Ablation Risks

Hello all. I am new to the forum. I have had Afib in varying degrees all my adult life I think. Mother had it and father had a pacemaker in his early eighties. I remember going for a run when I was around 17 or so and feeling my heart not "working properly" for a few minutes after stopping.
Anyway almost 70 now and for the last year and a half I have Afib approximately 30% of the time. Self correcting after 2 -4 days. I am not in the USA. Recently went for an appointment with one of the leading EP's here. He was straight to the point and said that ablations are only 70% successful and there is a one in a thousand chance of death, stroke or heart attack. Then the risk of accidently going through the heart wall and into the esophagus which isn't very good at all. My life in the last year and a half has been reduced in activity. Cardio output isn't what it was but when not in Afib I can still surf, paddleboard and ride my eMTB although with more caution now I am on Xeralto. So, question is. What do you guys think of the overall risks versus lifestyle? If it was a lottery with those odds I would definitely buy a ticket. When the odds are negative it doesn't appear that attractive. cheers Steve

Steve,

Any chance you could go to Professor Pierre Jais in Bordeaux, Fr for an ablation (out of pocket, but many out of the US have done this). The best way to up the odds of success and lower the risks of a bad outcome is to go to one of the top afit ablating EPs. Dr. Jais is one of these.

Depending on the skill AND experience of the EP, there is a small variance between them and other EPs. The risk is small anyway, or they wouldn't be performing the procedures as widely as they are practiced everywhere....world-wide, by literally thousands of EPs.

It's a calculated risk. Is your heart doing okay otherwise....no enlargement or prolapse? No ischemic heart disease? No other co-morbidities that could confound the efforts of even the best EPs out there?

My EP was frank and told me his rate of success was about 75% first time around, and he told me, again frankly, that there is a slight risk of perforation, pulmonary vein hypertension, yada yada.... He claimed a rate of success for a second attempt at ablating at about 80%. He did have to take a second 'stab' at me, but he succeeded the second time. Both times, I had a TEE (Trans Esophageal Echo-cardiogram) probe put down my throat after I was anesthetized. This allows the EP to see how close she/he is getting to the esophagus and rear walls of the heart. Personally, and based only on my own experience, the only drawback to even a failed first ablation is what it feels like in the throat if the tube is inserted or removed harshly or 'dry'. It's awful. I did speak to the anesthetist about my first experience, and he immediately said he was glad I told him and that he would make sure my second ablation was a lot better. It was...and I am in remission, thankfully.

Every time you are injected, there's a risk. There are reported cases of myocarditis and pericarditis because needles for the COVID vaccine was being injected directly in to an vein. Nurses were so busy that they often forget to aspirate before plunging. A vein leads directly to the heart, and that is where the troubles began for a lot of people.

I wouldn't hesitate to recommend you spend an hour scouting out a really great EP within a day's drive...if you can do that....and then make contact and get the bear off your back. You'll have a life with markedly improved quality.

According to this paper the stroke risks are much greater than 1 in 1000.

[www.ncbi.nlm.nih.gov]

Quote
KingFizzy
According to this paper the stroke risks are much greater than 1 in 1000.

[www.ncbi.nlm.nih.gov]

That study looks at ablation for ventricular arrhythmia, not atrial. Totally different beast.

Hi Gloaming. Yes there are some co-morbidities. Blood pressure is a bit high. I don't tolerate any BP medications very well. Just 1.25mg Bisoprolol and 4mg ARB daily. I could lose at least 10kg (20lb) which I seem to have put on since Covid and my reduced activity in the last year and a half due to Afib and affects of higher doses of medications initially. I think left atrium is a little enlarged or thickened. Not sure of that. Calcium score was zero. I am not athletic but active with my interests. EP was happy to go ahead. Just me being unhappy. When I am in Afib I can still walk, slowly paddle my SUP and ride my eMTB gently. I am not totally flattened by it. I was taking 100mg Flecainide for 10 months but have weened myself off as I don't think it was doing anything. Tried higher doses and it made my heart race. Anyway see what the future holds. A lot more thinking it over. cheers

I'm having issues with this. [www.afibbers.org]