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Can Afib Ablations Be Performed More Than Once?

Cardiac catheter ablation is one of the most powerful tools in an electrophysiologist’s armament of tools. But to understand the potential outcomes after an ablation, we need to explore what exactly and ablation entails.

Doctor holds a catheter preparing for a cardiac ablation for Afib at Huntington Heart Center

Cardiac catheter ablation involves the threading of a long, thin catheter from a small incision in the groin into the heart. The tip of the catheter has a mapping system that shows the Electrophysiologist the structures of the heart and the electrical patterns and signals emanating from the heart. This mapping system can accurately detect any abnormal heart rhythms, also known as arrhythmias. The cardiac catheter ablation procedure is relatively straightforward and very safe. However, as with any medical procedure, results vary between patients and there may be the possibility of having a second catheter ablation if the first does not completely resolve the arrhythmia issue.

Why might I need a second catheter ablation?

As you have undoubtedly seen in your research, cardiac arrhythmias are not one-size-fits-all and they are not necessarily predictable. People who are in Afib may be so infrequently. This is known as paroxysmal Afib, and this does not follow a pattern. As a result, when your initial ablation is being performed, there may be more malfunctioning heart tissue, but we simply do not see it because it is not detectable at the time of the ablation. With that being said, we can induce Afib mechanically or chemically during the procedure, and we may do so if we suspect more areas that require treatment.

An additional ablation may also be required because new arrhythmias can occur in the future. While the primary ablation may have handled all errant electrical signals at the time, this does not mean that arrhythmias cannot occur in the future. If this is the case, we can often perform a second procedure.

Is a second catheter ablation safe?

The risks of a second catheter ablation are only slightly higher than those of the primary ablation. This can be influenced by the patient’s general health as well as their cardiovascular health at the time of the ablation. If they have improved their cardiovascular health by the time they have their second ablation, it may be less risky than the primary. Regardless, the overall risks associated with a cardiac catheter ablation are relatively low.

What if a catheter ablation simply doesn’t work?

There are times where patients who undergo a cardiac catheter ablation once or twice simply do not receive the relief that they or their doctors expect. In these cases, patients may have to remain on some antiarrhythmic and anticoagulant medication to help ensure that their risk of stroke remains low. Typically, however, the catheter ablation is successful enough that they can reduce their medication significantly (or eliminate it), thus reducing the side effects of the medication as well.

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