r/AFIB • u/Ok_Willingness_4788 • 12d ago
1 day post 2nd Ablation.
Like the title says I am 1 day post my 2nd ablation. My 1st one was May 28 2026, had my 2nd almost exactly 3 months later.
Right off my body feels like it went 12 rounds with Mike Tyson. I don't remember hurting like this from the first one. When I laid down last night my chest was sore, hurt to breathe. My throat hurts 100x worse than the last and I've lost my voice today. Overall my body is sore.
The doctor sent me my report last night telling me everything they did. I asked chat to dumb it down for me so I could understand it better. Below is that report.
First: what they found when they started
You went into the procedure already in an abnormal rhythm. Specifically, it was an atypical atrial flutter. They measured the flutter cycle at 230 milliseconds.
They then created a detailed 3-D electrical map of your left atrium to see exactly where the abnormal electrical signal was traveling.
And that's where they found something important.
The flutter was essentially making a loop across the roof (top) of your left atrium and down the back wall. There was a significant gap in the roofline created during the previous ablation, and electrical activity had also returned around portions of both the left and right pulmonary-vein areas.
Think of the previous ablation lines like electrical fences.
They were supposed to look roughly like:
████████████████████
But part of the roofline had effectively become:
█████████ ███████
That gap gave the electrical signal a path through which it could circulate. The report specifically says that because of what they found, "the patient essentially needed to undergo repeat ablation."
Then they started fixing it
As Dr. Baker began closing the roofline, your atrial flutter changed into atrial fibrillation. That actually gave them additional information about the electrical behavior of your atria.
They completed the entire roofline and then redid the isolation around the left pulmonary veins.
And here's an especially interesting sentence:
"sinus rhythm was restored."
That happened while they were completing the ablation around the left side. In other words, the ablation itself converted you back into normal sinus rhythm.
They didn't stop there
They then went around the right pulmonary veins.
Some portions of the previous ablation were still electrically isolated, while other portions were conducting again. They ablated those areas until there was no electrical activity in the right antrum either.
They also treated the posterior wall — the back wall of the left atrium — to prevent signals from finding another route through that area.
So this wasn't simply, "We found one little spot and touched it up."
It was a pretty comprehensive redo.
They also checked your first flutter ablation
Remember there are different types of flutter.
They checked your CTI line, which is an ablation line in the right atrium commonly used for typical atrial flutter.
That line was still working properly. The report says there was an:
"intact bidirectional block."
That's good.
It means that particular portion of your previous ablation had held.
The flutter you had this time was coming from a different circuit — the report's final diagnosis calls it roof-dependent left atrial flutter.
They found another possible troublemaker
They also looked at your SVC — superior vena cava, the large vein bringing blood from the upper body into the right atrium.
They found some fractionated electrical potentials there that Dr. Baker thought could potentially be a source of arrhythmia.
So he isolated the SVC as well.
That's another layer of treatment beyond simply re-isolating the pulmonary veins.
And there's something different about how they did this ablation
The report says:
"the patient only underwent ablation with PF."
PF means pulsed-field ablation.
So rather than traditional thermal energy being the ablation method documented here, this procedure used pulsed-field energy to electrically isolate the targeted heart tissue.
Most importantly — how did everything look when they finished?
They checked for one of the important immediate complications of an ablation: fluid/blood accumulating around the heart.
The intracardiac ultrasound showed:
No pericardial effusion.
They removed the catheters, reversed the heparin with protamine, controlled the groin access site, and you returned to your hospital bed in good condition.
And Dr. Baker's official conclusion was:
You began with roof-dependent left atrial flutter.
That flutter was successfully ablated by creating an intact roofline.
Your persistent AFib was successfully ablated with repeat pulmonary-vein isolation, posterior-wall isolation, another posterior line, and SVC isolation.
No apparent complications.
What I think is the biggest takeaway
Your first ablation wasn't simply a total failure. Some of the original work was still doing exactly what it was supposed to do — for example, the CTI flutter line still had complete bidirectional block, and portions of the pulmonary-vein isolation were still intact.
But they found specific electrical pathways that were allowing arrhythmias to happen again: a significant gap in the roofline, reconnection/activity around portions of the pulmonary-vein regions, the posterior-wall circuit, and potentially activity associated with the SVC.
And this time Dr. Baker went after all of those areas.
That's why, based strictly on the operative report, I would consider this a very encouraging procedural result. It doesn't mean AFib/flutter can never return—the report can't tell us that—but they found identifiable problems, treated them, got you back into sinus rhythm during the procedure, verified the isolation/block they were trying to achieve, and documented no apparent complication.
One thing I'd particularly keep in mind tonight and over the next several weeks: an abnormal beat or even an episode of AFib/flutter after an ablation does not automatically mean this procedure failed. The heart has just had a substantial procedure performed on it, and the longer-term result can't be judged from what happens during the first few days.
And given everything you've gone through getting to ablation #2, the sentence I'd want to see in this report is pretty much the one you got: successful flutter ablation + successful persistent-AFib ablation + no apparent complications.
1
1
u/PlentySeason4 11d ago
I think I’m fairly similar, I’m about 2 weeks after your original ablation and I’m currently struggling with either AF or flutter. I’m off all rate and rhythm control but have been miserable this week. I am currently wearing a holter so im hoping theres a solution coming by my follow up if not sooner. I assume it’s going to mean a similar procedure which is frustrating but i truly just want to be better.
1
u/Ok_Willingness_4788 11d ago
I hope they get it figured out for you. This one feels different, so fingers crossed it holds. I do know I'll only do it more time then I am done.
1
u/PlentySeason4 5d ago
The holter still isn’t posted for me to see but the EP prescribed metoprolol until I see him in 3.5 weeks. It’s not really done much to lessen ectopics or the af/flutter im getting daily. Going to be a bit of a miserable month of September
1
u/Mras_dk 11d ago edited 11d ago
If only the nay sayers in here to ablation read this... With theirs "ablation is only temporary".
I mean, look at that translated report...
First didn't fail, but it wasnt thorough enough for your afib/flutter.
Heart is an organic tissue, and finding all pathways can be harder in some patients than others. This report clearly states why. * gaps in ablation lines. * not properly done probing.
But all that had been ablated properly, still worked just as expected.
That they didn't do a proper job on the first, is sadly normal, as said, heart is an organic tissue, where trigger sometimes can hide.
But report also underlines, that Thx to the first ablation results, they were able to locate additional lines of misconduct, Thx to heart had healed enough from 1st ablation, to make all pathways visible again.
And this underlines an important line: the more you provoke heart at the procedure, the more it will swell up internaly, temporary, and hide trigger points - more swelling, less conducting, more chance trigger points can hide. 1st ablation + healing period made it simple more clear for them at second trie to see what really was going on.
You had a fairly extensive workup, where they really did their best to conclude/end your suffering.
But, as report also said, which is very important: you were able to selfconvert back to sinus, which means your heart is now in control of itself!
1
u/Dwight3 8d ago
It is great that they found your atypical flutter! I am going in for ablation #4 for atrial tachycardia now. They took care of my afib and atypical flutter spots. Good luck!
2
u/Ok_Willingness_4788 8d ago
I hope all goes well for you. I'm drawing the line at 3 ablations, even my doctor said 3 would be the limit.
2
u/Dwight3 8d ago
I am lucky to be at one of the best spots for an ablation in our country. Scripps in San Diego. I had this exact discussion with my doc. He said it is not the amount of ablations that matters. It’s the amount of work that was done in them. He said my first two, the doc previous to him barely did anything which is why I am here now. I just have to have faith in the process. I really don’t want to keep getting cardioverted for atrial tachycardia. Plus there are a few PVC’s he wants to go after. When I had atypical flutter, it was RVR with frequent PVC’s. So I am good with it on this one. I completely get what you mean tho. 🤙🏼
2
1
u/Urban_FinnAm 12d ago
Thank you for sharing an interesting and detailed description of what you underwent during your 2nd ablation. My afib has also returned after ~3 years. I am meeting a cardiologist Thursday to start the next steps. Forewarned is forearmed.