Convergent Ablation

I will be getting a convergent ablation and also having the LAA clipped off on 9/30/25. I was wondering if anyone has heard of this procedure?

Quick history, back in 2018 I had 2 ablations by Dr. Natale. That lasted for a few years. In 2023 I started having atypical flutter. I had another ablation in 2024 by a different doctor closer to home. That lasted for a few months and then the flutter came back. The doctor said that pretty much everywhere that can be ablated inside the heart is.There is a small space that can be ablated but it has to be ablated from the outside area of the heart and to get there they cannot go through the normal groin catheter. I met with another surgeon who will cut a small incision in my chest and side of rib cage to do the ablation, plus at the same time they will clip off the LAA. I feel like I need to do this and if it doesn't work in the long run, I will have tried everything I can. The flutter keeps me at around 105 BPM which isn't good but it could be way worse. I can function and most of the time don't notice it unless I'm exercising, walking up hills, etc.

You haven’t tried everything until you tried the last resort, no going back, AV node ablation for your flutter. It stopped my 190hr flutter but it comes with a cost because it’s a drastic ablation.

Good luck with your procedure.

What you explain suggests to me that all the walls in your left atrium (6) have been extensively ablated, and that now they'd have to start ablating other areas, including your right atrium, and then consider the outer surfaces of your atria. This means going in behind, but obviously not using a catheter. A TX female EP posted a video on the 'hybrid ablation' about four years ago on YouTube with the title something like 'New Techniques for an Old Problem. [www.youtube.com]

Susan,

Did the AV node ablation get rid of your flutter for good?

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Victoria
Susan,

Did the AV node ablation get rid of your flutter for good?

AV node ablation does not stop whatever is happening in the atria. It disconnects the atria from the ventricles, from an electrical perspective. You get a pacemaker, that then provides the signals to your ventricles to beat. If your atria are fibrillating or fluttering, they will continue to do that. Hence you solve the ventricular rhythm problem, but not the atrial one.

And a word of caution. Although an AV node ablation renders most people asymptomatic, a small percentage still feel the afib even though their heart rate is normal. Not as uncomfortable as before the procedure, but not 100% asymptomatic.

It's definitely the last resort option with no alternatives once you do it.

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Victoria
Susan,

Did the AV node ablation get rid of your flutter for good?

Carey and George are correct.

It’s a final solution. It’s so drastic and irreversible. It has its pros and cons. I have been ER free of atrial flutter tachycardia since my AV node ablation the first week of December 22. I was admitted with 190hr flutter in the hospital 23 days out of 30 during 11-22 and they tried to convert with drugs and ECVs. Nothing worked.

The AV node ablation gave me back my life. I was basically living in the hospital. I was admitted 5 times that November and spent 23 days total that month suffering and no amount of IV drips, pushes, pills and ECVs did anything. I was offered a flutter ablation 9 days after my 23 days but that would mean being discharged and suffering at home without medical observation with a 190hr. I already had 3 failed ablations so there was no guarantee another would be successful so I decided to get the AV node ablation knowing my ventricles will no longer be so fast and I wouldn’t need to suffer and I could move on.

My pacemaker can convert around 82% of my afib but I still feel my palpitations and am symptomatic at times. My ventricles beat at 70 usually but my upper chambers can go as high as 350 according to my pacemaker reports. It is supposed to be safe at that rate and ok because my ventricles are at a steady 70 rate.



Edited 2 time(s). Last edit at 08/29/2025 11:19AM by susan.d.