I realized that it’s been about 5 years since I shared my Atrial Fibrillation updates with the readers of A-Fib.com. You can read my early story here. But for now, let me take you back to 2019.

Want to jump ahead? Click for 2021 Update and his 2026 Update.

In 2002, I started a website, Atrial Fibrillation: Resources for Patients (www.A‑Fib.com) written from a patient’s point of view, and in plain English, not medicalese. I wanted to spare others the frustration, depression, and debilitating quality of life the disease caused me. A-Fib.com is my way of passing on to others what I have learned (and will continue to learn) about Atrial Fibrillation.

2019: My A-Fib Returns after 20 years 

Steve S. Ryan, PhD. A-Fib-free (Again)

In 2019, my A-Fib recurred after 20 wonderful A-Fib-free years. My A-Fib recurrence didn’t come as much of a surprise.

My catheter ablation back in 1998 was primitive compared to what EPs are doing today. I had what was called at that time a “focal point catheter ablation”. They actually ablated inside just one of my pulmonary veins (PVs) to eliminate the A-Fib signal source. (Today they don’t ablate inside a PV anymore because of the possible danger of causing stenosis/swelling of the PV.)

Choosing a Touch-up Ablation Rather Than A-Fib Drugs

I was asymptomatic and was offered the treatment option of just taking A-Fib drugs. I chose instead to have a modern “touch-up” catheter ablation performed August 1st, 2019 by Dr. Shephal Doshi at St. John’s hospital in Santa Monica, CA.

My A-Fib catheter ablation went off without a hitch. I was in the cath lab by 8 am, out by 11 am, discharged by 5 pm and home by 6 pm. I felt great! (but no heavy lifting or workouts for two weeks.

Comparing My RF Catheter Ablations: 1998 vs 2019

When I developed paroxysmal Atrial Fibrillation in 1997, I was very symptomatic. This time, in 2019, I didn’t have any symptoms—instead my A-Fib was detected by my tiny, inserted Medtronic Reveal LINQ loop monitor/recorder (placed just under the skin on your chest).

Steve in Cath Lab before Catheter Ablation 2019

Since 1998, the treatment of A-Fib by catheter ablation has advanced by light years including 3-D Mapping, ablation systems and catheter technologies.

My last ablation 21 years ago in Bordeaux lasted eight+ hours. This one at St. John’s Hospital in Santa Monica, CA took only 2-3 hours.

In Bordeaux, I was in the hospital for 9 days (mostly for observation, and a “touch up” second EP lab visit). In 2019, I was in and out in 12 hours.

The Following Week Recurrence: Install a Pacemaker?

One morning in the following week at 6:27am unbeknownst to me, my LINQ recorder captured an A-Fib episode—a seven-second pause. Dr. Doshi wanted to install a pacemaker right away but I decided to wait and see. It’s not uncommon for A-Fib to reoccur during your three-month blanking period. Your heart is learning to beat again in normal sinus rhythm. So I didn’t panic. It was the right choice for me.

My 2-Month Post-Op: All is Good

I felt fine. I haven’t had an A-Fib episode for a month. My ECG looked perfect. Dr. Doshi took me off my anticoagulant (Xarelto). Yippee! A life free of A-Fib is truly a blessing. (Spoiler: At least for a few years.)

2021: A Touch-Up 3rd Ablation for “Extreme Late Recurrence” by Dr Natale

The return of my A-Fib was captured in 2021 by my Medtronic Reveal LINQ loop recorder. I was asymptomatic, often referred to as Silent A-Fib.

I’m was 80 years young and a very active runner, high jumper and weightlifter. While many EPs would likely prescribe A-Fib drugs, I chose a third “touch-up” ablation instead.

This ablation was for the condition called “Extreme Late Recurrence” where someone who has been A-Fib free for years develops A-Fib again. Previously these cases were considered very difficult or even impossible to fix.

Dr Natale, Steve, surgical nurse pre-ablation 2021

But thanks to the excellent research of Dr. Andrea Natale and his colleagues, “Very Late Recurrence” can now be fixed.

To learn more about Very Late Recurrence, see our article: After Two Years A-Fib Free, What Causes ‘Very Late Recurrence’ in Post-Ablation Patients?

My Third Ablation

My re-do catheter ablation was on August 19, 2021 and was performed by Dr. Andrea Natale at Los Robles hospital in Thousand Oaks, CA.

Research has shown that very late recurrence of A-Fib is primarily driven by non‐pulmonary vein triggers especially from the left atrial appendage and coronary sinus. Isolation of these triggers results in a high success rate.

During my ablation, this is exactly what Dr. Natale found.

Non-PV Triggers Galore

He isolated both my left atrial appendage (by installing a Watchman occlusion device) and my coronary sinus to eliminate the locations of these triggers. (My pulmonary veins had remained isolated.) He also made a roof line and an “infero-posterior” line with RF catheters to isolate the posterior wall of the left atrium.

He found non-PV electrograms/potentials in the left atrial septum, the floor of the left atrium, the left atrial lateral wall, and the anterior roof of the left atrium which he eliminated with RF ablation.

I was in the hospital overnight. Everything went fine. The only complication I had was irritation of the throat from being intubated. I had to return to the Los Robles emergency room, but they took care of that with medication.

A-Fib Free (Again)

I was temporarily on Multaq and of course the anticoagulant Eliquis.

I’ve cleared my three-month blanking period (the period when my heart is learning to beat normally again). For now, I’m A-Fib free once again. Glorious!

April 2026: Still A-Fib Free

Just a note to say I’m still A-Fib free after my 2021 touch-up ablation!

I’m still attending the annual AF Symposium and writing reports for our A-Fib.com readers. We continue to post insights on new developments in research that affects your A-Fib treatment choices.

Always remember, as we often say: Be Your Own Best Patient Advocate. 

That means keep educating yourself about all your treatment options. A-Fib.com is your unbiased source (we are independent, not sponsored by anyone, not a healthcare org. nor a drug company.)

And always…Aim for a cure! Not a life on meds.

Personal Life: Like other fellows in their 80s, I’ve had my share of other illnesses beyond Atrial Fibrillation (back surgery, a hip replacement, cataract eye surgery to name a few), but life is good.

As a matter of fact: Patti and I celebrated our 50th anniversary in August 2024.

Sidenote: I’m back on a blood thinner, Eliquis, but not for A-Fib.

They found an embolism (deep vein thrombosis) in my lower leg. This occurs when a blood clot forms in a deep leg vein. If left untreated, this clot can break free, travel to the lungs, and cause a life-threatening pulmonary embolism (PE).

Thus, I went on Eliquis to dissolve the clot and any future clots. Who could have guessed I’d be on a blood thinner after being free of A-Fib for the last five years?

Steve S. Ryan
Malibu, CA, USA, April 2026

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