Successful Ablations

[TJ]

I would like to know how successful ablations are at the Cleveland Clinic. I do have an arrythmia(PAC's and PVC's) and ablation is an option. There are alot of replies on this board about ablations and once in a while you will hear of a successful procedure. For the most part, it appears that they are unsuccessful. You see many people going in for more than one with no relief. What are success rates for this procedure? From what I have read here, ablations do not have a high success rate and that scares me. Also, it appears that the medications given for arrythmias are not very successful either. I see alot of replies from people that have complaints of symptoms after trying 3,4, or even 5 different meds. Why is that and why are arrythmias so hard to control? From my experience and from what I am reading from others on this board this appears to be the case. I am looking for hope for my seemingly hopeless situation but it appears there isn't any.

[CCF-M.D.-CRC]

Dear tj,

Quite the opposite of what you say is true.  In general ablation has a very high success rate for ablatable arrhythmias.  The problem comes with the type of rhythms that are ablatable.   In general for sporatic PACs and PVCs (which many people in this forum complain about) ablation is not a first-line option.  In some severe cases it may be considered and is moderately successful.   You don't say what type of arrhythmia you suffer from but for most other types of arrhythmias ablation is successful.  If you would like to be considered for an ablation at the Cleveland Clinic I would recommend Dr. Schweikert or Dr. Saliba.  You can make an appointment with one of them by calling the number below.

[arthur]

As no doubt the doctor here will attest to, ablations do work and the percent success rate depends on the complexity of the individual problem.  If you check the medical literature (instead of Web sites), you will find that the success rates run something like 60-90% when the problem is readily identifiable (like only a few foci, easily accessed).  

Drugs work to a lesser extent, and again vary according to the individual.  

Personally, I had PAF (which is one of those conditions previously considered nearly incurable) and I had an ablation of one of several pulmonary vein foci (which was found to cause the PAF), and now, a year later, I continue to be free of PAF.  Ablation for PAF runs at about a 60-70% success rate.

If you are only suffering from PACs and PVCs, and you can find a clinic which will treat those with ablation, I would think the success rate will be on the high end.  However, don't forget to ask about the risks, as there are several significant ones.

Good Luck.

[LaurieD]

I am wondering what the "significant risks" to ablation are. My doctor is sending me for an EP study soon, and I think ablation is going to be the only route to go. I have MVP, Atrial Fibrillation, and PSVT which is getting progressively worse as time goes on. I don't respond to beta blockers at all, it seems. I am on Tenormin 75 mg a day and why bother? I still have the problems. He is ruling out esophagus problems first, then on to the EP study. He also said it is a risky procedure. Can anyone tell me what these risks are and how dangerous it is and what could happen? I'd appreciate it, as my doctor is so vague about these things.

[arthur]

Significant risks in an ablation procedure are best explained by the EP...however, from what I know, there are basically two major risks: (1) thrombus formation, ie, blood clots due to the procedure could result in stroke, and (2) pulmonary vein stenosis, ie, thickening of the pulmonary vein, which is generally temporary but could pose problems.  Other risks include those related to the mechanics of the procedure:  perforation of the pulmonary vein, infection, and inappropriate ablation of the SV node (thus requiring a pacemaker).  The actual risks (chances of any of these occuring are pretty small, depending on the clinic and it's experience and it's degree of conservatism (ie, exactly how aggressive will they be re. the burns).  If you check the medical literature you'll find these things occur at about a 0-5% rate.  In my case, the EP had done about 60 procedures for PAF, had a success rate of about 67% and had no problems associated with any of them....that sounded okay to me.