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Hello my friends at Mayo Connect,

I have posted on several topics on Mayo Connect and have always had such good advice and comfort from all of you. I just need a little support and prayers concerning my second ablation happening on May 22nd.

I had my first ablation almost two years ago and becasue of an enlarged upper atrium and scarring, it was not an actual success. I was put on a small dose of flecainade and an increased dose of metoprolol along with my Eliquis and aside from not wanting to be on medicine, everything was fine and I did not have an Afib episode until a year and a half later.

My EP continually added more flecainade and metoprolol until I felt like I was walking thru mud daily. My heartrate was at 44 to 55 and I was having continuous events that became atrial flutter. My EP and I decided it was time to try again with a second ablaltion.

I was scheduled for April 12th of this year but a week before the procedure I received a phone call that my ablation was cancelled and my EP was not scheduling at this time. No one would give me the reason. I waited for several weeks and then consulted with another EP in the same group whom I absolutely loved. He told me I was overmedicated and immediately took me off of more than half of my medicines. My heart rate became normal and I had less episodes. My goal is to come off of flecainade because I live in fear of needing an antibiotic and flecainade, for me does not pair with any antibiotic. They would have to remove me entirely from this drug while I was on an antibiotic.

I am going to have my second ablation with this new doctor. I want so badly to become the person I used to be before I was diagnosed with Afib. My husband believes things happen for a reason and God has a hand in this.
I might never know the reason why my original EP is not doing procedures right now. He took care of me for at least 6 years but I was never comfortable with him and he was never positive with me. Hopefully, this new doctor will help me.

My question is…if the first one didn't work, what makes the second one work? I am finding myself so anxious about next Monday the 22nd…about the ablation and the recuperation period. I just need to hear some positive feedback from some of you so that I can breathe deep and relax.

Thank you so much,
Bless all of you,
CeCe 55

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Replies to "Hello my friends at Mayo Connect, I have posted on several topics on Mayo Connect and..."

It is such an anxious time isn't it. I know exactly how you feel about wanting to breathe deeply & relax. All I know is that it is very common to have a second ablation and this might be all you need to solve your afib. Huge success rates with second one. I wish you all the best .

Different situation. I had problems with arterial fibrillation and the ablation was performed to deal with that. To the surprise of everyone, I then began to have very serious Ventricular tachycardia. The rate was below the lower limit on my pacemaker. With help from the St Jude software engineers and local rep, the docs were able to reprogram the device to avoid the worst but not all. I then had a second ablation, very comprehensive, I was in OR for 6 hours. As a result, although I still have some PCs (which ablation doesn’t stop), for a year and a half no more a-fib or v-tac. In my case, the second ablation was a great success. Of course every case is different.

Hi CeCe, Yes as others have said my second one was a resounding success. I believe the reason was that during each one they get a baseline of what parts of the heart have issues. I've been told also that there is a limit to how much can be done during a single ablation so with a second, they already have some information from the first one to add to what they learn during the second one. So I hope that helps ease your anxiety and Ill put in a good word with the man upstairs. I completely agree that God does play a role. Prayers for the comfort and great outcome you seek.

CeCe55, it is exceedingly common for first ablations to fail. The reason is that the heart tissue is inflammed due to the burning (lesions), and the idea is that the lesions will eventually form scar tissue through, and around, which the spurious/extra signals cannot pass. The whole idea behind ablation surgery is to create scarring which dams, blocks, stockades, or cages (take your pick of descriptor) the signals from emerging from the pulmonary vein ostia and causing the atrium to contract chaotically. When a first ablation fails, the answer is simply that the eventual scarring that forms during the blanking period (ten-to-twelve weeks after the surgery) does not fully fence or block the entire circumference of the pulmonary veins. A second ablation will succeed because so much of the 'necessary' scarring as already taken place, and now the EP only has to begin to find the hole in the dam. In my case, they watched while they zapped three of my pulmonary veins. They didn't have to do the fourth vein because when they did one of the zaps, my heart immediately resumed normal sinus rhythm on its own. They stopped at that point (while do more scarring than the job needs?!), and my EP said he didn't even have to cardiovert me with shock to restore my normal rhythm, something that he and other EPs do routinely after catheter ablation. Yes, there were high fives all around when my heart thudded back into the normal thump-thump,…thump-thump. And, as you would probably enjoy hearing, I am now 14 weeks out and I feel SOOOOOO much better. People tell me I looked grey before the surgery, and that my demeanor is much improved. You can look forward to that.

Just one little tip. Remember that it is normal to have some bits, short runs, of AF during the blanking period, particularly in the early three-four weeks. If this should happen, and your rate remains above 100 for long, go get cardioverted. It is the right thing to do because your heart is not longer the same heart it was before this last ablation, and it needs to be shocked back into the proper rhythm. Since AF begets AF, don't let it go longer than 24 hours.