failed ablation

[ffmedic11]

Hi,

I was just wondering how many people have undergone ablations that are unsuccessful?  I had my first ablation in January of 09, this was successful but after about 2 months my symptoms and arrhythmia (atrial tach.) returned.  I was put on acebutolol and rhythmol which helped to control the symptoms most of the time but they also left me feeling physically weak and very tired.  I had my second ablation last week and after 2.5 hours of trying, they told me that they were unable to trigger the arrhythmia and so they couldn't ablate anything.  I had this done in Boston.  I was put back on medications and have an appointment with my cardiologist in Maine (my home) on Tuesday.  I have had a VERY frustrating week because I really hoped to be "fixed" after this ablation.  I have a very physically demanding job as a fire fighter and I have set a lot of fitness goals for myself including a triathlon in August.  Being on the medications makes these goals seem difficult to attain.  

Just looking for some feedback before my appointment this week.  Both my cardiologists are excellent and are very willing to try different medications and things to help my problem.

Thanks in advance for any help

[concernedmom278]

My son at 20 yrs old had 2 ablations of the heart. He is a pro-dirtbike rider and its been 5 months. He cannot seem to get in physical condition that he needs to be in. He is very worried and upset. How is your physical shape now?
concernedmom278

[Topher7]

Thanks for the comments Jerry. I'd love to have it done again, since my heart is still healthy and all of this has been a weird case of bad luck/timing, etc and the docs think it would work. But the first experience makes it so hard to even think about. I read stories of it being successful all the time but this scar on my chest tells me that I almost lost my wife, kids and family. It may have been harder on them.

I might try the Rhythmol, 150 mg, twice a day if they tell me to do it later..since 300 mg knocks it back into rhythm. Overall, it has just been frustrating and I'd like to be free of this at some point since the technology seems to get better.

[Jerry_NJ]

You are testimony to the fact that ablation is not risk-free.  Very sorry to hear you had such an experience and continue to suffer from AFib.

I too have had open heart surgery (through the chest/sternum) but mine was scheduled to repair my mitral valve.  The surgeon did a maze procedure while he had me open, but it didn't cure my AFib.  Seem AFib is a trough one to win, but at your age it may be worth the risk to try again.  

I have taken as much as 425 mg twice a day of Rythmol SR, and I am unaware of any side effects, unhappily I didn't gain any benefits either, still in AFib, so I quit taking Rhythmol.  I use only Metoprolol for rate control and warfarin to reduce clot formation.

Wish you and all good luck going forward.

[Topher7]

I'm a 39 year old male. In 2000 I never had any heart issues but got the flu that summer. A severe strain attacked my heart and almost killed me. Viral myocarditis. I miraculously recovered fully with the exception of some A-fib because of it. The A-fib only presented once every year and a half to 2 1/2 years. I was taking Zebeta and Monopril. The first many years I'd go to get it cardioverted but then the last 2-3 years Arrythmol/Propefenone would put it back into rhythm. Last year it went out 3 times and my cardiologist suggested I get it ablated because I was a) young, b) my heart was completely healthy and c) all other factors made it where there was a really good chance of success.

So November of this past year..2008.. I went in for the catheter ablation of the PVs and it turned nightmarish. They barely got the left two veins ablated when the catheter of the robot arm pierced my heart. They couldn't control the bleeding and they had to have emergency surgery where they opened me up and fixed the hole and finished the other two right veins. It was horrible for us and the painful recovery over the next months was hard. Especially with a 17 month old and a pregnant wife....now a 2 month old. So the first two months I had no A-fib or flutters in the recovery phase. At the end of month 2 and into month 3 I had 3 separate A-fib episodes that lasted anywhere from 20 seconds to 9 hours. 2 of them were put back with the Rythmol. So the guy who started the ablatation took it as this was a failure. Considering I barely had it before but now had it 3 times in a month and was cut open..I was a little incredulous. A 2nd opinion was nice and he told me there was still a slight chance at full success because I was also healing from the cracked open sternum and cut. I haven't had anything in weeks and have been going back to doing yardwork, etc. I again had two bouts of A-fib in May and then June...lasted 5 hours each and went back into rhythm with Rhythmol/Propafenone

My main cardiologist wanted to start me on the Rythmol twice a day for prevention but I refused because of the side effects and the warnings I had read. The new Arrythmia Specialists has yet to weigh in and I think he wants me to have a second ablation....though my wife and main cardilogist and many others are afraid after what happened to me. It's frustrating since ablation is supposed to be common yet I had open heart surgery to save my life and it puts the fear in me about #2....though I might still get it. I went from arrythmias every 2-3 years to every 6 months or so to now...worse after ablation.

[Jerry_NJ]

Sorry to read (again) that ablation is so much not a science, truly a practice or art.  My interest remains in the possibility of getting one for AFib in an enlarged left atrium, poor odds at best.

On medications and side effects, you say acebutolol and rhythmol  give you problems.  I have used high dose rhythmol (425 mg twice a day) and it doesn't seem to have any side effects in me, or any benefits either, so I've stopped taking.  Beta blockers do have the side effects you mention when I uses them, as I do.  Metoprolol taken at dosage over 100 mg a day can give me a real downer.

Not sure from what you said about your condition that it is a "show stopper" in your work, but it may be for a triathlon in August.  Wow, you've got my vote, let us know how it goes.

[grendslori]

My daughter has had several ablations done, sometimes they work, sometimes they don't and people don't understand that. If the electrical tract is not 'active' on the day of the ablation, no matter how hard the EP Doctor tries, he's not going to be able to ablate the tract because he can't find it. That happens a lot.

[ireneo]

Similar story here: first ablation my doc was sure it was fixed. Several months later the tachy started to creep back into my life. Had a second ablation but after several hours he stopped, knew he couldn't bring it under control. Eventually went for a 3rd try. I still have tachy and ectopics but it's so much better. Having tachy bursts that last less than a minute are very tolerable. I wish I had a normal heart but I don't. My job can be physically demanding at times (chasing and grabbing up an eagle, wrestling with a cranky raccoon or lifting a 45 lb beaver). It will set off my tachy but once I finish with what I'm doing, my heart goes back to normal.

Your job is much more demanding of course. I don't know how long your tachy lasts but if they can't bring it under better control, you may have to change your job a bit. You don't want to compromise your safety or others. Perhaps there are other positions in the department you could do?

Stress to your doctor how important it is to manage your arrhythmia in such a way that doesn't destroy your career. Another ablation, different meds perhaps. I wish you well.