PVC ablation

Blanking period for PVC ablation. Immediately following EP's Natale's and Burkhardt's PVC ablation no change in PVC's what so ever (less then 5hrs)

Doctor's were able to locate and ablate PVC's. But once I woke up same old PVC's.

Is this normal? I know afibb has a waiting/blanking period..

I would expect so. The reason for the blanking period is that's the period during which the ablated tissue is turning to scar tissue, which is non-conductive. Until that happens, the tissue can still conduct. The same would apply to any type of ablation.

Sure hope so. Came right back same pattern same burden.

So hopefully scar tissue will form and will be done with this is the idea?

Hi Carey, do scar tissues ever regrow and reconnect after a while and become conductive? Trying to understand why multiple ablations often needed. I understand sometimes the initial ablation may not generate a perfect circle around the PV area.

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Carey
I would expect so. The reason for the blanking period is that's the period during which the ablated tissue is turning to scar tissue, which is non-conductive. Until that happens, the tissue can still conduct. The same would apply to any type of ablation.

There is some repair and re-connect, but far more often it is the case that the heart tissue, as part of its continual remodeling during periods when it is in AF, will develop new re-entrant foci somewhere nearby. Also, it is more likely than a reconnect that the original effort simply did not completely close off the pathway for the unwanted electrical impulses, so they get through and the phenomenon continues as before. Dr, Natale, reported widely as such, often tells his patients that it is quite possible he'll have to do a touchup in due course. Sometimes, he's bang on.

Thanks for the explanation, gloaming.

His afibb ablation worked. Developed PVC literally right after I woke up 2020. Pretty sure something in the afibb ablation set them off.

I'm talking PVC's and if blanking period. Is it same train of thought or if it's supposed to work right away?

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gloaming
There is some repair and re-connect, but far more often it is the case that the heart tissue, as part of its continual remodeling during periods when it is in AF, will develop new re-entrant foci somewhere nearby. Also, it is more likely than a reconnect that the original effort simply did not completely close off the pathway for the unwanted electrical impulses, so they get through and the phenomenon continues as before. Dr, Natale, reported widely as such, often tells his patients that it is quite possible he'll have to do a touchup in due course. Sometimes, he's bang on.

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Kleinkp
I'm talking PVC's and if blanking period. Is it same train of thought or if it's supposed to work right away?

Same train of thought. Recurrent afib (or PVCs) months or years after an ablation may be due to what gloaming described, but if it occurs within the 3 months following the procedure it's what I described in my previous post and working right away shouldn't be expected.

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Yuxi
Hi Carey, do scar tissues ever regrow and reconnect after a while and become conductive? Trying to understand why multiple ablations often needed. I understand sometimes the initial ablation may not generate a perfect circle around the PV area.

Yes, they can if the EP didn't make adequately durable lesions and that's unfortunately common among less experienced EPs. Read How you end up with multiple ablations and still have afib, which is on exactly this subject.

I had an ablation with Dr Natale for PACs in August. First 11 days of pure bliss and then they came back with a vengeance DAILY for several hrs. I was literally desperate thinking it had failed, and I was dreading the 2 months mark cause that's when I was going to stop my meds (Felc+Met). Well, guess what...the day after I stopped my Flecanide, the PACs disappeared completely. Turns out for some ppl Flecanide can be a pro-arrhythmic!

So there's hope my friend, you gotta go through the whole blanking period of 2-3 months before declaring defeat. Some research says that it's only 4 weeks so I was super depressed about that...but I guess they are wrong and it's really 2-3 months afterall.

Best of luck.