A-Fib Ablations: Will My A-Fib Eventually Return?Atrial Fibrillation: Resources for Patients

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FAQs A-Fib Ablations: Will My A-Fib Return?

Catheter Ablation

“Since my PVI, I have been A-Fib free with no symptoms for 32 months. What do you think my chances of staying A-Fib free are?”

I think your chances of staying A-Fib free are pretty good. A Pulmonary Vein Isolation (Ablation) is like a kind of immunization against A-Fib. If your Pulmonary Veins (PV) are well isolated and stay that way, you can’t get A-Fib there again.

When the PVs are isolated and disconnected and haven’t reconnected, it seems to be permanent. Intuitively it makes sense that A-Fib wouldn’t reoccur in areas that were successfully ablated and that haven’t reconnected. But it’s too early in the history of PVA(I)s to say this definitively.

NOTE: PVA(I) is a relatively new procedure. I had my catheter ablation in 1998 when I was 57 years old and I’m still A-Fib free today at age 76. However, at that time of my ablation, only one of my Pulmonary Veins was isolated. In theory the other veins could start producing A-Fib signals. But that hasn’t happened. My catheter ablation procedure back in 1998 was primitive compared to what is done today.

Regrowth/Reconnection of Ablated Heart Tissue: There is a tendency for ablated heart tissue to heal itself, regrow the ablated area, reconnect, and start producing A-Fib signals again. But if this happens, it usually occurs within the first three to six months of the initial PVA(I).

Recent research indicates that for a small number of people, a successful Pulmonary Vein Ablation (Isolation) procedure may not be a permanent “cure.” Dr. Francis Marchlinski of the University of Pennsylvania persuaded patients who had experienced successful PV ablations and who were A-Fib symptom free, to be re-examined in the EP lab. He found that some had regrowth/reconnection in their ablated vein openings even though they were A-Fib symptom free. He also examined patients who had regrowth/reconnection and reoccurrence of A-Fib after a successful PV ablation.

He estimated that there is a 5-6% chance of regrowth/reconnection each year (though not necessarily of A-Fib recurrence), out to five years. He doesn’t have data for beyond five years.

There is a 5-6% chance of regrowth/reconnection each year (though not necessarily of A-Fib recurrence), out to five years. Click To Tweet

Who Is Most Likely to Have Recurrences? The people most likely to get recurrences often have pre-existing conditions or risk factors like obesity, diabetes, high blood pressure, sleep apnea, smoking, binge drinking, etc. Even though their PVs may remain well isolated, these risk factors could stimulate A-Fib in some other part of their heart or perhaps cause regrowth/reconnection in the PVs.

Don’t Fear Recurrence. But let’s say you do have a recurrence, for example, after seven years. It’s nothing to worry about and it can be fixed. You go in for a touch-up ablation which may take a whole 20 minutes to do.

Marilyn Shook

The EP usually only needs to fix a gap or a new spot that has appeared, rather than do a whole ablation and isolation of your PVs and heart. (And remember, you have been A-Fib free for all those years!)

This is exactly what happened to Marilyn. Read Marilyn Shook Updates Her 2008 Personal A-Fib Story. She had a ‘touchup’ ablation September 2014 and wrote us in July 2015 that she’s had no A-Fib since.

Live Life Like You Are Cured! It’s a waste of time to be concerned about something that may never happen (A-Fib recurrence). It’s like worrying about getting struck by lightning.

Thanks to Rob Muscolino for this question and to A-Fib Support Volunteer Jerry for helping write this answer.