Anxiety and frustration after cardioversion after 3rd ablation

OK, I don't think we disagree except for semantics. I don't think AFIB is a disease so much as a condition, so if you can make it go away permanently, as I hope, and it seems maybe you have, then it isn't wrong to say it is CURED. Ask you EP about the book, Dr's Day and Bunch, the authors are well known experts in the field, and yes they agree with you that "Ablations are good" Thanks,

Ted, it is very solidly progressive. As different people will tell you, they can go a good long time between visits to a cardiologist or back to an EP. Over on afibbers.org, the admin there had five ablations between three different EPs until he finally found out about Dr. Andrea Natale in Austin. He is now almost eight years AF-free. Previously, he was back in AF within a few months to a year. Other frequent posters there have gone several years, but they've all agreed that eventually they had to undergo yet another ablation because they began to get fibrillation again. It is an incurable disorder/disease (it is called both), but like some other conditions, it can be controlled well with proper care from a care provider and the patient, him/herself.

This site says, "...almost always progressive..." https://www.webmd.com/heart-disease/atrial-fibrillation/afib-gets-worse
This citation says '..chronic and progressive...' : https://pubmed.ncbi.nlm.nih.gov/33516398/
Scroll about 1/3 of the way down this page to where in bold it asks about AF going away:
https://drafib.com/blog/what-is-paroxysmal-atrial-fibrillation
Yet another 'almost always': https://health.clevelandclinic.org/atrial-fibrillation-dispelling-6-myths/

It is always the case that there are 'outliers' who beat the odds. Perhaps one out of 10-to-15 persons diagnosed with AF will need little or no treatment over many years. But the very heavy majority will need it strictly managed, and even then there will come a day when things change and they'll need another tool in their pocket to deal with it.

Obviously you are well studied on AFIB, so I won't argue that you are wrong, but the point of the book is that AFIB is caused by certain lifestyle choices we make and those can be corrected with a concerted effort, good medical advice/guidance, and the intervention of an effective ablation. The book is quite clear that an ablation alone won't permanently cure AFIB if the patient persists in the behavior that caused it in the first place. So yes, I agree with you that most cases recur, but the very fact that some don't should indicate that AFIB can be cured.

I had my first Cardioversion last Monday, 13 November. Four days later, my A/Fib returned. I'm now waiting for the next move, whatever it may be. I have to say, this is frustrating.

treeman, I have had two ablations. I was in the ER with more fibrillation within six days after the first attempt, and had to resort to the huge hammer that is Amiodarone in order to tame it. Seven months later, the same EP performed a corrective ablation which, happily, seems to have done the trick.

However.....two months after I stopped the Amiodarone, apparently in NSR again, I suddenly returned to AF. Over the next six weeks, I had three cardioversions. The first lasted 16 hours, the second about four, and the third I was back in AF after a whopping 20 minutes. Nobody said as much to me, but I concluded that my heart had indeed finally remodeled itself to be in persistent AF. Fortunately, that second ablation was soon enough and all seems good.

What I have shared isn't much encouragement, sadly, and I do understand fully what you are experiencing. It was unnerving for me. It led to not a little anxiety, and my quality of life suffered. If I could share another development: two weeks after my second touchup ablation, I went into AF again. I was aghast! What happened? I had done so well over the previous two weeks! I was put on metoprolol again and told to go home.
My heart did convert just as I was being released, so at least I went home with that much. I called the AF clinic's outreach nurse, a queen if there ever was one, who was adamant that my heart had been fixed. She said emphatically, "No, you do not have atrial fibrillation right now. Your heart is cranky and it needs a little encouragement. Also, you absolutely should have been cardioverted because your heart today is not the heart is was prior to the ablation two weeks ago. Your attending physician was wrong to deny you a cardioversion." She went on to say that my heart needs some metoprolol and some healing, and that it will show signs of that before long. She was absolutely correct: within two weeks I was off metoprolol again and I have not looked back.

You say it's frustrating. Yup, and very discouraging if you're being honest....right? Been there, and so have a great many of us. If I have any credibility here, I strongly urge you to get into the books of a highly sought and highly accomplished electrophysiologist, even if you have to travel and stay in a motel two or three nights, and get a catheter ablation. While drugs come and go, and cardioversions come and go, that fact is that this progressive disorder is going to get worse unless you undergo a truly remedial measure...ablation. The lesions and scarring that the procedure produces around the pulmonary veins acts as a stockade, or a fort, around the area where the spurious electrical signals gain access to the endothelial lining of the left atrium. Blocking them means they can't get out and make your atrium beat ectopically. I can't begin to describe to you how gratifying and reassuring it is to find your heart back into its welcome normal rhythm days, weeks, and months after a successful ablation. One fly in the ointment: even the vaunted Dr. Natale at the Heart Rhythm Clinic in Austin will tell his clients that he'll probably have to do a minor touchup in a few months. Sometimes, he's right.

@gloaming very well put and
@treeman1942 Yes typically after an ablation your heart needs to heal so expecting some minor rhythm issues is normal. But they will subside. I'm not a afib person as I had VT but ablations are the same no matter the condition. I've had quite a few and i was told typically about 1-3 months for the heart to reap the rewards of the ablation in full. Hang in there.

Good morning, Mr/Mrs/Ms Gloaming,

Thanks so much for your kind reply. I expect my cardiologist will call this morning, but the next move should be the ablation procedure, at least in my opinion. I have lost confidence in cardioversion and am willing to do anything to get back to normal. However, since taking the Metoprolol and the short-lived cardioversion, my energy level has at least doubled, sleeping far less, etc. As you advised, I will request an appointment with an electrophysiologist, which my cardiologist says is available through my health system. Thanks again.

Good morning, Dana,

I did not have an ablation, just a cardioversion. However, my following procedure will probably be the ablation procedure.

Just a little update since my av node ablation & my pacemaker. Ot is the best decision I have ever made. No more afib, no more in and out to A& E for cardioversions. Once I healed after pacemaker insertion I have much more energy etc. A much better quality of life. It does take a little while to adjust , mentally, to the pacemaker. I was anxious for a little while but now after nearly 2 months I don't even think about it. That's my story and I really hope it helps someone who may have to have the procedure.

I have had the same experience with PM. I had enough of the interim, wasted time ‘’stuff’’to give medical student’s experiences to practice cardioversion, etc. All that accomplished was prolonging the real need of pacemaker when my heart stopped several times, signaling immediate need of better, more appropriate treatment. I LOVE my pacemaker! My ‘’Getting used to PM’’ lasted about 2 hours! Just find competent cardiologists and DO it!