric

Erich, It really depends on how you want to define cure. I think the two posters with what we would consider cured here are Denver Fox and Gill. DF at 10+ years if recollection serves and that's really impressive considering that much more is known about AF now than 10 years ago and the ablation tools have advanced an order of magnitude since. If you go to Natale now with the condition you are now in, I think your chances are pretty good at least in stopping AF progression for a long long time if not a complete cure Compare that with your chances with meds and cardioversions and continued progression. I believe the CABANA trial when results get released will make it very hard for doctors that wants to "manage" AF with meds and continuous anticoagulation to continue along that path unless a patient has other illnesses that are more primary cause of morbidity or mortablity. My father in law in his 90's has asymptomatic AF and on warfarin. It doesn't seem to bother him that he has to go to ER occasionally if he has bleeding. Ablation would be very questionable for him. And he has other heart issues now.

So it depends. I would rephrase the question as "can ablation give me a better life than meds". You can also replace meds with meds+supplements.

Ablation doesnt "cure" anything. Basically you could view your heart muscle as a water dam. The electric signal should only be let out through one location (the spillway). In afib, water is trying to spurt out / leak out in different locations. All ablation does is block those locations, same as sealing leaks in a dam. They may break open again at any time and there may be new leaks emerge. We arent curing the problem only treating, trying to eliminate the result of the problem.
Most cases ablation will not fix ectopics. It can sometimes help. It can help with stress I mean if you feel better = less stress

My afib was like yours but it became more and more frequent and ablation is not going to be worth it until you are at a point that you want it and realize the af is too frequent for comfort.

I'm 2 years post ablation as my afib had gradually progressed to weekly attacks which I could no longer tolerate. I still get ectopics from time to time but they don't kick off into an Afib episode. Apart from the total absence of the 'hamster in the chest' debilitating episodes I no longer experience the stress of when is it going to strike nor the digestive upsets that sometimes preceded and followed episodes. . I have learned to look after myself better and nurture the chance ablation gave me towards a better quality of life. I have resumed the gym and hiking and cycling. In my opinion an ablation is well worth it and if not addressing the root cause it certainly goes a long way to making you feel a whole lot better !

tsco

Interesting that you should choose a dam as your example - in 2003, when I had my ablation in Bordeaux, Prof. Haissaguerre told me that it was like trying to build a dam with round stones, and it was difficult not to leave gaps in the wall.

My ablation certainly stopped the AF and I am into my 13th year of sinus rhythm. I had highly symptomatic AF, paroxysmal for many years, then 24/7 for 18 months. Felt as though my life was over, couldn't walk more than 5 minutes without breathlessness, couldn't climb stairs without pausing half way up. The ablation gave me my life back, I now excercise 3 times a week and do regular scuba diving trips to remote places. I have no regrets whatsoever. Whether this was a cure or not depends on how you define your terms.

I do still get a lot of ectopic beats, up to almost 9,000 sometimes on a 24 hour Holter. They used to be very uncomfortable, like being kicked in the chest every few minutes, but I experimented with magnesium, potassium, taurine and D-Ribose and have found a combination which suppresses them. I thought that they had disappeared but in fact they still happen, I just don't feel them any more. That's good enough for me.

Something you need to keep in mind is that over time AF increases in frequency and duration for many people. Once it is persistent it is much more difficult to ablate. So there seems to be a moment when the AF is still paroxysmal but is impacting your life - that is the time to go for ablation IMO.

Gill (pronounced 'Jill' and female)