Isolated Atrial Fibrillation Episodes: Is Ablation a Good Fit?

Posted by dao @dao, Dec 23, 2024

I have atrial fibrillation. I have very isolated episodes. The last one was in the summer of 2021.

A good friend also has AF and had ablation. He mentioned that in his recent discussion with his cardiologist, the cardiologist told him that ablation was being questioned due to new scientific findings. I could not find this information anywhere in my research.

I don't want to second guess my friend's comment, but I wonder if anyone here has heard of this supposed new research?

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

@buffyo

I had a PFA on 12/9/24. In addition to PVI, the EP used it on the back wall of my left atrium where there was evidence of scarring from AFib.

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Thank-you for your report. I'm always open to learning...or to unlearning...as the case may be. I'd love to know more about this because it seems to broaden the use of PFA.

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@buffyo

I had a PFA on 12/9/24. In addition to PVI, the EP used it on the back wall of my left atrium where there was evidence of scarring from AFib.

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I forgot to mention that the pulmonary veins are on the back wall of the left atrium, so it stands to reason that the practitioner would us the PFA applicator in that location. The applicator can't be used in the Left Atrial Appendage.

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@JustinMcClanahan

I'd like to remind members of the Community Guidelines (https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/), in particular:

2. Remain respectful at all times.
- Exercise tolerance and respect toward other participants whose views may differ from your
own. Disagreements are fine, but mutual respect is a must.
- Personal attacks against members or health care providers are not acceptable. Such posts will
be removed.

@jay71, it seems as though there may have been a misunderstanding. I believe @gloaming's intent with their questioning was to educate not only the members, but themselves in regards to your provider's confidence in PFA. It is important to remain respectful as we all navigate difficult medical decisions, especially in written communication where intent is a tad more difficult to decipher.

@jay71, You mentioned your provider is a head cardiologist and is confident in their treatment decision. Has your cardiologist performed the PVA before and discussed how the procedure will work compared to other ablation's you've had?

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He always explains everything to me, he has explained how it works, given me information on it, websites etc, he is very very good.

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Some posts have been removed to help the conversation get back on track and to focus on the issues and concerns originally asked by @dao. Posts calling out other members will be removed moving forward.

While remaining respectful, we must also be careful not to give medical advice or the appearance of giving medical advice. Through our own collective experiences, we often become knowledgeable in our diagnoses, but that is not a substitute for working with a provider and medical expert.

Dealing with anything related to our hearts is a big concern and navigating the treatment windows can be as mentally taxing as it is physically. @dao started this conversation facing such a diagnosis and wondering if secondhand information about new information ablation procedures is/was accurate.

I ask members focus on helping one-another and offering moral support as well in addition to suggestions on questions to discuss with your providers. @jay71, it sounds like you have full trust in your provider and they do a great job of explaining how and why they choose the treatments offered to you. That is a great relief when you have that kind of synergy between provider and patient. @dao, were you able to gather any more information from your provider on whether or not ablation is a good fit for your situation?

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@JustinMcClanahan

Some posts have been removed to help the conversation get back on track and to focus on the issues and concerns originally asked by @dao. Posts calling out other members will be removed moving forward.

While remaining respectful, we must also be careful not to give medical advice or the appearance of giving medical advice. Through our own collective experiences, we often become knowledgeable in our diagnoses, but that is not a substitute for working with a provider and medical expert.

Dealing with anything related to our hearts is a big concern and navigating the treatment windows can be as mentally taxing as it is physically. @dao started this conversation facing such a diagnosis and wondering if secondhand information about new information ablation procedures is/was accurate.

I ask members focus on helping one-another and offering moral support as well in addition to suggestions on questions to discuss with your providers. @jay71, it sounds like you have full trust in your provider and they do a great job of explaining how and why they choose the treatments offered to you. That is a great relief when you have that kind of synergy between provider and patient. @dao, were you able to gather any more information from your provider on whether or not ablation is a good fit for your situation?

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I called to have an appointment with him and I am still waiting to get an answer. I will try communicating with people here what comes out of our conversation. Thank you for your help.

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I reread posts by @gloaming and nowhere did I see any medical advice. Just because posts may have some dense medical info and personal experience, does not mean it is advice.

I am unaccustomed to the kind of hostility expressed recently in this thread, particularly in light of the very considerate and often quite humble posts by one of the more knowledgeable participants here.

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@windyshores

I reread posts by @gloaming and nowhere did I see any medical advice. Just because posts may have some dense medical info and personal experience, does not mean it is advice.

I am unaccustomed to the kind of hostility expressed recently in this thread, particularly in light of the very considerate and often quite humble posts by one of the more knowledgeable participants here.

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Good comments. I appreciate the postings by @gloaming and many others. They have always been filled with helpful information and shared experiences. The only advice I've ever noted is for everyone to seek out experienced healthcare professionals, be informed and for each individual to follow the treatment they feel is best for them.

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@gloaming

PFA is currently only approved for a simple PVI, or pulmonary vein isolation. I am not an expert in this field, but it seems to me that, after three previous ablations, the area around your pulmonary veins should be well scarred. So, you may have another focus, or re-entrant, for the new signal, and it won't be in a place where PFA can be applied. Again, maybe I'm not up to date and it is now approved for other areas of the left atrium. Last I knew, it was only to be used at the pulmonary vein ostia, or where they empty into the left atrium's posterior wall. So I'm curious as to how your EP knows that he/she can use PFA....for a fourth application.

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You have to be careful. We had two cardiologists in Maryland get caught over-diagnosing coronary artery disease so they could do unnecessary stents. I lost two teeth from a Maryland dentist who pretended to provide the necessary dental care so he could offer more expensive procedures. I would not be surprised if there were Cardiologists who under-treat patients so they can do more procedures. It may be worth getting a second opinion if it takes more than one ablation. What are they going to do, burn/scar your entire atria?

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@obdoc2001

You have to be careful. We had two cardiologists in Maryland get caught over-diagnosing coronary artery disease so they could do unnecessary stents. I lost two teeth from a Maryland dentist who pretended to provide the necessary dental care so he could offer more expensive procedures. I would not be surprised if there were Cardiologists who under-treat patients so they can do more procedures. It may be worth getting a second opinion if it takes more than one ablation. What are they going to do, burn/scar your entire atria?

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I agree totally. Doctors are given protocols that lead to handfuls of meds and yucky procedures that may or may not work and be worse than the issue. I have gotten rid of more health problems through nutrition etc. The docs did not help me and if I asked one question they would not look up because they were doing their reports or making out my bill. I know people who inject insulin but eat garbage and sweets because the doc says that they can adjust with meds. I know people who have died from cancer and spent the last year of their life in the hospital, doc office and taking chemo etc. and said if they had to do over again, would just live til they died. I know only one neighbor who lived through it so far. I have story after story of why I do things different. I am 76 and have a list of 37 people I knew that died, many smoking or drinking til they could no longer breathe.

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I have been diagnosed with AF Rapid and Persistent 5 years ago with Stroke and 4th day during a scan Papillary Thyroid Cancer.
I stay out of the actual debate on which ablation is best because of heart structural damage I can't consider one or cardioversion or anti-arrhymic med like Flec..
But I do read the overall debate on those debating to have an ablation vs meds. I have earlier nursing and read medical information by joining research papers. Radcliffe Research is very good.
My own information
Ablation procedures causes scarring - unable for the areas to be returned. Some say the scarring is success because it stops the rogue electrical way.
There is radiation used during the procedure which is not explained. The surgeons who do the procedure wear heavy aprons and some hide behind glass.
The balloon procedure is very successful.. But at one stage the balloon were collapsing.
% of success vary.
A cardiologist who has done ablations and stopped are very knowledgeable.
Its like me being under an Endocrinologist for my papillary cancer. She wanted to wait 6 months after stroke whereas surgeon and anaesthetist said asap. She wanted me to have RAI post op and TSH suppression when I said no and no. My surgeon said to her "we should respect Joy's decision'. No respect was taken over Joy's age 70 nor my heart condition and with AF.
Overall I saw a friend have an ablation - catheter where he discovered that he had two rogue electrcal responses doing on. These two were stopped, my friend relieved at last and tells no AF in 3 years. He was a success story.
Meds vs waiting for a better way to eleviate symptoms.
Always your decision to proceed or not. Ablation is a money making procedure overall and it is important that some push it when the med pathway is another.
cherio jOY. (Tuckie)

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