When should you get an Atrial Fibrillation Ablation?

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Interesting presentation – BUT – In my opinion the risks of further heart damage or even heart failure posed bu staying in afib are NOT worth the risk.  Remember also Afib begets mere afib so do what is possible to get in normal sinus rhythm.

This is an invasive therapy in which a variety of catheters (wires) are inserted through veins in the groin into the heart. The purpose is to ablate (or “zap” away) different areas of the left atrium (the left upper chamber).
Several important factors to keep in mind:
*The success of ablation in patients with paroxysmal AFib is between 60-70%. This is much lower than most other ablations for other heart rhythm disorders. If one has more persistent or permanent AFib that rate drops even further.
*It is not uncommon to require more than one ablation for AFib. Usually 20-30% of patients will require a second or even third procedure.
*This procedure is generally not considered first line therapy , and should be reserved for patients that are quite symptomatic, and have often failed medical treatment.
*One may still have AFib post ablation, and yet have reduced symptoms. The patient may feel better, but may still require blood thinning medication.
*Often, post ablation AADs that were previously unsuccessful now work well. This is know as hybrid therapy — combining more than one treatment modality.

Comments

John Shirk says:

Thank you for the reassuring information. ?

Dan Walter says:

Catheter ablation for Afib is a corporate-driven procedure that is riskier
and less effective than advertised: Look up collateral damage by dan walter

Peter Capozzoli says:

As an aside, timmersbc says ablation was a first resort for him… but then
goes on to say he was so symptomatic, he couldn’t even tie his shoe AND he
is into 2 ablations and has no assurance of long term durability of the
ablation as it is only 1 year out… it proves the doctor’s point…
ablation is not as successful as touted, many times takes multiple
ablations and maybe you will be asymptomatic afterwards, yet still have
afib needing anticoagulation… that is defined as a success. Thanks.

1weezergeezer1 says:

Thank you for taking the time to present this, Appreciate your good honest
and unbiased advice !

Peter Capozzoli says:

This is a great video. I hope he does a followup video covering afibbers’
(on rate control and anticoagulation) concerns about avoiding more
electrical and physical remodeling of the heart from being in persistent
afib and not falling into heart failure. Sites promoting ablation and maze
procedures always mention heart failure, remodeling and stroke as a reason
to have a procedure for the asymptomatic. This video clearly states that
ablation is for symptoms and not to affect longevity.

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