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.
Well, for now I've decided to have a 2nd ablation on Feb 3rd, almost one year after the first ablation. I am putting my faith in my Doctor one more time to go in and in his words, "clean it up." He says he has never had anyone come back a 3rd time. I spoke with a co-worker who goes to see some of the top docs at Ohio State and he said his doc told him to expect at least 2 ablations. My doctor did tell me a few years ago when we first started talking about the ablation that if he didn't get it the 1st time, he would on the 2nd. Anyway, still not sure if I am making the right decision as after the 1st ablation the recovery sucked and the ablation for whatever reason, made the AFIB more frequent. I am now going in it everyday, sometimes a few times a day. Could only be 20 mins, or 1 hr - 2hrs. It is also happening more often while I am sleeping; wakes me up. The first ablation reduced the intensity of the AFIB and reduced the duration of each episode but is more often. I worry that the 2nd ablation may cause it to be even more often if it does not work. I am for sure not looking forward to all the healing arrhythmias like I got the last time. I am currently off all meds and my resting heart rate is 55-65. I have 100% paid health care and would really like to get this taken care of while I have great insurance but still not sure if I should wait not that it would ever go away as its been a year. Could I still be healing?(wishful thinking) I've chosen Pradaxa for the blood thinner. Any thoughts/ opinions? Thanks.
I hope the second one will be a lot easier on you. I believe your experience is not the norm and most people I talked to are ready to resume their daily activities after a week. I truly hope the same for you.
I also think it is wise to be on blood thinners since you experience so many episodes. I do not take any myself, but I have researched them extensively and Pradaxa would be the one I would choose, if it didn't cause me any GI problems.
Wishing you all the best and please keep us informed.
Here is my undressed opinion since you asked. I hope you do NOT mind for speaking my mind. Here is what I think:
Based on results of your 1st ablation, you should NOT go to the same EP for a 2nd ablation. If after your 1st one you were okay and you would have gotten an occasional episode, then I would agree that you should go to the same EP for further clean up. But, based on what you are saying, your afib episodes even got worse.
If I were you, I would do a thorough research of EPs in your area and find a better EP than your current one. You can ask your current EP more questions regarding what he is going to do this time. If he is using cryo and RF combination, which is really the best way at this time. Apparently, with cryo, they can't get every point but it is safer and faster. The missed places can be touched up and ablated with RF catheter. So, please be choosy and do NOT go with any EP. Make sure your EP is experienced, very experienced.
In general, I am very picky and I do NOT give anybody a chance to screw up a 2nd time specially when it is my heart and my body, which is on the line.
By the way, after my recent ablation, I was in NSR and my EP told me there is a possibility that he might have to go in again and ablate my flutter. However, he took care of all the afib points, which were a lot of thm. He said my atria is stretched and that is the reason I might have flutters. BUT, he likes to give the atria a chance to shrink first. He said there is a good possibility that without afib, my atria might shrink by itself and he does NOT have to do anything later.
I am okay with what my EP has said and I will go to him for flutter ablation later since he knew about the flutter and on purpose he did NOT ablate it in the hope that it corrects itself in time. I call this being conservative, which is good.
So, please evaluate your situation after your 1st ablation and use sound reasoning as far as if you should go back to him again for a 2nd ablation or to find another more competent EP for your 2nd ablation.
Again, I hope you do not mind speaking my mind and being so up front with you. Please remember results always matter. As fellow afibber, I know what you are going through with your episodes. I really want your 2nd ablation to be successful so you can get on with your life. That is the reason I am speaking up :-)
I wish you the best of luck in whatever you decide.
Take care,
Scott
I was told by the EP that I might have to have 2 ablations. So far, the first one is keeping the monster A Fib at bay.
I was on Warfarin for over 1 year. If I ever have to go on a blood thinner again, think I'll choose one of the newer ones like Pradaxa.
The newer ones seem to be more effective, and the continual blood testing with Warfarin gets to be a pain----especially when you travel.
Good luck to you.
D.
the very best to you, my brother. Hopefully the 2nd time will be the charm! I would think that since you have been through this once before, nothing will come as a shock/surprise, and therefore (hopefully) no stress. I am sure the next 3 weeks will fly by for you. Please post on the 4th!
Bill
Gotta go, Mark, I have to work in the lower 40n now. :-) petey
Here is my undressed reply, I hope you do not mind for me speaking my mind.
I take offense to your reply as it sounds to me that you pretty much think I decided one day to have an ablation and went to an ablation drive thru. I did a "thorough" research and found a very experienced doctor in my area and so there for I did not choose just "any EP." This is why I am dumbfounded as to why the ablation didn't take. He is the Director of the cardiac unit at a major hospital around here and performs a lot of ablations with great success. But why not me? Is it me or was my ablation the day he decided to slack off? I do not know but what I do know is he put me into AFIB at my 1st ablation, he said I was the easiest to set off, and ablated, therefore achieving full isolation of the pulmonary veins with no need for cardioconversion to bring me out of the EP lab. He also did an atrial flutter ablation and tachycardia. He tried setting my heart off a few more times and did not get so much as a single skipped beat. I went back a little after 12pm and got back to my room about 8:30 pm. Yet I still have AFIB. I know all about being "conservative" and stressed that before I went back. I have "evaluated my situation" for the past 10 years. I used "sound reasoning" the first time yet still have AFIB? Most of all, you may be a fellow afibber but you have no clue as to what I am going thru or how my AFIB feels and what the symptoms are. Because your AFIB is one way does not mean it is like that for everyone else. I hope you do not mind me speaking my mind and being so up front with you. "Results always matter"? I didn't even think about that. With all that said, I hope your ablation takes the 1st go around as I would not wish this on anyone.
Hey Petey, do you think you can draw me a picture the next time?
I see why some people get off of this site. Thank you to all, you too Petey, for all of your advice, support and words of encouragement since I first had the ablation. I really hope everyone, you too Scott, gets their AFIB resolved. Godspeed.
Mark:
The reason I replied was that you asked "Any thoughts/ opinions?" I hope you didn't think I was talking down to you. I know you did much research. I can tell you that Scott has done an enormous amount of research too. When you said you were worried about things getting worse, I was only trying to help support what you already know: Sometimes it takes a 2nd or 3rd ablation to get all the spots. Some EPs are more conservative than others and would rather only do what seems to necessary. With that, comes a higher likelihood of the need for a 2nd ablation. Hence the "horse and fence" analogy. Some EPs just ablate the likely spots without detailed mapping.
I was wondering what you meant by: "The first ablation reduced the intensity of the AFIB and reduced the duration of each episode but is more often." Are you saying the TOTAL TIME in afib is longer or that the total time in afib is the same or less, but it starts and stops more frequently? If it is actually less time, but just switching back and forth more often (with less intensity), that is a partial success. That would make me think a 2nd ablation would make perfect sense.
Healing: I think the missing piece is what your EP thinks. Does he think you are still healing, or does he think there are more spots to hit? Depending on your answer above, what kind of explanation he gives you would seem like it would help you make a decision.
Mapping of the spots is really important, as I have read, for the tougher cases. That's why FIRM is being watched so closely. For me, I would want to know that they are hitting the right spots if I had an ablation. Mapping and experience with tougher cases would be my criteria for selection of an EP, as I have longstanding persistent afib. (I am asymptomatic, so I stayed away from ablation so far).
Concerning Pradaxa, it works for me. If your EP likes to use it with ablations, that is the way to go. Different EPs have different preferences. Since I take Pradaxa and have investigated ablation, I was on the lookout for opinions on Pradaxa pre-ablation.
Anyway, good luck with your decision. I'm interested in your answer regarding TOTAL TIME in afib now.
petey
I don't think anyone was questioning your decision here, or your research skills. The only question that matters is "Do you trust this guy with your life?" If so, then stay with him. But I am sure you have read in your research that many EPs recommend that if you don't have success with one EP, then don't continue to return to that person. The one EP said that "I went back in and saw very large areas that simply were NOT ablated by the original EP." If you trust your guy, go for it! But who wouldn't want Natale? I am surprised ANYBODY gets to use that guy anymore...he seems to be THE superstar these days. Best of luck, and don't abandon the group! You were NOT being attacked!
Bill