17. “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?”
It takes about three months to know if your ablation is a success. It takes that long for your heart to heal. For a period of time (which varies from patient to patient) your A-Fib may seem to get worse. Why?
Inflammation: This happens in some people because of the inflammation and trauma to the heart and body tissues caused by the catheter ablation burns and the poking around in your heart during the procedure. These can seem to exacerbate your A-Fib. (An ablation procedure doesn’t create new A-Fib producing areas in your heart, though it may stir up existing A-Fib areas temporarily.)
There is a tendency for ablated heart tissue to heal itself, re-grow the ablated area, reconnect, and start producing A-Fib signals again.
Gaps and Scar Tissue: Another reason you may still have A-Fib is because of gaps in the ablation lines. In the most common A-Fib ablation procedures used today, doctors try to create ablation lines around your pulmonary vein openings to isolate them from the rest of your heart. (A-Fib producing areas are usually found inside your pulmonary vein openings.) But it’s difficult making continuous, perfect ablation lines. Sometimes there are gaps in those lines which let A-Fib signals through. But as your heart heals, these gaps usually fill in gradually with scar tissue that reaches its thickest size at the end of three months.
Milestones: In general, if you’re in sinus rhythm after the third month, the chances are good you’ll stay in sinus rhythm. If you’re in sinus rhythm after the sixth month, the chances of a reoccurrence of A-Fib are even less.
Remember—it isn’t the end of the world if your ablation isn’t a total success. There is a tendency for ablated heart tissue to heal itself, re-grow the ablated area, reconnect, and start producing A-Fib signals again.
Second Ablation: Many people (as many as 15%-25%) have to go in for a ‘touch up’ ablation procedure (including myself). This second ablation is usually, though not always, easier than the first. Often all the doctor has to do is ablate any gaps that haven’t filled in or ablate where there has been re-growth/re-connection. This usually isn’t the doctor’s fault. Heart tissue is very tough and has a tendency to heal itself.
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