From one of the most renowned ablation centers (Bordeaux, France):

"...experiencing atrial tachycardia after an AF ablation is a good rather than a bad sign. "

http://www.afibbers.com/atrial_fibrillation/flutter/I91j.htm




Tachycardia following AF ablation
BORDEAUX, FRANCE. As more complex forms of

Professor Michel Haissaguerre and colleagues at Hopital Cardiologique du Haut-Leveque have just published a two-part report on the mapping and ablation of AT following AF ablations. They now consider this AT a natural progression on the road from afib to normal sinus rhythm and make the following somewhat surprising statement:

Conversion of AF to one or more intermediate ATs is an important step in the maintenance of lasting sinus rhythm. Recurrence of AF is rarely seen after this conversion occurs, while it is the most common recurrent atrial arrhythmia when it does not.

In other words, experiencing atrial tachycardia after an AF ablation is a good rather than a bad sign.

AT can be macroentrant or focal in origin and is often associated with gaps in the lesions made during the AF ablation. The origin of the AT is established by careful electrophysiological mapping. The first step involves checking that the isolation of the pulmonary veins is complete and, if it is not, filling in the gaps with fresh lesion lines. The second step involves the assessment of cycle length variability to see if the AT is of focal origin, while the third step involves checking for macroentrant circuits, particularly around the mitral valve and in the roof of the left atrium.

A recent study carried out by the Bordeaux group found that 46% of AT was macroentrant, while the remaining 54% was focal in origin (including localized reentry at the pulmonary vein junctions). The average mapping time to determine the origin of the AT was 10 minutes and 97% of all ATs were successfully mapped.

Veenhuyzen, GD, et al. Atrial tachycardias encountered during and after catheter ablation for atrial fibrillation: Part I: Classification, incidence, management. PACE, Vol. 32, March 2009, pp. 393-98
Knecht, S, et al. Atrial tachycardia encountered in the context of catheter ablation for atrial fibrillation: Part II: Mapping and ablation. PACE, April 2009, pp. 528-38

Hello heart2222 - Im sorry you have to stay on the meds for a while. I know it can be so disappointing to think you are getting off of them just to be told you have to wait another 6 months. Petey's post from afibbers.com seems encouraging. Give yourself plenty of time to make a comfortable decision for yourself. Take care and thinking of you!

Sorry to hear about your disappointing news, but the article that Petey referred to seems to be encouraging. Hang in there, positive thoughts are coming your way.

Heart,
So sorry to hear that things are not going as well as you had expected but Petey's new is good. Please give it a little more time.
Moy...

Petey,
Once again you have come up with a very helpful article thru all your searches!! Thanks a LOT!!

It does say another ablation is the cure. I don't know if I want to go thru that esp since the ablation caused the AT.

Very interesting. Obviously mine is not the one which disappeared in a few weeks since I'm 3 mos out.
The nurse practitioner did mention that Tikosyn isn't very effective against AT. So will see what the doc says about keeping me on it. However, if I develop a lot of AF off of it, I will have to be rehospitalized , like Moy, to get back on it. No fun.

There are so many uncertainties in dealing with this a fib. It's enough to drive you insane by itself!!

Thanks for the encouragement and Petey, thanks again for the very helpful article. Is France THE place for ablations???

Heart - that is a bummer! I'm up for my 3 month post ablation appointment next month. I have actually dropped all my AFIB meds already and have switched from Pradaxa to baby aspirin. I know how disappointing that would have been for me. Getting off the meds was one of the big reasons I had the ablation. Having to continue on and then being told I had to repeat the procedure would be tough. I know ablations often require a touch-up, but it is still disappointing news. Best of luck on whatever you decide.

Jim

Hi Heart,
Bordeaux i believe is THE place to go in Europe. Almost considered
it , since I'm German and I'm familiar with the region and the center. However, unless you're French, you have to pay about 35K US dollars out of pocket. I checked a few years ago, right after I was diagnosed. Could be more now, or maybe less due to the strong dollar.
It was too cumbersome for me. I've lived in the States too long, my family is here and I have American insurance and I don't remember much of my high school French anymore.
But yes, i consider them one of the top centers in the world and their research and experience is absolutely renowned

Thanks, Jim. I'm happy for you that you are off the meds. That was of course a major part of having this done!!

Sanibel-good to know about France. I couldn't afford to go there for sure!

They found a lesion on my spleen while doing the MRI. Yet another thing to worry about!!

heart2222: According to what I have read, an AT ablation is much easier than an afib ablation... very easy to map. It might not be a bad idea if it doesn't go awy on its own. -petey

Petey,
I surely hope it doesn't come to that. Thanks for your encouragement!!

The event monitor happened to catch one AT. But who knows if some of the other "runs" I feel are not AF?

This whole situation is rather depressing...

Heart, so sorry to hear the disappointing news about the meds. I'm glad Petey came up with some "heartening" data - sounds positive in the long run. I'm praying for you.

Thank you for your prayers, Terry.

I'm very grateful Petey is able to pull up all these helpful articles!!!

heart222...I feel your pain. Sounds like we are having similar results with ablation. Bummer.

This is a boat we don't want to be in, right ohiofibber?

I've read that even though we go through an ablation, our hearts still try to "return" to it's usual process - which means the afib continues.
Has anyone else heard of this?

I'm sure with all the problems I've had, my heart will do its best to defy me! I can only hope I'm stronger than it is!!! :)