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Paroxysmal atrial fibrillation

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1 hour ago, Martin Kotlar said:

I have been diagnosed with paroxysmal atrial fibrillation. I am scheduled for an ablation procedure.  My question is:  if I am not in a-fib at the time of the ablation, is the procedure still performed?

Thank you. Martin Kotlar

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.

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9 minutes ago, Daisy said:

If you go to a really experienced EP with top-notch credentials, it shouldn’t be a problem.

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.


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5 hours ago, Martin Kotlar said:

Daisy, are you saying that I do not have to be experiencing A-Fib just prior to getting the ablation procedure?  How does the cardiologist know what to do if I have a normal rhythm at the time of the procedure?  Thanks for your comments.

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.” 


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10 hours ago, Martin Kotlar said:

Thank you Daisy & Mark - your comments and information are extremely helpful.

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.

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