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Second Ablations Often Succeed

In 2001, I suddenly had a short in the electrical system of my heart, and this threw me into A-fib. I have had an ablation with a 67 percent cure, and am taking digoxin, Sotalol, and Cartia XT. Why do they say a second ablation usually has an 80 percent or better cure? I am 81 and they say the risk is too high for me to go through a second ablation. Do you concur?

Ablation procedures are usually catheter approaches designed to eliminate tissue in the heart responsible for causing, or contributing to, an arrhythmia—in your case, atrial fibrillation. This is commonly achieved with radio-frequency-produced burns and sometimes by freezing, delivered over the catheter tip. At times the first ablation procedure doesn’t destroy all the necessary tissue, and the arrhythmia recurs. Other times, the tissue appears dead during the first procedure but recovers over time to cause the arrhythmia again.

Whichever, a second ablation attempt is often successful. We perform such procedures in octogenarian patients, but it depends on how “young” the 80-year-old is. Your own doctor is in the best position to make that judgment call. Without question it would be nice for you to be able to stop your medications. That is why ablation procedures have become so popular. In fact, electrophysiologists are among the very few physicians in cardiovascular medicine who can produce an actual cure of a problem. However, there are some risks, particularly in the elderly and with second procedures, which is why your doctor is being cautious. I would suggest you and your doctor discuss the pros and cons and come to a decision with which you are both happy.

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