Ablation

Hi Folks


I had my PM implanted almost 4 years ago, I had Bradicardia and AF, at first the AF totally disappeared with 0 incidents over the 6 month period. The Doc messed about with medication and it gradually came back. When the PM technician downloaded the data it showed I was 6% of the total time in 6 months in AF, At recent visits this changed to 7 / 8 / and it November it was 14%.
But last week it got a hell of a lot worse and was really fatigued. My Doc referred me to the hospital and was seen within 48 hrs.

They carried out an ECG yest and bingo ! for once I was actually in AF while it was taken. Had a real lengthy discussion with the Doc and she has decided to do another scan and 24hr monitor to get a better picture of what is happening. She seems to think an ablation may be worth trying.

I have searched the web and it seems to mention a 60-80% success rate, with 25% needing further procedures.

Just wondering if any of you have first hand experience of having an ablation, and if it has been a success?

Also how long does it take to do an ablation,
is it a general or local anaesthetic?
are you in hospital for long?
what is the recovery time?
off work for long?
and do you notice immediately if it has been a success.

Sorry if I am asking questions that have been discussed on here lots of time, but I did use the search facility and did not find the answers.

Regards

12 Comments

general anaesthesia?

by golden_snitch - 2010-02-10 06:02:56

Hi Sheila,

are you sure about the general anaesthesia, did you talk to an anaethesist before and signed an informed consent sheet? Just wondering because I have never ever heard of anyone getting a full general anaesthesia for such a procedure, I mean it's basically just a heart cath that takes a bit longer. A general anaesthesia involves risks that are not worth it for a procedure like this. You sleep through it and do not remember anything when you are heavily sedated. They use meds like the propofol (yes, the one that killed Michael Jackson ;-)). You don't need to be intubated or anything like this. So, for the patient it feels as if he had had a real anaesthesia but in fact it was just a good sedation.

Just curious because like I said I know a bunch of arrhythmia patients from Germany, the UK and the US and none of them had a general anaesthesia for an ablation.

Best wishes
Inga

General Anaesthetic

by Wannabe - 2010-02-10 07:02:04

Yes, Inga, I'd a general anaesthetic and I signed a consent form before the operation indicating that I understood all the risks, etc, associated with the procedure. Apparently the Atrial Flutter was dealt with almost at once in my case because I was in flutter when the operation began. The only discomfort I had was in my groin and this had healed within a day or two. The fact of having atrial fibrillation and a pause of 7 seconds in my heartbeat was discovered while this procedure was being carried out. Four weeks later I'd the PM implanted and was given medication to treat the fibrillation. Following the sensational success of the ablation for atrial flutter I was keen to have such a procedure for the atrial fibrillation. It was explained to me that these are entirely different kinds of arrhythmia. One is generally successfully cured, i.e. flutter (cf. Tony Blair, our former and unlamented Prime Minister, who had this procedure carried out (under general anaesthetic) .

My PM was implanted under general anaesthetic too and, once again, I signed a form of consent having had all possible complications pointed out to me and my indemnifying the hospital in the event of an unfavourable outcome.

The point I was trying to make for Tom is that Atrial Flutter and Atrial Fibrillation are two different conditions and I sometimes wonder whether our members are aware of this when they refer simply to AF in general terms. Forgive my being pedantic in this matter. I'm inclined in this direction since my profession is as an academic in English Language - so tiresome, I know! Have often wished to point out also that the singular form of the (Latin) noun which so often occurs here in our message board is - its plural form is and its adjective is . However, feel this might alienate too many of our members who couldn't care less anyway - and why should they indeed?!

Best wishes, A. Pedant (aka Sheila xxx)

Swearing in Latin and in English!

by Wannabe - 2010-02-10 07:02:10

Oh, how are the mighty fallen? Where did my pedantic ramblings get me? I'll begin that sentence once again and hope for the best - really, I deserve all I get, wouldn't you say?

"Have often wished to point out also that the singular form of the (Latin) noun which so often occurs here in our message board is - its plural form is , and its adjective is .

As if it mattered! I'm off to bed. Thank God! I hear you cry!
Sheila xxx

I don't Believe It!!!???

by Wannabe - 2010-02-10 07:02:31

Look, it's done it again - and this system refuses to recognise the distinction between atrium, atria and atrial. Just shows you, no one cares! But how can this be? Have resolved that henceforth I shall no longer waste my energy posting on this board. Hurrah, for that I hear from all corners of the globe. Goodbye, Sheila

AF ablation

by golden_snitch - 2010-02-10 09:02:08

Hi Tom,

I haven't had an ablation for AF but for numerous other arrhythmias, and since I'm running a German website for arrhythmia patients I try to be up to date and read as much as possible about all the arrhythmia "business". So, I think I can answer a few of your questions:

1. How long the ablation takes depends on what is being ablated. For AF I would say it takes about three to five hours, but it can always be less or more. I have had ablations ranging from three hours to ten. The good thing about AF is that the cardios know what to target. AF almost always comes from the pulmonary veins while when you have an ectopic atrial tachycardia, for example, it can be very difficult to induce and map it.

2. I was sedated for five out of six ablations but didn't have a real general anaesthesia. Other patients stay awake and only get something to relax a bit. If you are afraid of the procedure you should talk to your EP about being sedated, I'm sure that is possible.

3. Recovery time generally is not long, maybe a day or two (in my case). Hospital stay for an AF ablation is from all I have heard and read normally about two or three days, at least here in Germany.

4. When I had my ablations done, I was still a student. I missed school for a week, sometimes just three days. I don't know what your job is but since you are not allowed to lift heavy things for about ten days, you might need to take a whole week or more off.

5. In AF ablations one has to wait at least three to six months before one can say whether it was a success. My EP puts all AF ablation patients on warfarin for three months, and Flecainide for up to six months following the ablation. It happens that patients get some more AF episodes in the first months after the ablation but that doesn't mean that it wasn't a success. It can take a while after the ablation until scar tissue has developed and blocks the fast impulses coming from the pulmonary veins.

Hope this helps a bit. I'm sure others here can answer your questions much better from their first-hand experience.

Best wishes
Inga

AF Definition

by Wannabe - 2010-02-10 10:02:23

Hello Tom - I think you should be aware of the distinction between Atrial Flutter and atrial Fibrillation. I've had an ablation for Atrial Flutter and it's been a complete success. I also have episodes of Atrial Fibrillation and I was told by my EP that the ablation for this arrhythmia is less likely to successful and is more complicated to perform. I am fortunate inasmuch as the Atrial Fibrillation is controlled by Sotolol (80mgs x 2 daily).

I think the medical profession distinguishes Flutter from Fibrillation by the abbreviations they use, i.e. AF = Atrial Fibrillation and FFl - Atrial Flutter. Google cardiac arrhythmia When heaps of reliable sites will come up w explaining the difference between these two very common conditions.

I was given a general anaesthetic when I'd my ablation, but I have to point out I had it done at a private hospital. I don't think you get this option in an NHS hospital. However you'll be heavily sedated, I'm sure, and the worst reports I've heard have concerned the fact that the patients at the NHS hospital are subjected to the manic ravings of Radio Sheffield blaring away throughout the whole procedure!

I hope all goes well and the procedure's a total success. With every good wish. Sheila

Sorry for Typo!

by Wannabe - 2010-02-10 10:02:54

Tom, the abbreviation for Atrial Flutter should read AFl - sorry about that Sheila

:-)

by golden_snitch - 2010-02-11 03:02:03

Hey Sheila,

being a British acadamic in English language there probably is a lot here that drives you mad ;-)

Speaking for myself, I know the difference of atrial fibrillation and atrial flutter. But you are right to say that it's important to point out the difference; atrial flutter ablations are much easier than for atrial fibrillation. At the EP meetings and conferences I attended, the cardios used "AF" for atrial fibrillation.

You sign an informed consent for the EP study and ablation, but if you have a general anaesthesia - at least in Germany - you need to speak to an anaesthesist before and sign another informed consent for the general anaesthesia. Might be different in the UK, though. Sorry I'm being a bit pedantic in this matter but I just think it might scare some people when they hear they get a full general anaesthesia for the ablation. I know lots of people who are afraid of general anaesthesia, of not waking up again and so on... So, I think it's important to tell them that they can be completely knocked out and sleep through the procedure without a general.

Bye
Inga

Thanks

by ScottishTom - 2010-02-11 04:02:57

Thanks for all the replies, I think I have a better picture of Afib and Aflutter, normally the doc or technician has mentioned AF or paroxysmal AF, only at my recent visit has the Doc mentioned Flutter. She told me I was on all the max medication, ameodarone 400 per day, bisoprolol, ramipril, simvastatin and warfarin.

I got appointments thro today for a scan and 24hr monitor on the 8th March. It will decide if they try cardio version again, or go for the ablation.

So from what I have read it sounds as tho an ablation has a better chnace of being a success if it is for flutter. It would be great this sorted out.

Ablation for A. Fl.

by Wannabe - 2010-02-11 06:02:07

Hello again Tom - I say go for the ablation if it's for A.Flutter. Mine was a total success and my A. Fib. is controlled successfully by Sotolol. I also had a cardioversion which got me out of A Flutter, but not for long. The later ablation was astonishingly successful.

Are you a Scot in actuality or of Scottish descent living in the dominions? Perhaps you remember a year or two ago Tony Blair had heart trouble. His was A Flutter which was successfully treated by an ablation. Flutter isn't difficult to ablate - fibrillation is a different kettle of fish (mixed metaphor here - forgive me).

I hope all goes well for you and please let's know how it goes. Thinking of you and wishing you well. Heaps of love. Sheila

General Anaesthetic

by Wannabe - 2010-02-11 09:02:37

Good Morning Inga - I certainly signed a form of consent for a general anaesthetic after speaking to an anaesthetist for both the ablation and for the implantation of the PM. However, as I pointed out above, these procedures both took place in a private hospital and I was grateful to have a general - being a total wimp!

In the NHS hospitals I don't think patients are given the option - hence my remarks about Radio Sheffield being imposed on the poor dears whilst they're on the table. I know this from others who've had it done in the local NHS hospital. Radio Sheffield is peopled by manic presenters whose style is not conducive to relaxation. There may be method in their madness since it will have the effect of getting the patients up and off the table and on the bus home the minute they've been sewn up!

Anyway, with a bit of academic investigation you can include this hitherto unknown option of general anaesthetic for an ablation in your dissertation - there's a whole further chapter there! Best of luck with your research..

Hope you're safe and well. Love, Sheila

Wannabe

by ScottishTom - 2010-02-12 02:02:11

Thanks, this sounds hopeful since they have now called it flutter.

Re your question, yes I am a real 'true Scotsman' :) born in Edinburgh and now in Dumfries. If my name was Tony Blair then I would probably have an ablation tomorrow !

Och well time for work, nearly the weekend.


Tom

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