How long does an ablation last? Are multiple ablations possible?

I am only one year into my A-fib diagnosis; I have had only 5 short "outbreaks" of arrhythmia since I was cardioverted on 12/04/24. I insisted on getting an EP involved after the third time when I actually went to the ED with a pulse of 130. I converted on my own in the ED but I decided not to live like this. I have an ablation scheduled for 33 days from now (but who is counting!) The trial on Flecainide that I agreed to was just too troublesome to me; the Black Box warnings scared me! I too have watched videos and read lots of articles about A-fib and it is a "no cure" condition but it is also a "can spread" condition, so that's why I want to get this in control before I have a "forest fire" instead of a "small trash fire." As for those labels that tend to annoy people like you and me, I have found that everything my husband and I get diagnosed with are "chronic" even if we have no real symptoms! He was just "identified" as having COPD due to a low blood oxygen level but he has had that for years and no doc ever bothered to address it until now! He's listed as prediabetic even though his A1Cs have never been over the top limit! I have "osteopenia" which is a BS diagnosis since almost 70% of women my age have some form of bone degeneration--and the doc NEVER suggest what I should do about that except to try to give me another troublesome medication with very serious side effects, too! As for A-fib, my cardiologist at the very beginning of this experience told me "don't worry, A-fib won't kill you!" Well, it won't technically kill you, but then you learn all the unfortunate things that it can trigger--like increased risk of strokes and heart damage and weakness and dizziness and depression and anxiety--and it seems to me that his casual attitude toward my initial concern was misguided. I hope you stay in NSR and I am betting you will; my brother had an ablation and he's been fine for 10 years. I made all sorts of lifestyle changes and I am very confident that I will be better off too. What I have learned from this site is that we all need to be our own advocates for the best treatment plan for us! If you get blown off by one doc, find another. I have an EP who is top rated in my state and I am really looking forward to getting this done and hopefully living more confidently with my "chronic" condition. Stay positive!

I am only one year into my A-fib diagnosis; I have had only 5 short "outbreaks" of arrhythmia since I was cardioverted on 12/04/24. I insisted on getting an EP involved after the third time when I actually went to the ED with a pulse of 130. I converted on my own in the ED but I decided not to live like this. I have an ablation scheduled for 33 days from now (but who is counting!) The trial on Flecainide that I agreed to was just too troublesome to me; the Black Box warnings scared me! I too have watched videos and read lots of articles about A-fib and it is a "no cure" condition but it is also a "can spread" condition, so that's why I want to get this in control before I have a "forest fire" instead of a "small trash fire." As for those labels that tend to annoy people like you and me, I have found that everything my husband and I get diagnosed with are "chronic" even if we have no real symptoms! He was just "identified" as having COPD due to a low blood oxygen level but he has had that for years and no doc ever bothered to address it until now! He's listed as prediabetic even though his A1Cs have never been over the top limit! I have "osteopenia" which is a BS diagnosis since almost 70% of women my age have some form of bone degeneration--and the doc NEVER suggest what I should do about that except to try to give me another troublesome medication with very serious side effects, too! As for A-fib, my cardiologist at the very beginning of this experience told me "don't worry, A-fib won't kill you!" Well, it won't technically kill you, but then you learn all the unfortunate things that it can trigger--like increased risk of strokes and heart damage and weakness and dizziness and depression and anxiety--and it seems to me that his casual attitude toward my initial concern was misguided. I hope you stay in NSR and I am betting you will; my brother had an ablation and he's been fine for 10 years. I made all sorts of lifestyle changes and I am very confident that I will be better off too. What I have learned from this site is that we all need to be our own advocates for the best treatment plan for us! If you get blown off by one doc, find another. I have an EP who is top rated in my state and I am really looking forward to getting this done and hopefully living more confidently with my "chronic" condition. Stay positive!

@suerte
Thank you for sharing your story. That’s helpful. I saw a local EP who was recommended and takes on complex cases that others won’t take or where others have failed. Told me no one has done more PFAs than he has. He predicts my afib case will take 2-3 ablations. There is another EP in the next county who was the first to do PFA and states he has the most experience. I’m thinking about getting a second opinion to see if he also thinks 2-3. That’s hard to hear up front, but I’ve been in paroxysmal afib 30% of the time in recent months and frequent for 5 years. Very symptomatic. Exhausting condition and hard to hear that estimate and even then no guarantees and told it will likely come back with more ablations needed. Rate control didn’t go well — scary and never again. Recently ended up in the hospital from a scary TIA and aphasia after afib. That got my attention. Have also had a few retinal TIAs after afib. Started Eliquis low dose now but have to double to qualify for ablation. Don’t metabolize meds well with missing liver enzymes so that scares me. Have added risk for nerve damage during ablation due to a rare hereditary neuropathy where light pressure can case nerve damage. All very worrisome. Talking to my regular cardiologist again today. We’ll see how this all plays out.

I definitely hear your concerns; it sounds like you do have a complex condition and I am very empathetic. From what I have read, it can take more than one ablation if there is a complex situation with many ectopic foci to deal with. I think it sounds like you have found an EP who is at least up front with what it will take for some resolution. I also know what you mean about the medication issue. Some people can tolerate them, but others can't. It is not "one size fits all." I am also surprised that you were started on low dose Eliquis; when I asked my cardiologist if I could back off the regular dose after several months of NSR, he practically had a fit about my trying to treatment plan. I don't know what your age is but I thought being close to 80 and pretty lean would qualify my taking a reduced dose and he made it clear that he didn't agree. I had to take Eliquis for a month before he would even allow me to have a cardioversion. The TIA you mentioned is truly scary. You do not want to have a stroke; it is very risky to not address that. I don't know what I think I would do if I were you; maybe seek out a specialized clinic where they are doing the latest research for a second opinion? Some of those large medical centers really want to handle complex cases and if you could afford to go somewhere that has the latest techniques, it might be worth it. It sounds like you really are seriously bothered by the symptoms, as I am when it occurs. I seriously don't know how anyone can "just live with this." I wish you the best; keep asking questions and decide to do what is best for you.

I have had 2 ablations, and they were 6 months apart and unfortunately, my AFIB returned about 2 to 3 months after my both ablations. Of course, you are only 20 years old and I am 80 years old so I more than sure that it's my old age that my ticker is not working as it should. I have other serious issues with my heart such as congestive heart failure, pulmonary hypertension, coronary disease and high blood pressure.

I also read an article that an individual has had 50 ablations and none of them have worked out for that person.

I told my Cardiologist that I don't want anymore procedures of any kind on my heart because to begin with i am too old and too tired.

@sjm46
Thank you for your thoughtful response. I’m sorry you’re dealing with this too. I had also read at your age they sometimes reduce the Eliquis dose but it seems they have no way of knowing if it’s effective. The EP flat out said no to low dose Eliquis. I’m 66. It was the ER doc and hospital neurologist that allowed me to do that as better than nothing. Just saw my cardiologist who talked me out of that so I’ll be starting 5 mg dose today. He’s so afraid I’m about to have a full stroke. I’m also trying to get in for a second opinion ablation consult at a tertiary facility in the next county. That EP there is waiting to receive my records and referral from my cardiologist for review before he’ll see me. Two month wait for consult appointments right now.
I finally decided I can’t take the stress of the afib stuff anymore and will just move forward with treatment and pray for a good outcome. I’m hoping this other EP will have a better prediction about my case. Another reason I’ve delayed treatment is because I’ve also been in treatment for two kinds of cancer for 5 years, one is recurrent, and figured that would get me first. That treatment is actually what started the afib issue. I didn’t expect to be here now but I'm doing well on treatment so far so it’s time to deal with what has become life ruining afib issues. Thanks again for your response and I hope everything goes well for your as well.

I can really understand your situation now! Boy, are you a brave soul! I love your attitude; go for quality of life! My motto: it's not the time in your life, it is the life in your time here. You deserve to feel as good as possible regardless! And you don't want a stroke! Good luck with your consult and go loaded with all your questions in writing, so you don't overlook anything! Hopefully you'll get a good EP doctor who will listen to you as an individual. Best wishes.

@sjm46
Yes, the EP needs to be a good listener as well as skilled. One can hope.

Quality of life is definitely my priority. I learned a lot watching my brothers battle and die way too young from cancer. When one had stage 4 esophageal cancer and in decline, a surgeon noticed very suspicious moles. So they did 30 deep and wide biopsies each requiring several stitches that left him even more miserable. I couldn’t believe it. 12 turned out to be stage 1 maybe 2 melanoma. Who cares about that? Ridiculous to put him through that. He died a few months later from his esophageal cancer. I’ve tried to learn from their experiences.