Skip to comments.Ablation treatment for AFib(Vanity)
Posted on 03/24/2012 6:02:18 PM PDT by calex59
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I had RF ablation surgery 12 years ago, to correct recurring episodes of tachycardia. My heart rate would take off to 200 bpm. I was awake during the procedure, with only very mild sedation. The scope probe was inserted in one side of my leg and the tool was inserted in the other.
First, the cardio electrophysiologist triggered the tachycardia and mapped the electrical path of the short circuit. Next, he burned the short circuit connection with the RF probe, just like cutting a wire. I could feel my heart take off during the testing.
There was no pain with this procedure. I don’t recall how long the surgery took. After it was over, I had no more tachycardia events.
About 6 years after the surgery, I developed an occasional irregular heart beat. This was found while I was preparing to have rotator cuff surgery. This problem was deemed to be not serious, and I was cleared for anesthesia on this and a couple of other occasions since.
I chose the RF ablation option instead of trying medicines, which might or might not have worked, to control the tachycarda. The doc said he could fix the problem, and he did. I would have the surgery again.
Good luck with your condition and with the surgery if you decide to have it.
I have some friends who are competitive cyclists (masters age categories, and high level) who have had the ablation treatment for afib and tachycardia. One of the had the cryo-ablation instead of the microwave ablation. It was part of the US clinical trials, since the procedure at the time was approved in Europe but not in the US. Cryo-ablation is supposed to leave less “collateral damage” than hitting the area with a high frequency RF current.
“Basically, they kill you by stopping your heart... wait 30 seconds. . .then try to jump-start you using the usual paddles. 1 time in 20, you stay dead.”
This is absolutely, totally and completely untrue! They never stop the heart with cardioversion. They use a regular defibrillator at reduced voltage levels to administer the jolt. It does not stop the heart, but merely “reboots” its rhythm. Sometimes it takes 2 or 3 jolts. You never flatline. Normally, they put you under with a very short acting anesthesia like Propofol. Compared to the use of extreme metabolic toxins like amiodarone for chemical conversion, cardioconversion is a vastly preferable option.
I personally worked for a medical device company that designed devices that treat afib. I worked for AtriCure as an engineer. Trust me, they are the gold standard for treatment, and have the largest market share in RF-based afib treatment. If the doctor is quoting 73%, that should be the AtriCure device. AtriCure is the only company that has FDA approval for afib treatment with an RF device.
Of course, it really depends on what kind of afib you have to determine your real success rate.
You can do an open procedure (like the original MAZE but they don’t cut the heart), or minimally invasive. The open procedure does a few more ablations and cures more patients. The minimally invasive can be really nice since it is done on a beating heart. AtriCure has some new devices that can almost do the complete maze minimally invasive.
AtriCure also has an AtriClip which is approved by the FDA. It is clamped over the left atrial appendage (which is where the blood clots originate when you are in afib). They used to use an Ethicon EZ45 stapler to remove the appendage. I was told by a surgeon that the stapler is the most dangerous part.
I have been in the OR during numerous procedures and it is pretty straight forward for an experienced cardiothoracic surgeon. The signals were always confirmed blocked (by a cardiologist or the surgeon himself).
Some surgeons work through a thoracotomy. There can be more pain post-op this way and is the number one complaint. In the past few years, a lot of doctors can now do it completely thoracoscopically... so three small holes.
There are other companies that sell devices without approval for afib, and the doctors are allowed to use them for afib. However, I have personally tried those other devices in a lab and they have a much lower success rate on pentrating cardiac tissue.
Catheter ablations have a very low succes rate (up through the groin). You can get this done multiple times, but you are damaging cardiac tissue each time which could make an RF ablation more difficult, should you need it.
I read a study once that said just as many people die from coumadin side-effects as they do from stroke. So I am not sure how well it is helping people.
I am obviously biased here, but I wanted to at least give you my take.
My mom has afib, too, but the anti-arrithmic drugs work OK, with some digestive side effects. She is still worried all the time though. If it gets worse, she may elect for the RF treatment.
I’ve known four people who had to undergo a second and even a third RF ablation right away because the first (or even second) ones failed. The docs routinely refer to these subsequent ablations as “touchups”, which really means the first procedures were simply failures.
RF ablation is an EXTREMELY demanding procedure and only a few docs can do it well enough to have a decent success rate. Make sure that if you do it, get a doc who has done hundreds, maybe even thousands. Definitely do not get a doc who does just a few a year.
Also, take a really good look at cryoablation done by Dr. Wilber Su in Phoenix as an alternative to RF ablation.
Also, check out StopAfib.org. It has more detail on all of the procedures, including lots of FAQ’s and a forum. You would do great going there.
I had it done in 2002 for atrial flutter. I came out with A Fib. I was told that I had both and the A Fib was masked by the A flutter until the A flutter was stopped.It was pretty damn depressing at the time.
I have had excellent results with rythmol, and am not using coumadin. My current cardiologist says that should meds become ineffective a second ablation is a good way to go. He says the leap in the technical capabilities of ablation over the last 10 years is tremendous. Much better success.
I better hope the meds keep working, I figure after ObamaCare kicks in there is no way I would get approval for ablation if it became necessary.
In answer to your question, if you are dealing with a good physician and he is or knows one who is rated very good at the procedure, it’s well worth the chance to get off meds.
Thanks to you guys for your info. FReepers are first rate, no doubt in my mind. I have garnered some really good info on this thread and greatly appreciate it.
A family member who had it done twice. First time it did not hold - his heart went out of beat again. Second time it did work perfectly. Really worth it. Changed his life.
It was worth the risk to him. Do it now before Obamacare kicks in. You might be denied it later. Pick a heart surgeon who has done a lot of the operations and who is top notch.
Good Luck!! God bless you and keep you safe and well.
I had the procedure done at Boone County Hospital, Columbia, Missouri about five or six years ago. Absolutely no problems relating to the experience and would highly recommend it.
Better to find out from your surgeon how his patients are doing.
I had an extremely similiar procedure that was an ablation of my sinus node (the heart’s pacemaker). I was SO nervous but several hours after the surgery I was able to walk through the hospital and through the parking garage to go home (I didn’t drive!).
If your doctor feels you need it, I would definitely get it if he/she feels it will help you.
There is about a 24% chance that a second procedure will be needed on any given patient and about a 3.4% chance that a 3rd try will be needed. The more experienced the physician doing the ablation the better chance of success on the first try. Generally it takes 3 months to fully recover from the procedure.
These are the things I have found out so far. Maybe your dad should have went in for the second go round. Odds are it would have cured him.
Many interesting afib stories on this thread.
First afib episode, I thought I was dying. Cardioversion jolt, all OK. Second cardio, same story. Third episode, cardio didn’t help and the coumadin effects were awful.
My cardiologist said open heart was the only remedy. So they did single bypass, MAZE, and a Cosgrove loop on the mitral valve. Pitt Medical Center in Greenville NC. Recommend highly.
That was a year ago and I have been fine since after the first month and I am off that #@$#!! coumadin.
Good luck & G-d bless to all afib sufferers.
That’s NOT how my cardiologist explained it to me. . .and why I was so relieved to have converted chemically.
1 pill a day ever since: Sotatol AF . .
“Thats NOT how my cardiologist explained it to me.”
Then your cardiologist is a fool, liar, or extremely poor communicator.
I’ve been electrocardioconverted three times and all three times my wife was present and watched the EKG the whole time I was under the Propofol. No flat-lining, period. Just the reappearance of the blessed p-waves that signal proper beating of the atria.
In our local hospital, electrocardioconversion is now so common that they no longer necessarily have an attending anesthesiologist administer the Propofol,or even necessarily have an attending cardiologist present, though when I had the procedures done they had both an attending anesthesiologist and an attending cardiologist.
When I was having heart problems, I found a little humor to be helpful.
Obviously, others disagree.
I'm going off-topic here; have you had an honest discussion with your cardiologist about the true necessity of coumadin?
I was caregiver to my late dad, and his numbers kept getting out of whack requiring blood tests a couple of times a week - and he'd gotten entirely too feeble to haul back and forth to the lab ---- I explained the dilemma to his doc and he just switched him to one baby aspirin a day.
End of situation, period. The local pharmacist concurred that this whole lab/coumadin thing is almost a "make work" scam.
Like my friend, you were lucky to figure out what was causing the problem so that you were able to avoid surgery.
Yes I feel very fortunate. It was the allergy doctor that suggested that I watch for food chemicals. The cardiologist said “I don’t know what is causing it but here take this pill and this one and this one” LOL!
Yes, I know I need coumadin. I have had blood clots without it and I know aspirin doesn’t do the job. Thanks anyway.
Well I have found that when a person posts a serious topic on health they don’t want some smart a**ed response from someone who thinks they should be a stand up comic. I have a great sense of humor but I know when to apply it and when not to. Wanting serious answers to a serious question has everything to do with how I react to attempted humor.
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