5 months post ablation

[heartysue]

I wonder if you could help me please?

Briefly, I had an ablation 3 years ago for Atrial Flutter, they couldn't induce AF, so treated the flutter and that was that..


Move on to May of this year, by now my life was being severely restricted with bouts of very symptomatic AF, had the ablation at The Brompton in London, they ablated the pulmonary veins and my Consultant was very  upbeat about how it had gone, had done about 100 ablates and I was down in theatre for about 5 hours.

First 8 weeks, just the odd missed beat, racing for 30 secs and then putting itself back in to rhythm - this I thought, I can put up with! then... come early August, the AF returned, for an hour at a time, then 2, then 4, then 15 leading up to a massive 22 hours (post op max  hours) were now coming every 36 hours - a couple of trips to A&E, resulted in me being put on the emergency waiting list and I am due 'another go' early December.

My question is, an ECG now shows I have atrial tachycardia as well as AF.. I understand that that particular arrythmia is quite easy to ablate, I am just wondering why the arrythmia has changed, AT makes me feel slightly off kilter, painful ache in my chest and very lightheaded if I exert myself during an episode, but having said that I am actually able to go to sleep whilst it's happening, which I never able to before the op.

Lots of questions, I hope you can help me understand a little better what is going on in this ol' heart of mine.  I am 46 and have had various arrythmias for the last 12 years - have no heart disease, no high BP, no diabetes - just some crazy electrical problem..

Thank you for your time.

[Michael J. McWilliams, M.D.]

Atrial arrhythmias can be very complicated.  Atrial fibrillation ablations are done by isolating the pulmonary veins.  In about 20-25% of the cases, a redo procedure is necessary because of recurrent atrial fibrillation or atrial flutter.  The atrial fibrillation ablation creates scar in the left atrium and sometimes leads to developing atrial flutter around the scar.  this is why people that have always had irregularly irregular heart rhythms with atrial fibrillation by develop regular tachycardias after an atrial fibrillation ablation.

Atrial flutter ablations involve mapping to determine the circuit and then attempts to interrupt the circuit with ablation or medications.

recurrent arrhythmias sometimes appear because the lesions caused by the previous ablation heal and allow conduction again.  I second ablation procedure usually helps alleviate this problem.

I hope this answers your questions.  Thanks for posting.

[heartysue]

Thank  you so much for replying to my post, things are a lot clearer now - I will, of course, let you know how this 3rd ablation goes - am praying my recovery will be less traumatic for me :)