Here are a few of my own:

- How many ablations have you performed?
- What is your measure of success (one year with no afib, etc)?
- What are my chances for success?
- Are you more comfortable with cryo or RF for my case, and why?
- If RF, do you have any way of monitoring the pressure used when making burns? If not, how do you know when you've used enough pressure to successfully ablate the tissue without using too much and burning through?
- How long have you worked with the team who will help you perform the ablation?
- Do you prefer sedated (general anesthesia) or fully concious for the ablation, and why?
- How long will I be in the hospital, post-surgery?
- Have any of your patients suffered any type of esophageal injury as a result of your ablation?

These are just a few that I can think of off-hand that would be important to me. Any reputable EP would be happy to answer these questions.

Read this:

http://www.everydayhealth.com/columns/jared-bunch-rhythm-of-life/what-questions-should-i-ask-before-my-atrial-fibrillation-ablation/

petey

And this:

http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=348

petey

And this:

http://www.stopafib.org/partnering.cfm

petey

And this:

http://www.drjohnm.org/2013/03/four-commonly-asked-questions-on-af-ablation/

petey

Lat one. This one talks about ablation for all arrhythmias (general questions):

http://www.heartracing.com/patients/finding.an.electrophysiologist.asp

petey

Thanks!!

Yes, thanks, Petey. Lots of good info. Learn more here than at any doc's office for sure.

Petey, distill it for us please! What 3 questions would be top of mind for *you* in a discussion of candidate catheter ablation?

I had posted this elsewhere a few weeks back:

A great question for electrophysiologist (EP) docs is, "How many a-fib specific ablations have you performed?" Total ablations is helpful, but an EP who has treated 500 ventricular arrhythmias will not have the same experience as someone who has treated 500 left atrial arrhythmias. However, a-fib is likely the most prevalent ablation indication. For me and my rare blood vessel condition, I wanted an EP that had performed at least a total of 1,000 ablations. This number likely dates them back to the very beginnings of mainstream electrophysiology for a-fib treatment (circa 2000). If their experience is less than 1,000 ablations, I would empower the patient to ask with whom the EP trained under and at which clinic. It is also good to get a firm understanding of how well the EP has addressed any atrial flutter following an a-fib ablation in the past. Mitigating a-fib with a PV lesion set can sometimes trigger atrial flutter, and it is a good dialogue with an EP to hear how confident they are at also addressing residual atrial flutter. There are some new tools these days, too, such as rotor mapping systems, that can help identify problem areas in the atrial wall which may not necessarily be emanating from the pulmonary vein. Don't hesitate to ask if the EP is using any alternate mapping systems.

And the best questions, especially if they have children, "What would you recommend if I were your child?"

Wow.....incredibly awesome information for those of us that know an ablation is in our future! Thank you so, so, so much!!!

3 questions?

1) How many afib ablations have you performed and how many this year?
2) How do you define success of an ablation?
3) What % are successful (performed by you)?
4) How often are repeat ablations needed (for your ablations)?
5) What is the incidence of major complications performed by you and what are the types of complications you encountered?
6) What is the average length of time patients are free from afib that you have performed ablations on.
7) How would you assess my chance of success?
8) What is the annual recurrence rate at your practice?
9) What technologies do you utilize?
10) How many ablations are too many?

Okay, that's 10.

petey

Id be asking a few questions, but Im not sure Id get an honest reply.
Can radiation from ablation cause cancer?
What percentage of patients get Tamponade from ablation and how many die?
Can diet, removing chemicals from the body, acupuncture and other alternatives treatments have the same success rate as ablation in alleviating symptoms?
How many patients are able to quit taking dangerous meds with black box warnings after ablation?
Will ablating affect any other organs or cause conditions such as brain bleeds later on?
Theres more, but I stand by my original opinion that ablation should never be a first line therapy and a last resort unless there is a proven underlying physical condition such as leaking valve , etc.

Hwkmn, the answer to most of your questions would be, "for some patients, yes". The adverse effects from ablation occur in a very small amount of people (compared to the total number of people having ablations), and most of that can be attributed to EPs who don't have significant experience.

Being surgeons, I doubt any EP would recommend vitamin C and magnesium as being all you'll ever need to treat afib. Researching alternative treatments is something you have to do on your own. I tried them all, and none were effective. I'm not even 100% sure that ablation will prove 100% effective for me in the long run. But for me, the reward outweighed the risk. If the ablation proves successful, it will allow me to stop taking antiarrhythmics at some point in the very near future. That definitely wouldn't be happening without the ablations.

I guess the point is - if you have afib, do your homework, and don't take what any one person says as gospel.

There are a lot of questions you can ask your EP before agreeing to an ablation (I had about 2 pages full!). Dont forget when asking to always reference to yourself (i.e. like my case, like me, similar to me and so on because everyone is a little different) Interesting would be to hear what answers make the EP acceptable and what answers make him/her an no go?
Petey, you have a nice list, what kind of answers do you think would be good answers?

Carpe diem,
atp