A study of radio-frequency catheter ablation by the Agency for Healthcare Research and Quality (AHRQ) was one of the first government-mandated Comparative Effectiveness Research (CER) studies released. The report found that catheter ablation appears effective up to one year after the procedure, but more research is needed into longer-term success as well as the impact on stroke and with certain populations. In addition, we need to know whether patients can have catheter ablation for afib as their first treatment rather than waiting for medications to fail before considering it. If you’re thinking about getting a catheter ablation, this report holds a wealth of information for you.
After you have read the article, please come back here and add your comments below for our discussion at the AHRQ conference on 9/14/09.
I have just had my second ablation. The first one was two years ago and did not work. I have been assured there is a 90% chance of success on the second ablation. This is the success rate at Abbott Heart Hospital in Minneapolis, MN.
I was out of options on drug therapy. I was on Amiodarone for 10 years, which worked, however one cannot stay on it without serious consequences. Other drugs were tried early on but were not effective.(I also have had an atrial induced stroke.) I am told it will take 3 to 4 months for the heart to heal thoroughly so I will not have a determination on success of the ablation until then. I have had breakthroughs since the ablation 10 days ago so I am now back on Amiodarone just to get through the healing process. I am disappointed to read on this web site that
an ablation, if successful, is only effective for about one year according to some reports. If that is really the case,RF cather ablation is not worth it.
Jay,
I’m sorry for what you’re going through. Yes, it does take several months for the heart to totally heal after ablation, so it’s not unusual to be on medications for a few months afterwards to make it easier for the heart to heal.
This report, from the Agency for Healthcare Research and Quality, is not saying that an ablation is only good for a year – it wouldn’t be worth it for just that. What the report is saying is that for many of the studies there is only data out for 12 months following the procedure and that we need more long-term data. Newer studies are capturing longer time frames, which will be reflected in future reports. Ablations are still so new that we don’t know how long they can last.
Mellanie
Jay,
I have not had an ablation myself because my episodes have been two years apart. I have been in contact with two individuals one has had one ablation and the other one has had two. Both of them are in their second to third year without another episode so you should be fine.
I am 63, 6’1″and 193lbs.
I am very active in racket sports and play in
senior games in Arizona & California
Before my ablation I could not tell when
I went into afib or flutter.
I also had stress test and nuclear stress tests
where during that time I did not go into afib or flutter.
I had an ablation for afib/flutter on July2/09.
During the ablation everything sounded like
it was going fine and then the doctor’s voice
changed and he rushed out of the room to
get a portable ultra sound machine and then
he pressed hard below my chest, I guess to try and see my heart.
Has anyone heard of a Dr.doing this ?
It has been 2 months since my ablation.
I had a stress tests and my heart went into afib & flutter
I work out at the gym and it seems if I get my heart rate above 85 it will go into afib or flutter.
At this point I am not very pleased with the results of the proceedure.
I am trying to be patient and waiting to see whats happening a month from now.
The only meds I am on is :
sotalol 40mg twice a day
aspirin
I am 56, very physically active, weigh 106 lbs, and feel great, but I have AFIB. My attacks use to occur about every 4 months. About 8 weeks ago, I had an ablation. The first 3 weeks I was doing great. Then the doctor told me that I could come off of the Toprol. About a week later, I started having little episodes lasting just a few seconds( acouple of times it lasted about 15 seconds). I am wondering if I should go back on the Toprol. Also, originally the doctor said that I could come off of the Coumadin after 3 months, but now I am not sure that he is still going to recommend that. My CHAD score is 0, so maybe. I am getting a little discouraged, b/c I am afraid that the ablation did not work. Maybe is is too early to tell though. Does anyone know if what is happening is normal? Is this common to have some of this 8 wks after an ablation? Any advice, comments or suggestions would be appreciated. Vicki
I’ve had this procedure twice, about six months apart, and neither of them helped. In fact, the first one made things worse. I was in uncontrolled A-Fib for two months until I had a cardioversion, which didn’t return me to regular rhythm for more than about two hours but at least I was in controlled A-Fib and felt a lot better.
I’ve had chronic persistent A-Fib for I guess about 5 years now and am still looking for something better. I know I won’t go through another ablation. I might be willing to try the Convergent Ex-Maze sometime down the road, but I think it’s still too early to tell if it is really effective.
Age 81 soon to be 82. Heart medicine makes me weak – cardizem and digoxin. Considering ablation.
A bit afraid. Have friend says “do no harm”. Gives me articles “complications of catheter ablation: incidence and predictors”. From eClips Consult. http://www.eclips.consult.com/eclips/article/Cardiology/S0145-414.
What should I do?
I had a valve replacement in Dec 2006. The following july, I began going into Afib and Aflutter and would have to be cardioconverted out. This happened 7 times in a 6 month period. I tried every kind of rhythm medication and finally got on sotolol…which I hated. that and the coumadin…nasty. I am too young for amiodarone. I finally had an ablation from Dr. Andrea Natale formerly of the Cleveland Clinic…now out of St David’s in Austin. I had to stay on all meds for another 4 months until the heart healed…then off the sotalol. After another 4 months, I got off the coumadin. That was January of this year. About July 4 of this year, I got into Aflutter and need cardioconversion. I truly believe that being dehydrated brings it on. I make sure I am hydrated and hope that it does not happen again.
I am 50 years old and in generally good health, regular excercise, but high stress work/life (NYC); no family history of heart problems. I went to the emergency room in December 2007 with Afib. Initially I had night time Afib, mostly while sleeping. I tried Metropolol; then Atenolol and Lanoxin; then Multaq and Lanoxin; at this point I am having Afib and Aflutter twice a day for 15 minutes to four hours at a time and it is taking its toll. Today I picked up a new prescription for Sotalol but I am not overly optimistic and I really don’t want to be on meds forever. A friend had ablation at the University of Pennsylvania several years ago (he had persistent Afib) and he feels satisfied with the improvement, but the benefits seem to diminish over time as the heart “heals.” I have mentioned ablation to my cardiologist but he wants to try the Sotalol first. I feel like no one really knows what is best; I wish I could contribute something more positive!
I am 58 years old and I’ve had A-Fib since 2003. I’ve had 13 cardioversions and 4 ablations. My last ablation was September 2009. My A-Fib has become progressively worse after the last ablation. My heart rate has increased and now go in and out of A-Fib regularly. Medication had controlled my A-Fib before this last ablation. My family doctor advised me to not to go through with it. He told me to wait for new and better procedures that will offer better success rates. I did not listen and will now suffer for the rest of my life.
My father had atrial fibrillation ablated surgically in Chicago area by Dr. Piluiko. He had additional afib after surgery for 1 month. Since then he has no afib and now is off coumadin and all drugs. It seems that mini Maze procedure is more painfull, but it also more effective. he has small incisions on his chest and doctor applied burns on his lung veins. We went through whole lot of research before we decided to go for it.We heard a lot of stories about safety of percutaneous ablation through groin, but it has a lot of complications- stroke, death and low success rate.
George,
I’m glad your father’s mini maze was successful. Mine was as well, having been afib-free for over 4 years now.
Good luck to him.
Mellanie
I was diagnosed with Afib back in Late November 2009. Had it regularly. Occassional high heart rate and definite irregular heartbeats. I personnaly believe it came about due to heavy racquetball workouts and possible dehydration. In any case, I was put on Metropolol at 25mg to control the rate and Rythmol 325mg twice a day. It worked but not the whole 24 hour period. I discussed a different approach with my Cardiologist and I asked if I could go with Rythmol 225mg three times a day or every 8 hours. Granted the dose would now be slightly higher at 675mg vs 650mg but it didn’t seem like the 325mg extended release version was getting me through the day.
The end result is that I am pretty stable the full 24 hour period now. I had a very irregular heartbeat before and occassionally the rate would go to 120. Now my heartbeat is typically in the 60 to 65 beats/second range and the irregularities are minimal and controllable. By going to the regular Ryhtmol vs the extended release, my cost also went down from $83/ prescription refill to $5.00.
What was a fairly scary situation is now under control but having said that, I know if I stopped the medication, I would go back into Afib fairly quickly. I have gone to U of M and they say I am a good candidate for Radio Ablation. Sounds good on the surface to think that one could get rid of this problem possibly for good. I must say I am a little discouraged regarding the lack of success experienced by some of the folks who commented here. The choice is to stay on the medicine regime that works for me or take a chance on a potential fix. I am leaning towards the ablation as the chances of the meds working for the rest of my life are probably not good.(I’m 55).
I will say that I do believe taking a good one a day vitamin that has magnesium in it has helped me as well as staying well hydrated. Magnesium seems to help with the electrical conductivity. This has been my experience.
i’m 30 years old, 6’3″ and 225lbs. i had a low heart rate of 38 bpm and 40 premature ventricular contractions per minute. i had my first oblesion surgery in january of 2010. for the next three months after that, i didn’t do much but lay around the house, and go for short walks. exactly three months later, i went back to the cardiologist for a follow up, and the EKG showed i was bigeminy. he set me up for another surgery about 2 weeks later. i just got out of the hospital last week. i’m constantly having chest pains now, and i keep telling my wife, as far as my chest pains and fatigue, i feel worse now then i did before the second surgery. i keep telling the cardiologist this, but he says it’s just because of the surgery. i did talk to a VA cardiologist at the VA hospital, and he told me that a second abletion surgery that quick is highly risky, cause my heart hasn
t had the full time to recover. so now, i’m second guessing my cardiolgist. i have talked with my family doctor about it, and he’s just floored why they don’t do a pacemaker. i’m 30 years old with a 10 year old and 4 year old at home. i’m tired of being tired and in pain and able to do the things i used to do. i’m wondering if anyone has any opinions on the problem, as in should there have been a second surgery within three months, and if the surgery is sucessful, is it sucessful permantly?