“I have Chronic Atrial Fibrillation (the heart remains in A-Fib all the time). Am I a candidate for a Pulmonary Vein Ablation? Will it cure me? What are my chances of being cured compared to someone with Paroxysmal (occasional) A-Fib?”
This is a question that is currently in dispute among researchers in A-Fib. However, most clinical studies suggest that Paroxysmal is more frequently curable by PVA(PVI) than Chronic.
In fact, the French Bordeaux medical group, considered among the world’s leaders in A-Fib research, now uses a combination PVI and linear catheter ablation procedure for Chronic A-Fib as compared to a PVI ablation procedure for Paroxysmal A-Fib. They only consider patients with chronic A-Fib if they have “symptomatic and complicated AF” because of the following reasons: patients with Chronic A-Fib often have “poor hemodynamic tolerance” (their blood isn’t being pumped out properly), “suspicion of tachycardiomyopathy” (the heart tissue may have been damaged by the rapid, irregular heart beats or fibrillation), and “suspicion of thromboembolic events” (a greater risk of stroke). (Added 2017: The Bordeaux group now uses ECGI (Medtronic’s CardioInsight system) in cases of Chronic A-Fib.)
Linear ablation techniques, though more difficult to perform effectively, may work better for people with chronic A-Fib and/or structural heart disease. In a Boston A-Fib Symposium 2006 presentation Dr. Jaïs from the French Bordeaux group reported a study in which 95% of Chronic A-Fib patients were restored to normal sinus rhythm.
For someone with Chronic A-Fib, you have a better chance of being cured of your A-Fib if you’ve been Chronic for a short period of time rather than for a number of years. Does that mean that people with Chronic A-Fib have little hope of being permanently cured by a catheter ablation? No. It’s just that right now most major heart centers have a long waiting list and have better success rates with Paroxysmal A-Fib.
• Adams Jr. H. “How To Avoid Stroke,” The Good Life. Boardroom Inc., 2001, p. 31.
• Jais, P. “Ablation Therapy for Atrial Fibrillation: Past, Present and Future,” Cardiovascular Research, Vol. 54, Issue 2, May 2002, P. 343.↵
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