Is complet ablation an option to eliminate A-Fib?

I had a St Jude PM implanted about a month ago because my A-fib was getting worse and the doc changed my meds from flecanide to propafennone. No A-fib incidents until Friday AM. Another last night that lasted 7 hours. It looks like the propafennone is not going to completely control the A-fib. Maybe I’m already building up an intolerance of it.

Two questions:
1) What part of the atrium triggers an AF episode? (I suspect it is the SA Node but in 2007 I had a minimally invasive high intensity focused ultrasound (HIFU) cardiac ablation. My understanding was that by scaring the pulmonary veins at the back of the heart this should eliminate the signals that trigger the A-Fib. This procedure coupled with flecanide controlled my A-fib with only a few mild episodes for 2 ½ years.)

2) Is it feasible to have a complete ablation of the SA node to stop A-fib attacks? If so has anyone had this done.

Since I already have a PM I’m thinking that I would have a better quality for the remainder of life (am 73) to be 100% pacing dependent than having to go through frequent A-fib bouts and feel like crap afterwards. Of course, I’ll ask my cardiologist about this but want to get other members thinking.
Thanks, Bill T

5 Comments

AV node ablation

by aldeer - 2010-07-25 01:07:57

my a-fib was no longer controlled after years of different meds. The EP did tha AV node ablation that does not stop the a-fib, but you will no longer feel it and you will be paced at 100%.... lots of good luck to you... aldeer

Ablation/PM Implant ~ ~

by Carolyn65 - 2010-07-26 01:07:52

Pre PM, I had very noticeable Afib for years. I would feel 'fluttering' in my chest or I would feel like I had to cough, like a lil' breath had been taken away, but I never had 'bad bouts' after my Afib like you say you do.

The heart Dr. tried meds, electronic heart stops/starts, etc. and nothing helped. I had the ablation/PM implant in 10/09 and felt sure the Afib was gone. Several months later at one of my PM checks, the nurse told me I still had the Afib! What a shock to me.

The ablation/PM will not get rid of Afib, but I do not feel my Afib anymore nor know when it is happening.

???

by pete - 2010-07-26 04:07:09

Dont ever consider any kind of "MAZE" proceedure its more likely to finish you off than offer some kind of cure. The signals that cause Afib can be generated in quit a few places but the most common is the pulmonary vein. If you can find an outstanding doctor you can get rid of Afib. I only know of one that I can trust and he is quite famous and works in a hospital in Bordeaux France. Im in the UK.By the time I had discovered him it was to late. Now have biventricular cardiac resynchronisation pacemaker and an AV node ablation ( one of the much less risky ablation proceedures).
Im quite well and perfectly happy. Still have Afib. Cheers Peter

Thanks for the replies

by Bill T - 2010-07-26 04:07:09

The minimally invasive high intensity focused ultrasound (HIFU) cardiac ablation is supposed to be the same type maze procedure but doesn't involve going inside the heart. I had that during the fall of 2007. Even though HIFU is a new procedure and my cardiac surgeon had preformed about 100 procedures with an 85% success rate. Guess I fell into the 15%. I think it helped somewhat but obviously didn't block the A-fib triggers from the pulmonary veins. Pete, I agree with you and will not ever consider another MAZE procedure. I was in the Hospital for a week and fell I was lucky to get out of the hospital. My heart rate went to 125 bpm for a day or so and when they got it headed down it went to the 30s. They were considering a PM but finally got me back into sinus rhythm. I know that I will have to be observed for some time to see the frequency and severity of the A-fib attacks. From your replies I now have some info on ablations and will be able talk to my cardiologist. Thanks for sharing.
Bill T

av node

by rdelvis07 - 2010-07-26 12:07:13

I also had a cardiac ablation then i had to have a AV node ablation. I no longer have as much a-fib as i once did but i still feel it. have you looked into the wolf mini maze? i was thinking about it but they said my heart was to weak.

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