Had second ablation - how long until a/fib bouts stabilize? Thank you!

Posted by jimbehun @jimbehun, 5 days ago

Second ablation about a month ago; still in and out of a/ fib daily- how long until stable in most cases? First ablation six months ago- frustrating- thank you for any info!

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Profile picture for aard @aard

I talked with my cardiologist a couple weeks after my ablation about the same thing you are experiencing. He said that this was not unexpected and that I was "along for the ride." After my ablation, I was in and out of a-fib for about 1-1/2 months, then rarely for the next couple weeks, then pretty much free of a-fib after that.

Hang in there, hoping it calms down for you soon.

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@aard Thank you for your reply and information! Encouraging to see my situation appears “ normal” from a recovery prospective- frustrating, but must be patient! Best, Jim B

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Profile picture for jayhen @jayhen

@gloaming loop recorders are worn longer than a few days

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@jayhen
Normally, yes, and it depends on the patient's individual needs and the EP's requirements for them as to which of the two he/she will ask the patient to use. In my case it was a Holter, in others it might be a loop recorder, especially is there is concern an ICD/pacemaker is likely to be needed before long.

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Yes, loop recorders are inserted and can be left in up to 3 years. They are more long term, not short

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My question to everyone who had a failed ablation. Did your afib at least improve so you had less frequent episodes or shorter ones? I asked the first EP I saw that question about failed ablations and his flippant response was, “The definition of success is improved.” Did your EPs say that’s the definition of success? My second opinion is next week.

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Profile picture for Zebra @californiazebra

My question to everyone who had a failed ablation. Did your afib at least improve so you had less frequent episodes or shorter ones? I asked the first EP I saw that question about failed ablations and his flippant response was, “The definition of success is improved.” Did your EPs say that’s the definition of success? My second opinion is next week.

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@californiazebra My EP only told me that if his first attempt was not successful that he would gladly try a second time, and that his success rate for second ablations ran about 80%. I didn't ever get to talk to him between ablations, but he was kind enough to take an uploaded ECG from my Galaxy watch as evidence that his first attempt had failed....quite obviously.

I don't know how up-to-speed you are on AF and ablations, but success in the industry means 12 full months free of the treated arrhythmia from the date of the ablation. Some EPs state that an ablation has done some good if the ectopy or AF is diminished substantially, hopefully near 50%, and that would be determined by a Holter monitor assessment near the end of the blanking period. I feel, as do many EPs, that unless the AF is stopped fully, an ablation has not corrected the heart's rhythm and that it will continue to deteriorate or 'remodel' itself the more and longer it fibrillates. It is confusing because ostensibly you can have a qualified 'successful' ablation and then have recurring AF at the 53rd week. You went a full year without AF, so you had a successful ablation. I can't imagine how disappointing that would be, although I have a good idea since my index ablation lasted a whole six days before I had to spend a night in the local ICU starting amiodarone to get my heart back into normal sinus.

I had a horrible recurrence, and that's my side of the story. Second ablation worked. But I know that many patients are grateful for a marked reduction in their arrhythmia after an ablation. Maybe that's the 'improved' definition of success.

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Profile picture for gloaming @gloaming

@californiazebra My EP only told me that if his first attempt was not successful that he would gladly try a second time, and that his success rate for second ablations ran about 80%. I didn't ever get to talk to him between ablations, but he was kind enough to take an uploaded ECG from my Galaxy watch as evidence that his first attempt had failed....quite obviously.

I don't know how up-to-speed you are on AF and ablations, but success in the industry means 12 full months free of the treated arrhythmia from the date of the ablation. Some EPs state that an ablation has done some good if the ectopy or AF is diminished substantially, hopefully near 50%, and that would be determined by a Holter monitor assessment near the end of the blanking period. I feel, as do many EPs, that unless the AF is stopped fully, an ablation has not corrected the heart's rhythm and that it will continue to deteriorate or 'remodel' itself the more and longer it fibrillates. It is confusing because ostensibly you can have a qualified 'successful' ablation and then have recurring AF at the 53rd week. You went a full year without AF, so you had a successful ablation. I can't imagine how disappointing that would be, although I have a good idea since my index ablation lasted a whole six days before I had to spend a night in the local ICU starting amiodarone to get my heart back into normal sinus.

I had a horrible recurrence, and that's my side of the story. Second ablation worked. But I know that many patients are grateful for a marked reduction in their arrhythmia after an ablation. Maybe that's the 'improved' definition of success.

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@gloaming
Thank you for the taking the time to respond. Good info. Glad your second ablation worked. 😊

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Profile picture for sjm46 @sjm46

Just curious but how long did you have A-fib before you got the first ablation? How successful was that one--did you have a period of NSR? What was the goal of the second ablation? Were you on anti-arrhthymic meds? My EP associate (whom I did not care for) said that "you have to wait at least 3 months before the ablation can be considered a "failure.") The second visit following up by ablation (with a differnt associate) was much more helpful and appropriate. The PAC's that I was having for a time after the ablation had almost stopped and I was reassured that this was not worrisome or unusual. I am 80 and my ablation was in November 2025; I have not had an A-fib episode since then. I had paroxsmal A-fib and I decided, after much research, to have it treated ASAP before it "spread" to more frequent episdodes. My advice to anyone with a new diagnosis is to request/demand to see an EP ASAP and get it reviewed and treated aggressively before it becomes more chronic with frequent episodes and requiring heavy-duty meds. That is just my opinion.

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@sjm46
Not sure who your message was for. My ablations were for ventricles tachycardia and PVCs not atrial.

I do have AFIB but is on an off. For that I take Eliquis. I was already on aspirin and the aspirin seem to make minor cuts bleed much more than the Eliquis.

Two things I would suggest is to have a electrophysiologist (EP) who are cardiologist specialized in electrical functions of heart. Second suggestion if you have access to a major medical institution such as Mayo, Cleveland Clinic, John Hopkins to see the most experience EPs you can with great testing equipment and treatments.

I drove 4 hours each way to Mayo for years which came from my primary care doctor is a small city to go there. He worked hand and hand with Mayo. Mayo shared all their treatments, test, with my local PCP and PCP did it with Mayo.

I moved to Jacksonville area in 2015. Now my commute to Mayo is 20 minutes. And after my wife and I got into our late 70s so glad we did. But the community we moved into (Del Webb) has outstanding amenities and activities I probably would have moved just for that.

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