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"Steve Ryan's summaries of the Boston A-Fib Symposium are terrific. Steve has the ability to synthesize and communicate accurately in clear and simple terms the essence of complex subjects. This is an exceptional skill and a great service to patients with atrial fibrillation."

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Carolyn Thomas, blogger and heart attack survivor; MyHeartSisters.org

"Steve, your website was so helpful. Thank you! After two ablations I am now A-fib free. You are a great help to a lot of people, keep up the good work."

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"If you want to do some research on AF go to A-Fib.com by Steve Ryan, this site was a big help to me, and helped me be free of AF."

Roy Salmon Patient, A-Fib Free; pacemakerclub.com, Sept. 2013


degenerative disease

FAQs A-Fib Ablations: Wait or Ablate Now?

 FAQs A-Fib Ablations: Wait or Ablate?

Catheter Ablation

Catheter Ablation

2. “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?”

A-Fib is a progressive disease. The longer you have it, in general the worse it gets. In a process called “remodeling” your heart may change physically and electrically if you have A-Fib long enough. The longer you have A-Fib, the harder it is to cure.

For instance, a patient can be diagnosed with paroxysmal A-Fib initially and then transition to persistent, and eventually to long-standing persistent A-Fib. This progressive nature of atrial fibrillation is why doctors say, “A-Fib begets A-Fib”.

So, it’s important to be cured as soon as reasonably possible. See our Overview of A-Fib.

With today’s current Pulmonary Vein Ablation (Isolation) procedures using Pulmonary Vein Potentials, you have an 70%-85% chance of becoming A-Fib-free (in cases of Paroxysmal A-Fib). (The other 15% though not cured are often significantly improved; meds that didn’t work before may now work.) With a second ablation the success rate is 90% or greater.

So don’t wait. Your odds aren’t going to get much better than that.

References
¤  Haïssaguerre M. “Electrophysiological End Point for Catheter Ablation of Atrial Fibrillation Initiated From Multiple Pulmonary Venous Foci,” Circulation. 2000;101:p. 1409.
¤  Jaïs, P. NASPE Convention presentation, San Diego, CA, May 8, 2002.

Return to FAQ Catheter Ablations

FAQs Coping with A-Fib: Progression of Disease

 FAQs Coping with A-Fib: Progression of Disease

red-heart-negative 150 pix by 96 res4. “I’m worried about going into permanent (Chronic) A-Fib which I know is harder to cure. I’ve had Paroxysmal (occasional) A-Fib for a couple of months, but the A-Fib episodes seem to be getting longer and more frequent. How long do I have before I go into permanent A-Fib?”

Worst case scenario, Paroxysmal (occasional) A-Fib can progress to permanent in about one year. In a study of 5,000+ A-Fib patients, 54% of those on rate control meds went into permanent A-Fib in one year. However, there are people who’ve had Paroxysmal A-Fib for years and never progress to permanent A-Fib.

But the odds are against you. You are correct that the longer you have Atrial Fibrillation, the harder it can be to cure it. Consider working aggressively to stop your A-Fib as with antiarrhythmic meds or with a minimally-invasive Pulmonary Vein Ablation or a Mini-maze surgery. You don’t want to be part of the 54% whose A-Fib becomes permanent.1

To learn about various Treatment options for Atrial Fibrillation, see our Treatments page. Think about your treatment goals. Is managing your A-Fib and increased stroke risk with meds okay with you? Or do you prefer to aim for a cure? Discuss the options with your doctor. Take action as soon as practical.

Back to FAQs: Coping with Your A-Fib

References    (↵ returns to text)

  1. O’Riordan, M. RECORD AF: Better Success With Rhythm Control, But No Difference in Outcomes. Heartwire/Medscape Medical News. November 17, 2009. Last accessed March 29, 2014. URL: http://www.medscape.com/viewarticle/712576

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