Afib Ablation

[bigburn]

Ok, experts, here is maybe a tough one for you all.

I have had a ten history of parox afib, with episodes occuring 1-2 monthly, converting with Norpace (600 mg).  I had not used cumadin, as the episodes were not all that frequent and did not take any anti arriymetics on a regular basis, but used the "pill in the pocket" approach recommended by my cardiologist and ep.  No other heart related issues, or any other health issues.  

2 months ago I elected (was talked into?) an PVI (pulmonary vein isolation) by your friends at the University of Michigan Hospital.  Since the procedure, i had a flood of arrymetias, like 12 during the first month following the procedure.  About half were left atrial flutter, which is yet another arrymethia that i didnt even know existed!  Anyway, during the 2nd month, the arrythmeia marathon subsided, and the left atrial flutter seems to have disappeared.  However, i continue to have short lasting but periodic afib episodes, two months afterwards.  I have had three of these in the 2nd month, so the trend is better.

But my qeustion is this:  Did i just make things better or worse?  My EPs at UofM seem to think this is all very normal, and that these arrymetias should subside/disappear  even further.  But i would like a 2nd view of this, as this isnt exactly what i thought would happen here.  Seems to me that 2 months after this surgery, if it were successful, i shouldnt be having these episodes, even if they dont last very long (they last about 0ne hour and convert with the same dose of norpace as above)

Would greatly appreciate your opinion.

Thank you much

[kay1745]

A related discussion, afib ablation was started.

[ddavey]

who are your drs at u of m?   my daughter is seeing dr michael lehmann and dr bogun(ep) at the U of M, she underwent an unsuccessful ablation there in july    she has dilated cardiomyopathy and very frequent pac's with afib and svt's.   due to a defect on her mitral valve they were not able to ablate on the left, and we now know that everything is coming from the left  (27,000+ on a 48 hr holter)    we wish you the best         dawn davey

[Cleveland Clinic]

Atrial flutters are common after PVI.  They may occur as a sign of a healing atrium and ultimately most of them will go away.  However, there are some that persist requiring a second procedure (PVI).  Atrial fibrillation, when it occurs after PVI may have two meanings.  It may simply be a recurrence due to incomplete ablation, and we have seen this in up to 20% of patients.  But we have noticed that in the first 2-3 months afib recurrence doesn't necessarily mean that the procedure was unsuccessful.  Sometime it takes some time for the atrium to heal and reorganize.  Of course if the episodes of afib are becoming more common it probably is a sign of recurrence.