Atrial Fibrillation patients seeking a cure and relief from their symptoms often have many questions about catheter ablation procedures. Here are answers to the most frequently asked questions by patients and their families. (Click on the question to jump to the answer)
1. Heart Function: “Does this burning and scarring during the ablation procedure affect how the heart functions? Should athletes, for example, be concerned that their heart won’t function as well after an ablation?”
Related question: “I’m a life-long runner. I recently got intermittent A-Fib. Does ablation (whether RF or Cryo) affect the heart’s blood pumping output potential because of the destruction of cardiac tissue? And if so, how much? One doc said it does.”
2. Radiation: “How dangerous is the fluoroscopy radiation during an ablation? I know I need a Pulmonary Vein Ablation (Isolation) procedure to stop my A-Fib—A-Fib destroys my life. I’m worried about radiation exposure.”
3. Condition of Heart: “What is an enlarged heart? Does it cause A-Fib? I was told I can’t have a catheter ablation because I have an enlarged heart. Why is that?”
Related question: “I have serious heart problems and chronic heart disease along with Atrial Fibrillation. Would a Pulmonary Vein Ablation help me? Should I get one?”
Related question: “I have a defective Mitral Valve. Is it causing my A-Fib? Should I have my Mitral Valve fixed first before I have a PVA?”
4. Age: “I am 82 years old. Am I too old to have a successful Pulmonary Vein Ablation? What doctors or medical centers perform PVAs on patients my age?”
Related question: “I’m 80 and have been in Chronic (persistent/permanent) A-Fib for 3 years. I actually feel somewhat better now than when I had occasional (Paroxysmal) A-Fib. Is it worth trying to get an ablation?“
5. Blanking Period: “How long before you know a Pulmonary Vein Ablation procedure is a success? I just had a PVA(I). I’ve got bruising on my leg, my chest hurts, and I have a fever at night. I still don’t feel quite right. Is this normal?”
Related question: “Since my ablation, my A-Fib feels worse and is more frequent than before, though I do seem to be improving each week. My doctor said I shouldn’t worry, that this is normal. Is my ablation a failure?”
6. O.R. Report: “I want to read exactly what was done during my Pulmonary Vein Ablation. Where can I get the specifics? What records are kept?”
7. Procedure Length: “What is the typical length of a catheter ablation today versus when you had your catheter ablation in 1998 in Bordeaux, France? What makes it possible?”
8. Clots/Blood Thinners: “After my successful Pulmonary Vein Ablation, do I still need to be on blood thinners like Coumadin, an NOAC or aspirin?”
Related question: “I was told that I will have to take an anticoagulant for about 2-3 months after my ablation. Afterwards shouldn’t there be even less need for a prescription anticoagulant rather than more?”
Related question: “During an ablation, how much danger is there of developing a clot? What are the odds? How can these clots be prevented?”
9. Exercise: “I’m having a PVA and I love to exercise. Everything I read says ‘You can resume normal activity in a few days.’ Can I return to what’s ‘normal’ exercise for me?”
10. Non-PV Triggers: “Are there other areas besides the pulmonary veins with the potential to turn into A-Fib hot spots? I had a successful catheter ablation and feel great. Could they eventually be turned on and put me back into A-Fib?
11. Heart Rate: “I’m six months post CryoBalloon ablation and very pleased. But my resting heart rate remains higher in the low 80s. Why? I’ve been told it’s not a problem. I’m 64 and exercise okay, but I’ve had to drop interval training.”
12. The Bordeaux Group: “I’ve heard good things about the French Bordeaux group. Didn’t Prof. Michel Häissaguerre invent catheter ablation for A-Fib? Where can I get more info about them? How much does it cost to go there?”
13. Cure? “I have Chronic Atrial Fibrillation. 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?”
Related question: “I’ve read that an ablation only treats A-Fib symptoms, that it isn’t a ‘cure’. If I take meds like flecainide which stop all A-Fib symptoms and have no significant side effects, isn’t that a ‘cure?’”
14. Tech Advances: “I’m getting by with my Atrial Fibrillation. With the recent improvements in Pulmonary Vein ablation techniques, should I wait until a better technique is developed?”
6. “Is Atrial Fibrillation curable? Or can you only treat or control it? Should I seek a cure?”
A-Fib is definitely curable. (I was cured of my A-Fib in 1998). If you have A-Fib, no matter how long you’ve had it, you should aim for a complete and permanent cure.
Currently, Catheter Ablation and the Maze/Mini-Maze operations both offer the hope of becoming A-Fib free permanently. For example, Pulmonary Veins Ablation/Isolation (PVA/I) techniques are achieving success rates of 70%-85% in making Paroxysmal patients A-Fib free. A second procedure, when required, raises the success rate to 90% or higher.
Being ‘cured’ of A-Fib is possible for more and more patients every day. Discuss these treatment options with your cardiologist or electrophysiologist.
If your doctor is satisfied with just keeping your A-Fib “under control,” I recommend you get a second opinion.
Refer to our Finding the Right Doctor page and related readings. We step you through all you need to know to find the right doctor for you and your treatment goals.
Last updated: Monday, February 13, 2017
Frequently Asked Questions by Newly Diagnosed Patients
Newly diagnosed Atrial Fibrillation patients have many questions about living with A-Fib. These are answers to the most frequently asked questions by patients and their families. (Click on the question to jump to the answer)
1. Cause: “Did I cause my Atrial Fibrillation? Am I responsible for getting A-Fib?”
2. Severity: “My doctor says I had an attack of Atrial Fibrillation. How much trouble am I in?”
Related Question: “Is Atrial Fibrillation a prelude to a heart attack?”
Related Question: “Can I die from my Atrial Fibrillation? Is it life threatening?”
3. Anomaly? “Could my Atrial Fibrillation go away on its own? I don’t want to take any medication. Can I just wait and see?”
Related Question: “Is it possible to have a single Atrial Fibrillation attack and not have any others? I had a single episode of A-Fib and was successfully converted in the ER with meds.”
Related Question: “How can I tell when I’m in A-Fib or just having something like indigestion?”
5. Driving: “Can I drive my car if I have Atrial Fibrillation?”
6. Nutrition: “Is drinking coffee (tea, colas, other products with caffeine) going to make my Atrial Fibrillation worse or trigger an A-Fib attack?”
Related Question: “Is there a diet I could follow which would cure my Atrial Fibrillation?”
7. Medical ID: “Should I carry a wallet card or a medical ID? I have A-Fib and take Coumadin (warfarin). In case of an A-Fib emergency, what information should I include?”
8. Coping: “I have a lot of stress at work. Does this stress cause or trigger my Atrial Fibrillation?”
Related Question: “I live in fear of my Atrial Fibrillation. I never know when I’m going to get an A-Fib attack or how long it will last. How do I deal with the anxiety?”
Related Question: “Is there anything I can do to get out of an Atrial Fibrillation episode? How do others deal with their episodes?”
9. Specialist? “Should I see a cardiologist for my Atrial Fibrillation and not just my primary care doctor? (He wants to prescribe medication.) Should I also see an A-Fib specialist?”
10. Cure? “Is Atrial Fibrillation curable? Or can you only treat or control it? Should I seek a cure?”
If you find any errors on this page, email us. ♥ Last updated: Monday, February 13, 2017
Return to Frequently Asked Questions
by Steve S. Ryan, PhD, June 2014
Ed Grossman recently wrote and asked me about recurrence of A-Fib after a successful catheter ablation:
“I’ve read studies from the French Bordeaux group that talk about A-Fib recurring after a catheter ablation, that A-Fib tends to come back. Can A-Fib be cured permanently by a catheter ablation? After a successful catheter ablation, what are my chances of A-Fib recurring?”
The French Bordeaux group pioneered the original Pulmonary Vein Isolation procedure.
The studies you refer to were done in 2001-2002 with 100 patients. There’s been a great deal of improvement in the procedure since then, such as the use of irrigated tip catheters and the increased use of circumferential pulmonary vein isolation (PVI). (For example, when I had my procedure done in Bordeaux in 1998, they did what was then called a focal ablation in only one of my pulmonary vein openings. I’ve been A-Fib free “cured” for 16 years. Today though, they routinely isolate all four pulmonary veins.)
Don’t let the threat of recurrence put you off of having a catheter ablation. Recurrence is often influenced by several factors unrelated to the actual catheter ablation procedure, some of which you can control.
Certain Health Conditions Cause Recurrence of A-Fib
There are health conditions which tend to cause A-Fib to recur including hypertension, obesity, sleep apnea, diabetes, smoking and binge drinking. Controlling these conditions will reduce the risk of recurrence.
For example, let’s say patient “Joe” has A-Fib and sleep apnea, then has a successful A-Fib ablation and is A-Fib free. Because of his sleep apnea, Joe’s A-Fib is more likely to recur than someone without sleep apnea. So much so, that Electrophysiologists (EPs) today are insisting that A-Fib patients with sleep apnea be treated and use devices like a CPAP breathing machine before they can get a catheter ablation. In one study sleep apnea was an independent predictor for catheter ablation failure after a single procedure.
Also, those with long-standing persistent A-Fib, or those with vascular heart disease, or cardiomyopathy are more likely to have a recurrence.
Less recurrence for those with Lone A-Fib
Around 50% of A-Fib patients have no apparent pre-existing medical condition—called “lone A-Fib” because there’s no other contributing health condition. After a successful catheter ablation, those with lone a-fib are less likely to have a recurrence. But some lone A-Fib patients do have recurrences. (Some studies estimate a 7% chance of recurrence out to five years, though most recurrences occur in the first six to 12 months.)
So why the recurrence for lone a-fib patients? Heart tissue is very tough and tends to heal itself after an ablation. Or, there may be gaps in the ablation lines and the spots may require a touch-up ablation (usually with a much shorter procedure time and easier to perform than the first ablation).
The joy of Years of living in ‘Normal Sinus Rhythm’
Let’s discuss a worst-case scenario. You have a catheter ablation that makes you A-Fib free. Then three years later you develop A-Fib again. But the bottom line is you’ve been “cured” for three years. (The dictionary defines “cure” as “restoration of health; recovery from disease”.)
Most people with symptomatic A-Fib are overjoyed to have a normal heart beat and a normal life for three years, to be freed from both A-Fib symptoms and from the anxiety, fear and depression that often accompany A-Fib.
(See the personal experience stories by patients who had recurrence and a successful second ablation: Jay Teresi, “In A-Fib at Age 25“ and Robert Dell’s A-Fib Experience: “Daddy is always tired”.)
Only people with A-Fib appreciate how wonderful it is to be in ‘Normal Sinus Rhythm’ (NSR). For most of us, catheter ablation provides “acceptable” long-term relief from A-Fib. And it’s comforting to know, you can go back for another ablation, if you need it.
Catheter Ablation is the Best Hope for a “Cure”
Today, catheter ablation is the best A-Fib treatment offering hope for a “cure”—for making you A-Fib free. Current medications, for the most part, don’t work or have bad side effects or lose their effectiveness over time. Electrocardioversions usually don’t last. Surgical approaches work, but are generally more invasive, traumatic, and risky, and not recommended as first-line therapy for A-Fib.
Yes, A-Fib can return after a catheter ablation; the benefit may not be permanent. But, as a point of reference, consider heart by-pass operations or heart stents—are they always permanent? (Often they aren’t.) Do patients need additional surgeries? (Often they do.) With the option to return for an additional or “touch-up” procedure, catheter ablation is still today’s best hope for a life free from the burden of Atrial Fibrillation.
Last updated: Monday, August 17, 2015