markflint

I may remember this wrong, but around a month before I got mine somebody else on this forum got a pericardial effusion during a Natale ablation. He only ablated areas showing up generating arrhythmias for me, too, but that meant going into the LAA, and that's a place most EPs don't dare to go. My EP, who was fine with me seeing Natalie and considers him one of the best, did comment that he, in his words, "ablated the sh** out of you." He wasn't saying that was a bad thing, just a big thing.

I kind of thought the same thing as Daisy, but was going to wait before coming right out and saying your guy doesn't sound like he's a big dog when it comes to treating AFib. If I lived in Texas and needed another ablation I would go to Austin and have it done by Natale. I don't like the man, and he pushes the boundaries, which means he takes risks, but he's a savant with the probe. Mark

It's understandable to be upset, but those symptoms probably don't mean your ablation was a failure. You are in what is known as the blanking period, and your heart is well and truly pissed off about being messed with. During the blanking period scarring will form and close off the ability of misbehaving cells to cause AFib. The unknown is whether the EP got all of the miscreants. In the meantime, if the AFib is intolerable, they may try a stronger antiarrhythmic med, such as amiodarone or Tikosyn (dofetilide). These drugs can have serious side effects, and tikosyn requires hospitalization for a few days to monitor to make sure it doesn't have the side effect of QT interval elongation, which can be serious. I would only take drugs on that tier if the AFib was intolerable, or I were in AFib after the blanking period -- and I'd be scheduling a follow-up ablation ASAP to get me into NSR to minimize time on them. Your EP should have given you information about the blanking period as part of your discharge, and you also should have been told to stay on the Eliquis. Not having you on anticoagulants is a pretty serious error. Mark

Yes. They can induce AFib. https://www.mayoclinic.org/tests-procedures/cardiac-ablation/about/pac-20384993#:~:text=Sensors on the tip of,where to apply the ablation.

This is the important part. Really important. Mandatory if you want the best chance for success. There are people here who have had multiple ablations that failed to get the job done. It may take more than one, and in my case, which was complicated, took three. Your EP should have thousands of ablations on the books, and share his success record -- which should be defined as NSR unaided by antiarrhythmic medications after the blanking period. I would be as diplomatic as possible, but do not worry about offending anybody when pushing for this. You have a right to put your future in the hands of someone you trust to get it right. --Mark