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Catheter Ablation for Atrial Fibrillation-How long does it last?

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“sinus rhythm was achieved in 58% of atrial fibrillation patients after a single procedure, 8% of whom were on antiarrhythmic medications, and in 88% of patients after multiple procedures…”

Is it me or does an average failure rate of 88% for atrial fibrillation (a-fib) patients undergoing catheter ablation procedures sould like a bad deal? To add insult to injury, those a-fib patients who do have a successful outcome from their catheter ablation have more than a 40% risk of recurrence of their a-fib sometime during the next 10 years.

I developed chronic a-fib in late 2010. Atrial fibrillation comes with a well-documented increased risk of stroke. And to be honest, it feels really strange having my heart rhythm jumping around all over the place.

My ejection fraction dropped to 40-45% and I did experience heavier breathing on occasion though I was able to exercise as I always had.

Being a cancer survivor since 1994 has taught me to put most every health decision into a pro/con, risk versus benefit scenario. In the case of my a-fib, the benefit is a higher quality of life and a normal risk of stoke. The risk, or I should say the cost of fixing my a-fib is cathater ablation that costs 000’s of dollars every time the procedure is done regardless of the outcome. And regardless of how long a successful procedure lasts.

I chose not to undergo drug therapy to fix my a-fib, nor did I undergo catheter ablation therapy. I have been living with chronic a-fib since late 2010 and my ejection fraction is still 40-45%.

To learn more about managing your stroke risk with evidence-based but non-toxic therapies scroll down the page post a question or comment and I will reply to you ASAP.

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

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paroxysmal atrial fibrillation

“Paroxysmal atrial fibrillation occurs when a rapid, erratic heart rate begins suddenly and then stops on its own within 7 days. It is also known as intermittent A-fib and often lasts for less than 24 hours.

The American Heart Association (AHA) estimate that 2.7 million American people live with some form of A-fib. The likelihood of experiencing paroxysmal A-fib increases with age…”

In paroxysmal AF, more than 40% had recurrence 10 years after pulmonary vein isolation

“More than 40% of patients with paroxysmal atrial fibrillation had recurrence within 10 years after single-procedure pulmonary vein isolation, according findings published in HeartRhythm

The researchers analyzed 176 retrospectively enrolled patients with drug-refractory symptomatic paroxysmal AF who underwent electroanatomical-guided pulmonary vein isolation (mean age, 51 years; 131 men). Ten-year follow-up was completed through medical records or telephone interviews.

According to the researchers, sinus rhythm was achieved in 58% of patients after a single procedure, 8% of whom were on antiarrhythmic medications, and in 88% of patients after multiple procedures, 10% of whom were on antiarrhythmic medications…

Left atrium diameter (OR = 1.067; 95% CI, 1.009-1.127) was a predictor of atrial tachyarrhythmia after one ablation procedure, with those who had enlarged left atrial diameters having more atrial tachyarrhythmia recurrences…”

Long-Term Results of Catheter Ablation in Paroxysmal Atrial Fibrillation

“Background— Paroxysmal atrial fibrillation (AF) naturally progresses toward chronic AF at an estimated rate of 15% to 30% over a 1- to 3-year period. Pulmonary vein (PV) isolation is increasingly performed for the treatment of drug-refractory paroxysmal AF. The long-term data on clinical outcome after circumferential PV isolation are limited…

Conclusion—In patients with paroxysmal AF and normal left ventricular function, circumferential PV isolation results in stable sinus rhythm in the majority of patients, and low incidence of chronic AF was observed after ablation during up to 5 years of follow-up…”

 

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6 comments
Malcolm Gealt says a few months ago

Had ablation. Symptom free for several weeks. Cardiologist wants me to get watchman. Why do I need that if I stay symptom free. Thanks so much. Iam age 76 with hcontrolled hypertension and sleep apnea. No other health issues

Reply
    David Emerson says a few months ago

    Hi Malcom-

    I am no expert but my understanding is that your Cardiologist is concerned about your increased risk of a stroke caused by your Afib. Yes, because of your ablation you are symptom free. I take this to mean your heart rythm is normal and therefore you figure you do not have an increased risk of stroke?

    You should ask your Cardiologist but my assumption would be that your Cardiologist knows that there is a good chance that you will experience Afib again- either sporadically or permanently.

    This is my guess but I really can’t speak for your Cardiologist.

    I hope this helps.

    David Emerson

    Reply
Dee says a few months ago

Interesting viewpoint. It seems success and safety stats have changed for the better since this was first written. And now there is strong evidence that AF can predispose you to dementia. Successful catheter ablation seems to reduce stroke and cognitive decline. Stroke risk is equivalent for PAF and chronic AF.

I was reluctant to have a CA, but the fear of a stroke and/or dementia convinced me it was the better choice at the time. I just wish I had known more about possible sequelae beforehand.

Reply
    David Emerson says a few months ago

    Hi Dee-

    I agree with you about increased risks of both stroke and dementia. Rather than have a CA I chose to reduce my risk of stroke with supplementation and my risk of dementia with both lifestyle and supplementation.

    We’ll see if my non-conventional therapies help me :-).

    thanks,

    David

    Reply
John D Callahan says last year

See my book. I have had atrial fibrillation (AFib) for approximately 40 years (from my mid-20s to mid-60s), but the disease has progressed very slowly. I am still paroxysmal (intermittent) with minimal AFib burden; in fact, I am in sinus rhythm over 99% of the time.

Reply
    David Emerson says last year

    Hi John-

    I emailed you directly. Great to see someone else in a similar situation.

    David

    Reply
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