Atrial Fibrillation (AFib) Support Group
Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). Heart beats in a normal heart begin after electricity generated in the atria by the sinoatrial node spread through the heart and cause contraction of the heart muscle and pumping of blood.
In which sense ablation (possibly with touch up) is not a cure?
(1) Is it because the rate of immediate success is too low?
(2) It is because even after ablation you have a reasonably high chance of having to face the Afib problem fairly soon?
(3) Is it because after ablation you still need heart drugs and thinners?
(4) Is it because it is too early to come to a conclusion because it is a fairly recent procedure?
Thanks
(1) Is it because the rate of immediate success is too low?
(2) It is because even after ablation you have a reasonably high chance of having to face the Afib problem fairly soon?
(3) Is it because after ablation you still need heart drugs and thinners?
(4) Is it because it is too early to come to a conclusion because it is a fairly recent procedure?
Thanks
In my mind, it is because of the fact that there is no proof it is permanent.
petey
The question is "what constitutes a success"?
Getting off the heart medications and staying in sinus rhythm forever. I thinks that's unrealistic.
Heart valve replacements don't last forever, but they still consider them a success if the new valve works and improves the patient's quality of life.
Jim
The danger here is that a lot of people put their full trust in doctors and don't question what they say. They then have unrealistic expectations and are very disappointed when their afib returns.
If you have no symptoms then just stay on rate control and blood thinners, but if you are highly symptomatic then it is not okay to just go on like this. Quality of life is important and most highly symptomatic people will do almost anything to stay in NSR.
I believe none of us is so naive that we believe that ablation is a cure, but it can give us precious time in NSR and time for research to advance and often no more meds.
In my mind your 4 points are all correct and state why ablation is not a cure.. BUT, there are many buts and everybody who went for an ablation can give half a dozen reasons why they consider it to be a success for them personally.
On the subject of "what constitutes a success".
There's no question success can be claimed if the "quality of life" or a particular patient has been improved to any degree compared to what it had been. Whether temporary or long term, especially if that patient has failed all reasonable alternatives and strategies.
But that said however. if ones' quality of life has been improved the ultimate question still remains, what will this patient be faced with down the road? Will they find themselves starting from square one again after repeated procedures with long standing recovery periods?
No doubt we all hope and pray that there will be more substantial advancements in treating AF now (ASAP) and in the near future.
;) - Thomas
I can certainly understand the motivation to seek relief from what can be a very annoying condition causing lower quality of life.
Let me state a definition of "cure".
Being in NSR for 5 years or more, no need for thinners.
Do you have references to studies showing eventual return of Afib after an apparently successful (no Afib for 1 year) ablation?
I still take Sotatol and low dose asprin. I have had an almost episode one day, but I took one half of the Soltadol and by the time I got to the ER i was back in rythum.
So I guess I am not cured.
http://www.stopafib.org/newsitem.cfm/NEWSID/311/predicting%20very%20late%20recurrence%20of%20atrial%20fibrillation%20after%20catheter%20ablation/persistent%20atrial%20fibrillation
Maybe you can go back and find the posts.
Here are two interesting articles
Six year follow up of cath. ablation
www.ncbi.nim.nih.gov/pubmed/22245414
Does cath ablation cure Afib?
www.ncbi.nim.nih.gov/pubmed/19887458
It also infuriates me that there is no SOP on reporting ablation results by the various centers around the world.
So for me, I take the old research reports in account , but at the same time I am 100% convinced that the ablation techniques and catheters etc have improved and therefore the outcome of recent ablations will be considerably better.
Congrats on 8 weeks of NSR , it's a bit over 9 months for me.
Of course, where you go for an ablation matters big time.
And then there is cure versus success... success is good too.
Another point: If you look at cancer cure rates, they define cure as X years out... like 5 years I think. after that, it is a new cancer... or you could use the word remission...
Maybe AFIB IN REMISSION is an accomplishment.
petey
By the way, my step-dad had an ablation for afib 9 years ago. He never had any more problems with afib up to his death a few months back (he was 84 and his death was not afib related). There is a man in my office who had an afib ablation 10 years ago. He did not have another episode of afib until a couple of weeks ago. I still think his ablation was a "cure" and successful. He has diabetes, is a heavy smoker, is over-weight, and has high blood-pressure. Because he did not significantly change his life-style I believe he developed afib again because the circumstances were ripe for it. It does not mean his ablation was unsuccessful.
I don't think there is any reason to avoid an ablation because it's not a "permanent" cure. No medical treatment is permanent in that it can guarentee you will never develop that same condition again at some point in your life.
It is also good to hear of stories where people have gone 10 years! Katywhite, we newbies need to hear those encouraging stories of success.