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Hi There,

I suffer from Atrial Fibrillation. I have had two ablations in the past:

The first was to isolate the pulmonary veins and the second ablated a part of the heart where I was told I had atrial flutter been generated.

After my second ablation, my cardiologist told me they had examined my pulmonary veins also and found they were still isolated from the first ablation (ie there were no gaps).

My last ablation was 10 months ago. 

I still get runs of AF - from 10 seconds to 30 seconds though nothing sustained (as yet).

My question is how come I am still getting these small runs of Atrial fibrillation if I have had two ablation procedures? Could it be that the pulmonary veins sustain the AF and as they are isolated I do not get sustained arrythmia, however I still have "focal points" which can still fire off the arrythmia?

Thank you.

Category: Cardiologist

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Category: Internal Medicine Specialist
 32 Doctors Online

Thank you for your query at
I have gone through your case history. The recurrence of atrial fibrillation is usually due to re growth of sleeve across the ablation site. Usually we say ablation is successful if there is no recurrence of fibrillation even after one year of procedure.
In your case since you have recurrence of Atrial fibrillation though not sustained you should be require repeat electrophysiological study to confirm the growth of sleeves across the ablation site.

Dr Satish

Patient replied :

Thank you doctor. Yes I never had a complete remission from AF. I even had it after the operation and it has continued although non sustained.
Is my initial my initial statement plausible? Ie that although I can get AF for 10-30 seconds the fact that my pulmonary veins are abated (as mentioned the 2nd ablation confirmed they were still isolated) and the scarring from my 2nd ablation is enough to mean the arrythmia (so far at least) cannot be sustained?

Since you didn't have complete relief from A Fib from the first procedure , so it's possible that during the first procedure the whole trans-mural myocardium that is whole thickness of the muscle may not have been ablated and some fibers would have escaped and would have regrown now to develop A Fib rather than the scar of second ablation
Dr Satish

Dr. E. Satish Kumar
Category: Internal Medicine Specialist
Fellowship, Cardiology - Tamil Nadu Doctor M.G.R. Medical University - DNB, Cardiology, 2002 – 2005Training in Germany in Complicated AngioplastiesMedical School - Maharaja Krushna Chandra Gajapati Medical college, MBBBS MD, Int Medicine, 1989 – 1999.
Trained in Rota Abalation for treating Calcific coronary artery disease in Japan
Dr. E. Satish Kumar and 4 other Medical Specialists are ready to help you

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