2nd time ablation

[drdan503]

the first time didnt work, after tapering off the meds 2xs. this was done in aug 2008. the heart took a week plus to get back into rhythm after the second time-going in and out.  the odds of the second ablation being successful are supposed to be 95% vs 80% the first time. Im goin to go for the 2nd time while im relatively young and in good shape. what do you think?   The ep told me that theres a higher risk of pulmonary vein stenosis but couldnt give me data because its too new

[Jerry_NJ]

Not sure I understand your question, but I take it to be mostly about the risk involved.

The risk depends in part, major part I think, on where the work has to be done.  You haven't given enough information to determine, i.e., PVC, PAC, AFib???

As an AFib sufferer I know the risk of ablation is relatively high because the ablation has to take place in the left atrial chamber, and the catheter first enters the heart on the right side, so the catheter has to "break" through an internal wall to get into the left side of the heart.

The risk of complications when an ablation requires entry into the left atrial is much higher than for work in the right side, best I recall the risk is in few percent range, perhaps 10 to 100 times higher than work in the right side.

[drdan503]

the condition is afib. thanks for any feedback

[Jerry_NJ]

Ok, for an AFib ablation I understand the risk of a complication is in the range of a few percent, say about 3 or 4%, as contrasted to what we'd like for it to be far less than 1%, perhaps what the risk is for work on the right atrial chamber.  The reason, as already stated is the catheter enters the heart vai a main vein/artery (not sure which it is) called the Inferior Vena Cava (I believe).  The provides entry into the right atrial chamber with the only "incision" being the small cut on the upper leg to gain access to the vein/artery.

This level of risk is considered by my advisors (an EP and a Cardiologist) to be too risky given my "mild" symptoms from AFib.  The other part of this argument of risk management is that my long-term survival is not improved by my regaining sinus rhythm.  That is, taking warfarin to reduce the probability of a clot forming (never zero) and Metoprolol to reduce my HR, patient tracking says my life expectancy is not improved (really slightly reduced) by taking measures to get back into sinus.

You say your second ablation, so you already have personal data on complications, you didn't have any.  This may fact may give you a lower than typical risk factor.

[drdan503]

thanks for the feedback.  It may not increase life expectancy, but it sure feels better for me to be in sinus rhythm. I would also love to get off the tambocor and especially the cumadin (coumadin). Ive got to tell you that a big hematoma in the left leg was not fun, following the ablation. I figure i will try it once more at cleveland and so be it.