Ablation

Hi all. I have been reading all the feedback about people who have had ablation procedures on here and have been rather discouraged. I am in the process of having the procedure done because of an irregular heart beat. I have been on a calcium blocker which has helped, but not completely. My heart wants to jump ahead of my pacemaker, so my heart is sometimes beating together and sometimes the ventrical ahead of the atrium. I thought having the procedure might help, but now am not so sure. Is there anyone who has a successful story to tell??? I would appreciate any help with this. Diane Michele

4 Comments

Success Story

by IAN MC - 2014-01-06 05:01:58

Hi Diane Michele As many people have said before,on this forum. we tend to hear about the problems, the failures , the side-effects, the poor medical care and people like yourself end up feeling very negative .

So here's one success story . I had atrial flutter which is a specific type of fibrillation .Like you I was on a calcium blocker which certainly helped but I didn't fancy being on drugs for life ; I wanted to be CURED rather than just having my condition managed by drugs.

And " cured" I certainly was. One ablation , which took 40 minutes and my normal sinus rhythm was restored so NO MORE DRUGS ! I had the ablation almost 3 years ago and it has really worked for me

But and it's a big "but" , atrial flutter is condition which responds very well to ablation with something like 95 % cure rates after single ablation.

Other types of atrial fibrillation have lower cure-rates and sometimes a second ablation may be needed. There are other options of course e.g. cardioversion which can cure you if you're lucky but the irregular heart beat often returns , or there are more major procedures such as open-heart maze surgery which sounds rather drastic to me.

Only your cardiologist will know about your own individual condition and the likelihood of success.

I think it is very important , before having an ablation, to quiz the doctor very carefully before putting your heart in his hands. " How many ablations has he done ? " '
What are his success rates etc.

There is good evidence that the high volume ablation centres have much better success rates than the places where the guy does an ablation only occasionally.

Best of luck

Ian

2nd opinion?

by BillMFl - 2014-01-06 07:01:50

I was once advised that I needed an ablation. The same Cardio pushed lots of other procedures such as an annual thallium stress test. Before having the ablation I got a second opinion from a well respected cardio who is somewhat conservative when it comes to procedures. After reviewing my records he scoffed at the need for an ablation. Invasive procedures should be a last resort and a second opinion would be a good idea. If two docs draw the same conclusion then I would feel much more confident. A lot depends on how well you can tolerate your symptoms. If meds alone allow you to function normally fine. If not, then go for it. But consider a second look by a cardio who is totally independent (not in the same office/group. By the way, I switched to the more conservative guy 4 years ago.

Ablations

by golden_snitch - 2014-01-06 11:01:35

Hi!

Diane, it depends a bit on what kind of arrhythmia you have that's going to be ablated. Ablations are extremely successful in most atrial arrhythmias (SVTs) with success rates of up to 97%! Ablations can in fact cure some arrhythmias.

I have had some ectopic atrial tachycardias, atrial flutter, and AVNRT ablated successfully - they never appeared again. My permanent sinus tachycardia was more tricky, and so was my junctional tachycardia. The latter two ablations (for the sinus node I needed four) could not be done without damaging the sinus node and the AV-node, so that I'm now paced 100% in the atria and ventricles. But I knew about that before. When the sinus or AV-node are part of the problem, it's difficult to do an ablation that "destroys" only the bad cells without damaging the rest of the node and its whole function.

Also tricky are the atrial fibrillation ablations. There has been tremendous progress in the past 5 to 10 years, but they ablations are still not the 1st line therapy for Afib, because the success rates still aren't as good as in other atrial arrhythmias. So, for Afib you usually try several drugs and cardioversions first, before attempting an ablation.

I went back to your first two postings, and from those I understand that what you are now dealing with is probably a (ectopic) junctional rhythm. It makes the ventricles and atria beat either at the same time, or the ventricles first. This is a problem I'm familiar with - been there, done that. Usually, to ablate this kind of arrhythmia does not work without destroying the AV-node, so that you end up with a 100% block afterwards. In my case, they tried to modulate first, but this did not even slow the junctional rhythm down. So, then they did an AV-node ablation, and this worked.

BUT: This AV-node ablation was a last, last, last resort therapy. Before my doctors did it, I had to try ALL antiarrhythmic drugs (some in combinations). Some drugs worked for a while, for instance Propafenone + Nebivolol, so in the end it took me four whole years until I ran out of drug options.

If you should be in the situation that you now have only intermittent heart blocks, so sometimes your AV-node works and sometimes not, and the ablation would cause a complete and permanent heart block, I'd urge you to exhaust all drug options before going for an AV-node ablation. 100% right ventricular pacing increases the risk of heart failure and onset of atrial fibrillation, you should be aware of that. I'm not paced in my right ventricle, but have an epicardial pacer lead on my left ventricle, so I don't have this risk, but you will.

Best wishes
Inga

didn't work

by jodo - 2014-01-07 08:01:47

I had ablation done. or was suppose to on 12-20-14. I went in. and they could not get my heart to go out of rhythm. (Just like a car that has not made the sound since you took it to the shop.) Even though my heart had done it for 2 days really bad.. Now I'm on a drug called Mexilitine. It makes me nauseous. so I take a pill for that. Don't want you to think that it will work, because they could not get my heart to do it. I had sinus node block. and pm was placed on 10-31-2012. Thought that was going to be enough until this year I developed an arrhythmia. I had just retired, and am only 55. I would have loved to have the ablation if my heart would done what it was suppose to.

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