"Success rate" as it relates to persistent atrial fibrillation.

Depending upon which report, website or newsletter you read, the success rate for an ablation can be interpreted many different ways. How do you define success? My naïve definition of success when I first learned that I had afib would have been afib free for five years. Once I learned more about afib, I learned that the definition of success is afib free after one year. Recently, I learned the definition of success is afib free for six (6) months. I’m curious what the long term numbers are for persistent afib. Does anybody know or is such information available? Thank you. –Chuck-

Chuck Connors Wrote:
-------------------------------------------------------
> ... the definition of success is afib free for
> six (6) months...

Like Johnny used to say: "that's some wild and crazy stuff!"

/L

No groups doing really significant work use six months now as a success metric, unless its for a specific comparison to another study that uses that benchmark, but most now have one year as the minimum and many use 20 months +/- 4 to 6 months as a study endpoint.

The key thing in all this kind of discussion, is that we can play around and find all kinds of middling to horrible stats from largely greenhorns, or those that are just not very skilled at this, as there are a fair number practicing out there. But if you are wise enough to chose a top tier elite level EP up front, then all the 'ridiculous and crazy' stats ..as real as they may be for the naive and careless decision making ablation patient ... are meaningless for you to consider, unless the goal is to scare oneself out of an ablation using faulty logic.

I dont recall anyone here being seriously harmed by Dr Natale or his protege colleagues reported here over the many years... contrast that with the overwhelming success people have reported from those same highly skilled hands ... As such, the better part of valor is to just step out off the merry-go-round of questionable and anxiety producing speculation inherent when choosing someone with a spotty or not well understood track record with ablations.

Why do such a thing or worry oneself silly over such 'what ifs' when you can avoid all that by holding your EP to very high standards ... Even with top level EPs when traveling a long distance to see one, I would avoid a follow up touch up within the first month after an index ablation if there are breakthroughs and one is offered so soon.

I know Dr Natale really frowns on that practice and there is some evidence that it can be quite risky for some to go back in for a touch up when there is still so much inflammation from the initial ablation. I know a number of folks here have done so at Bordeaux and came through okay , even if with a somewhat longer recovery period, but unless there is some really compelling reason why you should have a follow up so soon after a full tilt initial ablation, I would go out of my way to push that touch up out by two to three months at least .. try a cardioversion of some AAR drugs until your atrial tissue is well healed and then go back in after the blanking period is over, if need be.

That is certainly the most prudent thing to do, cost and convenience be damned of having to leave and fly a long way home only to have to return in a few months. Be smart on this one is the motto I would choose is such a situation. You will be hard pressed to find Dr N offering such a follow up within the first month unless its due to unusual circumstances and perhaps if the first ablation in this series was itself a minor touch up with very little work and inflammation done.

Other than that caveat, that applies to all skill levels of EPs, just relax once you have choose a true maestro and trust the job will be well done indeed.

And when you are looking at 'success rates' we all know this is an 'ablation process' and even with a great maestro can take two to tango for the long term, so accept that up front and realize that the first ablation will almost invariably be a major step forward in your battle with the beast and represents a huge percentage of your way home free, with such an elite level operator at the helm. From that perspective, judging such a top level 'ablation a 'failure' if there is a little flutter that needs touching up after 3 months, is a misleading concept. I would only judge such a repeat second ablation a big disappointment if it was found that a lot of reconnections were driving the need for that touch up ... that is a far more telling and informative way to look at this process in reality. What you want to avoid is getting roped in to an ongoing series of almost complete 'redo' PVI ablations .. that is really counterproductive and the best way to avoid that is .... make the right choice up front for an ablationist renowned for very low percentage of reconnections found in any follow up procedures in patients they did the index ablation on as well.

That is what separates the men from the boys in this field.

Just take the longer and more open view from the outset. Expect two procedures and be exceeding glad if, and when, you are one and done, and see this through what ever it takes in your case with the best possible EP you can bring to your disposal, and then this will all be over sooner rather than latter and with the result of a grateful ex-AFIB patient wearing your name tag.

Shannon



Edited 1 time(s). Last edit at 05/21/2015 03:24PM by Shannon.

Many previously AF afflicted have been AF free for many years without invasive procedure or drugs by applying science-based nutritional strategies, e.g. The Strategy

Moerk: Thank you for mentioning The Strategy. If you should feel called upon to deliver more information about non-drug, non-surgical methods, try referring folk to session 61 of the Conference Room Proceedings, where 50 people have recounted the exact non-drug, non-surgical steps they took in order to get afib out of their lives, Where they used supplements they have given brand name, dosage, and timing. Where they used dietary changes they have described these changes as well. If any other non drug, non surgical means were used, they have described these means very carefully, with the intent to show others how it was done. Some of these people are still posting here and can be questioned directly about their no-more-afib techniques. Nearly all of them have email addresses that were valid when they made their posts. All of them made these posts with the intent to let others know about a means to get the afib boogies to go flap their leathery wings someplace else.

Yours for NSR,
PeggyM

HI Moerk and Peggy,

Yes indeed there are a good number of folks who have been able to quell the beast for the long term with dedicated nutritional and life style modification methods i.e. The Strategy .. which why this is the first and on-going step in our comprehensive and truly holistic approach to using ALL the best tools in our tool kit to address such a complex and multi-facited condition.

Everyone owes it to themselves to really find out if they might be one of the lucky ones who can put the lid on the kettle with such nutritional methods and other life style and risk factor modification methods as the first core step in defending against AFIB breakthroughs.

Furthermore, even when such methods prove not to be 100% effective, which we have found to be the case with a large majority of those who have reported making a long term dedicated effort at applying such natural changes, there almost always is some degree, and most often a lot, of net benefit in overall health and often with some degree of reduction in arrhythmia symptoms too from making such changes a permanent part of one's life, even after a successful ablation process has been added into the mix.

Doing everything one can to improve overall and cardio-specific health only makes all kinds of good sense, and yet the experience of a whole lot of us here too, that have had full blown AFIB and have been able to put the genie back in the bottle for many many years by nutritional means alone, is that overall such folks belong to the lucky relatively fewer numbers side of the ledger.

I feel it's vitally important for everyone who discovers our website to come away with that broader all inclusive message and not look at this as only all about allopathic ablation and drugs or all only about natural and life style enhancement means alone and avoiding any medical help or procedures at all costs ... taking a too dogmatic a view of sitting firmly on one side often fence or the other, just because one of the two perspectives have apparently done the trick for oneself and a good number of others, is shortsighted in my view and doesn't fully serve the best interest of all AFIB patients.

Ideally, everyone who comes to afibbers.org will come away enriched by a wealth of great insights in both nutritional and life style and risk factor modification schemes and protocols that may totally eliminate their AFIB while improving over all health, but also learn as much as possible about how to insure the best possible odds of having the most successfully and shortest number of procedures when an expert ablation process is obviously the next best step after adopting the natural life style improvements when those prove not sufficient to get the job satisfactorily done.

AFIB can be a humbling adversary. I had near total control over what had been a steadily advancing paroxysmal AFIB history of 16 years. I maintain this truly excellent level of control for approximately a five year period of intensely dedicated application of The Strategy and careful dietary, risk factor avoidance and related protocols, which I still practice today ... but still in spite of doing everything right and after such initial long term success, the beast made its way back with a vengeance and I flipped suddenly into an aggressive persistent AFIB that required a two step expert ablation process, along with all the great nutritional support I still use daily, to finally give my heart the real peace it now enjoys.

Most every new comer here should be able to discover within a years time, maximum, if the natural means alone is likely to do the trick for them. If they have not gotten dramatic reductions in AFIB within a year of dedicated and educated effort, then its time to cast a wider net to include too the best example of ablation therapy along with the good dietary, nutrition and life style choses and, as Peggy noted, conference room 61 has a list of those who have been fortunate enough to do it all solo without needing any ablation or medical intervention, for everyone to learn from in addition to The Strategy and the wealth of other great info found within these pages.

Just don't rule out the possibility that an expert elite level ablation may yet prove to be the golden key to tying everything together ,. even for the most diehard "I'll never let a doctor near me" type of persona. Being smart also includes getting the most from your nutritional and life style enhancement dedication for a life time. They are both mutually compatible and supportive and the wise Afibber will keep an open and flexible mind toward both key methodologies for getting and staying on top of the beast long term.

Cheers!
Shannon



Edited 1 time(s). Last edit at 05/26/2015 03:44PM by Shannon.

Peggy, thank you for the suggestion. How to access 'session 61 of the Conference Room Proceedings' ? Also 'The Strategy'?

To find the Conference Room Proceedings, do this:
1] go to the top of any page here on this site.
2] click on the yellow bar marked "Conference Rooms",
3] in the page that appears, there is, on the left hand part of the page, a list of titles. The 8th one down reads "Conference Proceedings". Click on that.
4] in the page that appears after that click, scroll down from session 1 to session 61, and click on that.

You might want to read some of those other 60-odd sessions as well. They all have interesting topics, interesting to an afibber anyway.

PeggyM

And i completely forgot to look up "the strategy" for you. to find it, i personally would put in Jackie as author and scan thru til i saw The Strategy and click on that. I may do that later today when the furor dies down a little around here. Busy greeting longlost friend just arrived.

PeggyM

Thanks for the mention of The Strategy… and here’s the link [www.afibbers.org]

On the boxes above the post messages… See Afib Resources. Click there and note a lengthy menu of important reports related to Afib… that’s where The Strategy is located. …or just go here: [www.afibbers.org]

The Conference Room topics – same thing… look in the boxes at the top…
Click here Conference Room proceedings: [www.afibbers.org]

There's a huge amount of valuable information to help afibbers not typically found anywhere else.

Jackie

Thank you PeggyM and Jackie for guidance.