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Failed ablation

Heart Rhythm Conditions | Last Active: Aug 24 5:52pm | Replies (56)

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Ann - thanks for your post. I have been on nearly all the meds for AFib, and they have not worked. I am currently in AFib while I am on 225 mg of Propafenone 3 times a day. The only thing that did work were cardioversions, but while they took me out of AFib - it was for just a short time. My EP and I discussed various ablations, and I have read so much about the PFA that I asked about that. Of course, as you say, so many on this site mention the ablation failing. In addition, my doctor said that with all my other issues (leaking valves, CKD, etc.), it would probably not be successful. He has recommended the Pacemaker ablation (he calls it a "simple" ablation). I already have a pacemaker; I had to get one when one of the AFib meds put me into bradycardia, and I passed out. I am scheduled for the AV Node Ablation later this month, and I am very anxious about it, so I appreciated your message. Yes, he told me that I would still have AFib in the atria - but the ventricles will have a normal pulse. My major symptom with AFib is my being short of breath. He told me that I would no longer have that issue. However, you indicate that your breathing is compromised when you go into AFib. So, I guess I will have to "wait and see" how this ablation affects me. Glad you are six weeks out, and all is well with you - and you are "keeping on"!

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Replies to "Ann - thanks for your post. I have been on nearly all the meds for AFib,..."

There is such a thing as 'RVR' which is 'rapid ventricular response'. It isn't good having AF, but when the left ventricle contracts in the same frequency, this can be a slow recipe for disaster. The heart is a muscle, after all, and muscles to need to have periods of low activity/low demand. If you're sleeping, but still in AF, and also in RVR, the left side of your heart is getting no rest, and will eventually lead to heart failure due to enlargement of those vessels' walls.
An AV node destruction stops the rapid ventricular response (RVR), but it does not normally also stop any further AF. AF occurs because of a 'leaked' electrical impulse emitting from one or more places inside the left atrium that causes it so contract chaotically. An ablation is meant to place a 'dam', a circular dam, of many small lesions around the 'focus' or reentrant where this extra beat signal enters the left atrium. Those lesions become scar tissue, over which the electrical impulse cannot pass. No passage, no extra beats. AF stops. That's what ablation is meant to do. There is no ablation, no lesions, when doing an pacemaker implant.