Ablation longevity

Does anyone know what the longevity is for ablation surgery? This is slightly off topic but several members have talked about having an ablation for afib in addition to having a pacemaker.

I'm trying to find out how long the ablation surgery keeps the heart from going into afib. Does the procedure keep afib away for a year, five years, indefinitely?

On a second note, APP (Atrial Preference Pacing) was turned on on my pacemaker. APP is supposed to help with afib. My doctor said, "We don't know if it works for sure but, it definitely won't hurt."

I've had my APP turned on for about a month now. Finally had my first session of afib with APP turned on. The afib was definitely less intense. Lasted a little longer than usual but I was able to function. Previous sessions of afib prior to having APP turned on meant I had to head for the recliner and lie down most of the time until the afib stopped. With APP turned on, I was able to function, keep moving around, and have less pain than with a full blown session of afib.

Whatever members can tell me will be helpful. Thanks, in advance, for your consideration.

Theknotguy

2 Comments

PVI success rates

by golden_snitch - 2014-03-16 04:03:49

Hi!

That is a difficult question. I guess you want to know about the long-term outcomes of so called "pulmonary vein isolations" (PVI), and not the "ablate & pace approach".
Ablate and pace means ablating the AV-node and putting in a pacemaker in patients with persistent Afib that doesn't respond to any other treatment (drugs, cardioversions, PVIs). This approach doesn't directly target the Afib, you atria will continue to fibrillate.
PVIs, on the other hand, target the area where the Afib originates, the pulmonary veins. During a PVI a circle of scar tissue is created around the pulmonary veins (usually either one by one, or around two and two veins).

The thing is that, although PVIs have been performed for a bit more than 10 years, long-term results are still scarce. That's also because in the beginning different and often much less effective methods were used than today. Consequently, it comes to no big surprise, if someone who had a PVI in 2005 relapses; someone who had the ablation in 2012 might not, simply because a better technique and equipment was used. But from those ablated more recently, there are no long-term date, yet.

Also, are we talking about long-term outcomes after just one PVI? Or after multiple? Generally one can say that one PVI often does not cure you from Afib, many patients have to undergo a second or third procedure to become Afib-free or at least get better (less and/or shorter episodes, better response to antiarrhythmic drugs). I have often read about success rates being at 70-80% after multiple procedures, while after one they are just around 50%-70%. The success rates also depends on whether you have paroxysmal Afib or persistent or permanent.

So, there is no simple answer to your question. Google "PVI + long-term outcomes", and you'll get some data. But those data published now that report about a PVI follow-up of, let's say, 5 years are from PVIs that were performed between 2003-2005 or a bit later. "Long- term" with regards to PVI success rates refers to follow-ups of not more than 5 years at the moment. At least I haven't seen any data where you look at 10 years.

Good luck!

Inga

Ablations

by LitLady - 2014-03-21 05:03:12

I have had A-Fib for 20 years. Since 2002 I have had 3 ablations. Mine have lasted a year or more and then, gradually, A-Fib events begin to occur again. BUT, it depends on your electrical problem. I have friends who had one ablation and have no further problems for years. Go ahead and get it done if your doctor recommends it. At worst you'll get a reprieve and at best you'll solve the problem and be symptom free! I now have sick sinus syndrome so will have a pacemaker installed on 4/3. Good luck with your choices!

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