How often and far apart should cardiac ablations be?

[berbmcq]

My husband has had 4 cardio versions and 3 ablations and is still in artrial fib. It has been recommended to have another ablation...my question is how many ablations are safe? And what is recommended time period between them?  His last one was in December.  I realize the cardiologist has the best info to make this decision but was curious what the "general rule of thumb" was.

Thank you.

[researcher09]

Just because a doctor suggest ablation doesn't mean that he is any good at it.  The first job of a patient or parent is to make sure you are getting a skilled ablationist that do a high volume of procedures. Preferably a couple of hundred per year if not more.

[researcher09]

Also take into the account the complexity of the procedures.  Right sided procedures are the easiest.  Left sided higher in complexity and skill.

[JS1974]

I'm looking into cryo ablations for my son. Freezing rather than burning is supposed to be less traumatic for tissue and less scaring

[feather1997]

Im 18 and my problems started back when I turned 16. Ive had 3 ablations and have a 4th one in a matter of two weeks. Ive had 2 of the 3 this year.

[JS1974]

My son is 19 years old. He's had three ablations within 2 years by two doctors. The last 2 by the same doctor. . One in June and another in October. The dr just informed us he wants to try for a 3rd which will be my sons 4th. This is so discouraging to say the least. Has anyone read any studies about how many are too many? He was burned each time and obviously it didn't work so the wrong area was burned. What's the repercussions of this? Burning healthy tissue can't be good. I have decided to seek a few more opinions before doing this again.  My son wants to rush in and do it again because he's tired of being tired... but I feel this can get worse if we keep these surgeries up. He does seem to be getting more symptomatic.

[JS1974]

My son is 19 years old. He's had three ablations within 2 years by two doctors. The last 2 by the same doctor. . One in June and another in October. The dr just informed us he wants to try for a 3rd which will be my sons 4th. This is so discouraging to say the least. Has anyone read any studies about how many are too many? He was burned each time and obviously it did not work so the wrong area was burned. What are the repercussions of this? Burning healthy tissue can not be good. Especially for long term. I have decided to seek a few more opinions before doing this again.  My son wants to rush in and do it again because he is  tired of being tired... but I feel this can get worse if we keep these surgeries up. He does seem to be getting more symptomatic.

[JS1974]

Feather - how did the fourth one work out for you. I hope it was successful

[hosehead]

I assume these were catheter ablations.  From what I know, and it's more every day, ideally the errant signals cause the AF are coming into the upper left atria via the pulmonary veins (from the lungs).  Ideally, these signals would be interrupted by ablating the tissue outside of the heart.  With catheter ablation, done inside the heart, scar tissue is created around the vein openings in several different patterns (doctors preference).  This second method is newer and I don't believe as successful.  Again, I'm just a 52 year old guy in afib myself but, I've done a lot of research and asked a lot of questions.  At $500 for a basic cardiac consult, I GET my (insurance company's) monies worth.  I've heard that 2nd CA are not unusual to get those minute areas that might have been missed originally but, three times does sound a little bit much.  Are you in a teaching hosp?  That can have an effect.  I wouldn't even want to be the first one to get a haircut from a new barber, much less this.  Good luck, hope this helps in some way.

Todd

[LindaTX]

Your poor husband.  Maybe you should get a second opinion.  I've heard a lot of doctors say 3 is the limit.

[ireneo]

I've had 3 ablations and said no more. I don't have a-fib, just PSVT. They did zap the a-flutter the first time out but the PSVT has been more difficult to control. But mine is greatly improved so that my PSVT usually lasts less than a minute. A little annoying but at least I don't have to lie down and wait it out like I used to.

I agree that maybe it's time for another opinion, another EP cardio to take a look at what's going on.

[cindy707]

I don't actually know what protocol is for max. of ablations with a human but as long as they are not "burning" the areas he should be pretty safe because i know that burning causes scarring and is not the way to go.  I am however questioning the doctors skills if your hubby has had 3 ablations already and the doc hasn't caught the problem and he is still in a fib.  To me i would be seeking out a second opinion here and trying my best to find out what my docs background is here because we can't take chances with the heart.  My personal criteria for a heart doc is pretty basic...the doc for me has to have performed more than 1500 ablations with no losses....he/she has to have had training under Dr. Natale/Scheinmann the developers of the procedure or at the very least followed the same training protocol as they have developed, i would check their record with the American Medical Association, look for patient reviews of your doc, find out how many hospital privliges that he/she has and how many hospitals accept that doctor, find out if he/she has written papers on the procedure, etc.   The positive here is that the doc has waited the 6 months that most docs follow before deciding that another ablation would be needed.  From everything i know a good doc waits the full six months before doing another procedure.  I would question why he is being subjected to so many procedures and why didn't they get it the first or second time?  Obviously your husband can't stay in a fib but i would better my odds with this one.....i chose a doc that did it all and have never looked back...he was diagnostic, surgeon, ablater, etc.  I chose not to go with a doc that did solely EP studies because i felt that he was not well rounded enough and i wanted someone who once the procedure began could diagnose without having to call in another doc if it was something other than what we knew i was facing....good luck but i would get pro active here.....