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Svt

Heart Rhythm Conditions | Last Active: Jan 19 8:58am | Replies (16)

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Profile picture for gloaming @gloaming

Just going by what you say your EP said about you, you are in at least long-standing persistent AF, but you may have gone on further into permanent AF. Each successive stage of AF is more difficult to treat because it usually means all six walls of the atrium are affected by rogue firing cells. In early AF, paroxysmal, only the area around the pulmonary veins is affected, and ablating that area is relatively straightforward, and the quickest of all the procedures. It has the highest rates of success.
I don't think anyone is particularly tickled that they need their heart 'burned' in order to be rid of the discomforts of AF. However, the procedure is now widely accepted as the 'gold standard of care' for AF patients. The reason is what I just explained earlier: getting it early is simple, effective, and gives long term relief. It gives long term relief from the sometimes horrible symptoms, but it also gives long term relief from the dangers associated with more advanced stages of AF (atrial enlargement, mitral valve prolapse, deposition of collagen and its resultant fibrosis in the underlying substrate, and possibly heart failure).
Try to learn as much as you can about ablation. Your goal is to be so enlightened that you literally can't wait for it to happen. That is where I was after reading a lot of research and watching several excellent YouTube videos (go to YouTube and search for 'AFib Education Center' and watch Dr. Lee's videos. They're quite good). I was so happy when my cardiologist asked me, after a hospital visit for AF, if he had ever mentioned being referred to an electrophysiologist to me. I replied that no, he had not, but that I was very happy he was mentioning it now. He didn't raise an eyebrow or ask me why, but he knew me well enough that I was soaking up everything he threw at me and I was able to discuss my case knowledgeably by then...so he must have put two and two together an understood that I knew what he was offering. You need to be there as well...educated, reassured, confident, and very, very eager to get this AF under control!
I have had two ablations. Why two? Because the failure rate for index ablations (first attempts) is 25%. This is because the lesions generated during that first go did not completely seal off the source of the extra beats, which are almost 100% certain to be around the mouths of the four pulmonary veins at the back wall of the left atrium. Chalk up this failure rate to conservatism. The EPs are loath to cause more damage than is absolutely necessary, and the cauterizing does damage to tissue. They want to spare the phrenic nerve and the soft tissue of the esophagus, both of which pass right behind the left atrium's posterior wall. They burn less, and if they fail to close it off, they'll offer to do it again. Happened to me, and I'm now 30 months free of AF.
Try to find security and reassurance. Get a really good, top notch, EP, get in line, and hope for the best. Learn all you can about the procedure, remind yourself that it's just day surgery, just like a colonoscopy or a laparoscopic procedure like an appendectomy. Most patients are discharged by supper time and your friend/relative drives you home.

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Replies to "Just going by what you say your EP said about you, you are in at least..."

@gloaming A week ago I had a second ablation for SVT but my symptoms came roaring back after the third day. Does it take awhile for symptoms to settle down? I think I prefer ablation to flecainide so how do I find "a really good, top notch EP?"