post PVI ablation paroxysmal atrial fibrillation

I am a 65 year old woman with a long standing paroxysmal atrial fibrillaton. (PAF episodes occurring once per week and lasting 2-4 hours)

I recently (Nov 8, 2007) underwent a pulmonary vein isolation procedure using RF ablation at a major medical center
I have continued to take flecanide 100mg bid and toprol xl 12.5mg daily.

My episodes of PAF have continued although changed somewhat in character. The rhythm seems less irregular, but I experience the same discomfort and anxiety these episodes have always generated.

My question... Does this mean the procedure (RF ablation with PVI) has failed? Is this a premature judgement? Do some patients experience recurrent PAF in the early post op period while the "heart is healing" and later experience success? How long post op do recurrences of PAF signal a failure.

And finally... How successful are "touch up"  ablation procedures?

Thank You
Carol Corbett

[Michael J. McWilliams, M.D.]

Hi Carol,

Does this mean the procedure (RF ablation with PVI) has failed?

Recurrent AF soon after a PVI means that it is less likely to be successful, but there is still a chance that the scar will heal to cure the AF.  There is also a chance that your AF will end up being less frequent and easier to control  with medications.  I know your goal is probably to come off medication -- sometimes the decision comes down another procedure or accepting less frequent AF or medication controlled AF.

Is this a premature judgement?

It is premature to draw final conclusions.  At the Cleveland Clinic we considered recurrent AF after three months a failure.

Do some patients experience recurrent PAF in the early post op period while the "heart is healing" and later experience success?

That is correct.  As I stated above, early recurrence means that a success is slightly less likely, but it is still possible -- don't lose hope.

How long post op do recurrences of PAF signal a failure.

Should have read all your questions first.  We considered recurrence after three months a failure.  For true paroxysmal AF, the success rate after a single procedure is around 60%, a second and sometimes third procedure can increase the success rates to close to 80-90%.

Keep the faith. I hope this helps and thanks for posting.

[paaljala]

are you still having episodes ? sincerely Paul

[mbcmd]

No symptoms for 4 days.

[Norm009]

A related discussion, Fever and afib return post PVI was started.

[racketball]

A related discussion, Why an ablation? was started.