Success after ablation, PVI

[Guest guest]

It seems so many who have an ablation or PVI wind up back in afib or having

afib episodes. Also it seems they are still on the antiarrhythmic meds. When

the studies report that a certain percentage is " cured " of afib after

ablation/PVI...what do they mean by cured? Only occasional bouts of afib? No

afib

with medicines? No medicines, and no afib? One year after the surgery, I

wonder how many are " cured. "

Lil

In a message dated 4/28/2006 12:46:51 P.M. Pacific Standard Time,

STahaney@... writes:

Then I went into a-fib and have been in it ever since. I am now back on

the

medicine and waiting for a cardioversion. Hopefully, it will work in the

end, I found it all so worrying.

[Guest guest]

Lil, That is an interesting question and one I would like to know the

answer to. My EP here in the UK told me the success rate is around 60%, but on

the internet they quote something like 85% with l5 having much improved

syptoms. I think the only time you can say you are cured is when you do not

have

any episodes at all without having to take medication. Mine is still early

days and better than the kind of a-fib I was experiencing pre-ablation. My

feeling is that you have to have it done more than once. I have heard of

people

who have had it done twice, who are completely cured.

Pat

[Guest guest]

Thanks Gordon, If this ablation does not work, I think I may have to get

myself off to see Dr.

Natale as his success rate is better than anyone is getting over here. Does

anyone know what the success rate is in Bordeaux, France as that is a lot

nearer for me. Pat

[Guest guest]

Hi Gordon, thanks for your very informative post on success re ablation. I

know that ectopics are considered benign...at times they can be far more

annoying and disconcerting even than afib and they are essential not " fixable. "

Kind of like those darned floaters you get in your eyes.

Lil

In a message dated 4/29/2006 11:35:09 A.M. Pacific Standard Time,

ggheld@... writes:

Ectopic beats are considered benign and not afib

[Guest guest]

> Lil, That is an interesting question and one I would like to know

the

> answer to. My EP here in the UK told me the success rate is

around 60%, but on

> the internet they quote something like 85% with l5 having much

improved

> syptoms. I think the only time you can say you are cured is when

you do not have

> any episodes at all without having to take medication. Mine is

still early

> days and better than the kind of a-fib I was experiencing pre-

ablation. My

> feeling is that you have to have it done more than once. I have

heard of people

> who have had it done twice, who are completely cured.

Lil & Pat:

A couple of thoughts:

1. Many of those who are cured probably drop off of the newsgroups

and bulletin boards as fib is not top of mind anymore for them.

2. Dr. Natale's success rate of 80+ percent the first time and over

90% if a second is needed is, I believe, after the 90 day Holter

monitor showing no fib and successful withdrawal from fib meds

although I'm not sure there is a follow up on the meds. Perhaps

Salwa would help out on this if she reads it. It may also be the

number of PVI's he does and the percentage of ablatees who return

for more treatment.

3. Ectopic beats are considered benign and not afib.

4. Overall success rates need to be modified for individual cases.

A 30 y/o with no structural heart damage and no other problems would

probably have a higher success rate than an 80 y/o with bunches of

other medical issues.

5. I think most EP's give you their estimate of success in any

given case. In my case I got estimates both from my cardiologist

based upon his patients and a different number from Dr. Natale.

They were both above 50% so I went for it and after 5 months I's

still afib free and happy I did it. Still a few ectopic beats but

they seem to be diminishing. 68 y/o with no structural heart

damage, a slightly enlarged atrium and contolled hypertension.

Gordon

[Guest guest]

>

> Thanks Gordon, If this ablation does not work, I think I may have

to get

> myself off to see Dr.

> Natale as his success rate is better than anyone is getting over

here. Does

> anyone know what the success rate is in Bordeaux, France as that

is a lot

> nearer for me. Pat

Pat: I believe the top two EP's there are in the same league as Dr.

Natale and wouldn't hesitate to go to them at all if in were in your

situation. I understand that when contacting Bordeaux you must

specify Prof. Hass------ or Prof. Jaix and pay a little extra to get

only them but it's well worth it and about half the price of the

procedure in the US. I know of people in the US who didn't have

insurance coverage who went to Bordeaux for their procedure because

of the cost difference and are very happy with the outcome.

Gordon

[Guest guest]

>

> My EP told me that THE cure rate (not just his)was about 33%.

About 15% of the time the ablation has no affect at all. The rest of

the time there is some improvement. He told me this before the

ablation. I still had the procedure. I am in the healing process

with some afib events. I have had a great improvement and am very

happy with the results.

>

> It seems so many who have an ablation or PVI wind up back in afib

or having

> afib episodes. Also it seems they are still on the antiarrhythmic

meds. When

> the studies report that a certain percentage is " cured " of afib

after

> ablation/PVI...what do they mean by cured? Only occasional bouts of

afib? No afib

> with medicines? No medicines, and no afib? One year after the

surgery, I

> wonder how many are " cured. "

> Lil

>

> In a message dated 4/28/2006 12:46:51 P.M. Pacific Standard Time,

> STahaney@... writes:

>

> Then I went into a-fib and have been in it ever since. I am now

back on

> the

> medicine and waiting for a cardioversion. Hopefully, it will

work in the

> end, I found it all so worrying.

>

>

>

>

>

>

>

>

[Guest guest]

Earl,

Success rates for ablation are quoted by so many people, it is

impossible to get the real picture.

If you want the best odds for success, I think it has become clear

that you need to go to one of the big names. The guys who have done

the most and are the most skilled. A lot of EPs have excellent

credentials, but they just haven't done enough afib ablation

procedures to have a lot of success.For instance a medical degree

from Harvard medical school does not alone mean that your EP will

know how to do an afib ablation successfully.

That being said, I think at this time that many more EPs have or are

reaching the point that they are becoming somewhat competent.But

anyone who is contemplating an ablation needs to get several

opinions, and ask many questions. The most important questions to ask

are, how many have you done, and what is your success rate? Success

meaning that the patient will no longer have afib and will be off all

of the drugs.

If the EP has done less than 300, I would look elsewhere. Even if the

EP has done 300 or more, you need to closely question him about his

success rate, and his complication rate. And ask what kind of

complications has he had? Where did he have his training? Is he

certified in electrophysiology? Is the hospital where he practices

set up to do afib ablations, or are they just sharing space with the

cardiac catherization guys? Does it have the newest equipment? Is the

staff well-trained for afib ablations?

You have to do your homework. There is a lot of competition out there

among EPs for patients,and cardiac surgeons as well, for the mini-

maze procedures, as well as the full Maze procedures.

You might have to spend some money to travel to see the best EP. This

is money so well spent. You might have to get on a long waiting list

for the best EPs, so you can't wait until the last minute to decide

who you want to do your procedure.

This is the only way you can assure that you will find an EP whose

success rate really is in the 80% range, and who does not have the

troubling complications that we all have read about.

My very best to all of you.

> >

> > My EP told me that THE cure rate (not just his)was about 33%.

> About 15% of the time the ablation has no affect at all. The rest

of

> the time there is some improvement. He told me this before the

> ablation. I still had the procedure. I am in the healing process

> with some afib events. I have had a great improvement and am very

> happy with the results.

> >

> > It seems so many who have an ablation or PVI wind up back in afib

> or having

> > afib episodes. Also it seems they are still on the antiarrhythmic

> meds. When

> > the studies report that a certain percentage is " cured " of afib

> after

> > ablation/PVI...what do they mean by cured? Only occasional bouts

of

> afib? No afib

> > with medicines? No medicines, and no afib? One year after the

> surgery, I

> > wonder how many are " cured. "

> > Lil

>

[Guest guest]

Thanks Gordon, I will remember those names for the future. Hopefully, the

PVI I had will work out and I won't have to, but it is good to know there are

EP's out there with good success rates. It is possible to get it done on the

NHS here, but the waiting lists are huge and lots of hospitals have stopped

doing ablations because of the high costs and low success rates. They would

rather treat it with medicine, if possible. In my case I opted to have it

done privately with my medical insurance. That will not cover me for France,

but if it's that good and I need to I do not mind paying. Pat