![]() Many doctors base their decision on an individual’s CHADS2 score, which is a composite of a patient’s risk factors for stroke. ![]() Atrial fibrillation puts people at risk of a stroke, and those with afib have more severe and debilitating strokes, so doctors must decide whether or not those who are still having some afib should remain on anticoagulant medications, such as warfarin. However, there are some medical implications, such as the need for stroke prevention if the procedure is not a complete success. So while the ablation may not be a success based on a strict medical definition, the patient may consider it a success due to a significantly reduced afib burden and the ability to return to a normal lifestyle. The ablation may not eliminate AF, but it could significantly reduce the symptoms, such as palpitations, rapid heart beat, fatigue, dizziness, and others. Some doctors say that whether or not the procedure is a success ultimately depends on the patient. Implications of the Definitions of Success If patients continue to have atrial fibrillation, can the procedure be considered a success? ![]() In fact, it’s estimated that these “asymptomatic” events, those which are not felt, occur 4.5 times more often than symptomatic episodes. She counseled physicians to stop the medication three months after the procedure to determine if the patient’s atrial fibrillation was indeed cured.Īn ECG (electrocardiogram), which is used to record the rhythm of the heart, is essential to determine whether ablation has been successful as individuals may continue to have afib episodes after the blanking period but just not feel them. She also noted in her HRS presentation that there is no agreement among doctors on whether patients should remain on antiarrhythmic drugs during this time. Curtis advises patients to hold off on such “repeat” ablations during the blanking period since early recurrence is so common. Some physicians perform another ablation during the blanking period if the patient experiences early recurrence afib or flutter. Curtis, early recurrence does not mean that ablation has failed-although not having early recurrence suggests that the ablation will ultimately be considered a success. This is called the “blanking period”, and AF episodes during this period are known as “early recurrence”. Many patients experience some afib or atrial flutter in the three months following either catheter ablation or surgery for afib. “Cure should be the goal of any interventional treatment,” says Anne Curtis, M.D., who spoke at this HRS session. Traditionally success has been defined as the absence of atrial fibrillation (AF) episodes and the ability to discontinue antiarrhythmic drugs. Healthcare providers at Heart Rhythm Society 2010 seemed to be grappling with what constitutes “success” following catheter ablation. What is Catheter Ablation Success and What are the Implicationsīy Christine Welniak and Mellanie True Hills What is Catheter Ablation Success and What are the Implications.
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