Have you been told that you, personally, have developed complications due to ablation scars or have you heard that there have been incidences of this in other patients? If this relates to you personally, I'm very sorry to hear of it and wonder for what condition did you have your ablation? How long ago? What type of energy source as used (RF or cryo)? What problems did you develop from the scar tissue and what are the specialists advising you to do about it? I am asking because there are both clinical notes and anecdotal reports of patients developing IST, loss of HRV, late heart block and onset of new arrhythmias post ablation in time periods ranging from a few weeks, to many months, to several years later. Those that occur in the immediate post ablation period of a few weeks to a few months may often resolve on their own, but it is my understanding that those that appear much later in the post ablation period are less likely to resolve -- but some DO still occasionally resolve so there is always room for hope.
IST is sometimes thought to possibly occur late post ablation due to disruption of the parasympathetic nerves in the heart. Disruption of these nerves is also thought to cause a decrease in HRT (heart rate variability) a common measure of heart health. Development of A-Flutter and A-Fib have also been reported to be higher in patients who have had ablations -- especially in some locations of the heart for specific types of SVT. Development of ventricular arrhythmias has also been correlated with ablations. there are a few reports of weakened ventricular muscular and decreased ejection fraction post ablation as well as problems with valves and veins that may develop after ablation -- sometimes years after. While I am aware of these issues, my experience from researching the data I have access to is that these incidences are relatively rare, but that from my experience on various boards such as this one, just the opposite seems to be the case -- I am assuming there are more reports of post ablation problems on boards such as this one because those patients without problems have no reason to post, but it does raise the issue of just what the long term complication rates might really be. As you may be aware, there seems to be a shocking lack of long term studies on the health and well being of patiens who have undergone cardiac ablation considereing how common the procedure has become and I hope that in time some of these "hidden" concerns will come to light and be addressed so that we can have some real and reliable statistics on the benefits and risks of ablation for various conditions and a cross section of patients.
Scar tissue, particularly from RF ablations has an element of "uncontollability" and there is evidence that often even once the catheters have been removed, tissue damage continues to occur for several minutes, hours, days, weeks and months post ablation -- which is why sometimes several weeks after what seems to be a "successful" ablation, heart block may suddenly or gradually develop. The formation of scar tissue in the heart also seems to be somewhat individual to each patient given patient age, overall health, area ablated and type of ablation equipment used. It is the development of the "scar" that in theory "corrects" the arrhythmia.
Also, as we age, most of us begin to have changes in our heart muscles in which our cells become more and more fibrous -- they believe this is in part what gives rise to A-Fib in older patients. This increase in fibrous heart cells may act synergistically with ablation scars to precipitate new problems long after ablation.
If you have any information to add to this from what you have been told or experienced personally and are comfortable sharing it, I would certainly be interested -- after post-poning it for 20 years, and despite some continued skepticism, I recently underwent cryo-ablation of the left free wall for SVT due to congenital WPW and am waiting to find out if it will be successful long-term. Because of my experiences, I have a 30 year interest in the subject of both arrhythmia and ablation.
Thank you so much for your prompt and comprehensive reply. I have not yet had ablation. It's being considered instead of amioderone but my doctor has warned me of possible late post ablation complications.
My decision now is to whether I chose the amioderone, which I am wary of, or the ablation.
Another question: ablation for what problem? Ablation for simple PSVT is generally pretty straight forward. For some other problems like a-fib or a case where they have to enter from the left is more complicated.
You're welcome -- I'm glad to hear you have not developed problems post ablation. However, I am interested to hear that your physician has raised the issue of late complications from scar tissue and would be very keen to know what specific complications s/he has warned you about as well as the type of arrhythmia issue you are dealing with. As Ireneo points out, some types of ablations seem to have more risks than others.
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