Daisy

Yep, a big thing! He also had to ablate my LAA in order to end my flutter, and yes few dare to go there!

Yes, I went to Natale. In my case I don’t think that he took any risks as he only ablated areas that were showing up generating arrhythmias. Main thing, it worked.

I agree with Mark's comments. However, if it were me and this didn't stop after the 3 month blanking period, I would not go back to the same EP for a second ablation. The biggest predictor of success is who does it and while "good and experienced" is good, better is someone with a track record of 85 - 90% success and there are a very limited number with those stats. I traveled (to Texas) for mine and it was certainly worth it.

P.S. one (of many!) why it is so important to have the best of the best EPs is that, not some but actually many, will not do mapping but simply go in and ablate around the pulmonary veins (PVI ablation) as this area is the most common source of Afib. This will often be enough but it is also the cause of many failed ablations as there are many other areas where Afib can arise. For instance, in my case, isolating the pulmonary veins had no effect on my Afib and Aflutter. I was with a top notch EP and he traced all the sources of arrhythmias until each area tested as “electrically silent” and he could not induce any more arrhythmias. But, yes, it is helpful if you are actually in Afib when you get in the table, but not necessary if you are with an excellent EP.

No, you don’t have to be in Afib as you go into an ablation, but you do need a very experienced, top notch EP who can both do mapping (an electrophysiology study) and induce Afib with drugs. During the mapping they measure electrical potentials to help identify where the arrhythmias are coming from. Here is a quote from the link Mark gave: “Sensors on the tip of the catheter send electrical impulses and record your heart's electricity. Your health care provider uses this information to identify the area that is causing your arrhythmia and to decide where to apply the ablation. This part of the procedure is called an electrophysiology (EP) study.”

If you go to a really experienced EP with top-notch credentials, it shouldn’t be a problem. They will do mapping to find the sources and also provoke them during the ablation.