All about AF ablation 

I cut down on caffeine, reduced stress and limit carbs. My palpitations, PCV and irregular heart rhythm has gone back to normal. No surgery was required. There is hope.

The humility of Dr. Gupta is so refreshing. You do not act as if you know everything. You are asking questions as a student would. Deep admiration.

Fascinating conversation between two heart professionals. Thank you Dr Sanjay for letting us into this most interesting discussion. May I add, Magnesium Taurate has greatly improved my AFib.

A specialist interviewing a sub specialist both in the same area This can’t get any better. Dr Gupta asks him questions that brings out THE MOST TEAL RELEVANT critical issues. I learned tons of things here that even in books you will not find. Most interviews are made by people of different areas and they often miss a lot of insiders issues. Thank you. This was phenomenal

Thank you Dr. Gupta and Dr. Manssor for taking time to have and share this insightful conversation about AF and AF ablations. I will be listening again. Congratulations to Dr. Manssor for joining York Cardiology. Wishing you both the very best. Constance

Excellent talk. I had a RF ablation 10 days ago, for both PAF (pulmonary vein ablation) and flutter (flutter ablation in right atria). My heart is structurally sound, I am fit, do not drink alcohol etc. but have previously undertaken endurance sports. No AF since ablation (early days!). This talk was very reassuring that, on balance, i made a good decision, especially given the potential for increasing fibrosis once the AF becomes persistent. Also that i have a good lifestyle, sleep well, low BMI and still suffered arrhythmias. Thanks Docs, so clear and informative.

I had my ablation 6 weeks ago and all is going as advertised. Amazing

Best procedure I ever had, seriously improved my lifestyle, and so far (three years) my AF has not come back other than a couple of seconds here and there. It wasnt in York though Doc..sorry. Oxford.

Thank you, Dr. Gupta & Dr. Nasir. This was very informative. It is sad that you are not located in the United States.

My AF became so severe that I was unable to move too much. The result was that my weight then increased. I finally had an ablation, remapping and reset of the heart. The doctor used a new method for the ablation that doesn’t use heat or freezing. It is supposed to do less damage to the heart. I’m now two months after the ablation. It worked immediately and nothing has returned since. My heart is so regular that I keep checking my pulse just in case! I can run, cut the lawn and have returned to my old self after two years of becoming slower and slower. I’m nearly 70 now, but this operation has really changed my quality of life. Now I’m working on getting the weight off after being inactive for so long. The benefits of ablation are instant (once the entrance wound clears up) and I feel that I have got a more ‘normal’ life back again thanks to having it done.

Dr Sanjay, can you please talk about the powerful anti arrhythmatic effects of taurine on the heart 😃 I know you have a few on magnesium but taurine my god!! so many of us lack it and it has a really powerful balancing effect on sodium potassium and calcium rations and also acts as a natural adrenaline suppressant while also lowering the excitability of the myocardium!! powerful stuff :)

What is the risk of dying from this procedure? What would cause this?

Dr Nazir seems to be a Kind, knowledgeable and very informative doctor!

Dr Gupta..your questions and approach to excellent medicine are amazing!! Thank you for your concern and radical integrity ❤❤❤

It just shows you how many ppl are living with this horrible condition, afib, palpitations , ectopics etc, etc. Just like me, ❤ absolutely hate them and every shit heart beat that’s felt , and every shock of a beat it’s missed , like feeling that it gives you is absolutely crap, 😢but he ho

Fantastic video, Answered almost every question I had regarding ablation. Have suffered P.A.F most of my adult life, with on average 2 attacks weekly lasting on average 12 hours each time. A gradual increase in my flecanide to 200mg daily seems to finally have it under control with only 2 attacks in 9 months. Having expressed my concern at the long term effects of such a high dose I have been offered ablation as an option. This excellent conversation has reassured me that its something I should seriously consider in future in the event that my bloodwork starts to show irregularities with my liver/kidney function. Thanks once again for your time and dedication to the subject.

Brilliant & honored guest. Enjoyed the information. Thank you.

It was " believed" that my Father had an "electrical" problem with his heart. From what I understand this can be very difficult to diagnose. He had a team of Drs that were not sure about this diagnosis...

I have had 2 cryo ablations. (Emphasis on posterior area in the 2nd one.) 200mg of amiodarone/day. *NO* atrial fibrillation for two-and-a-half years...

I started with palpitations over 30 yrs ago a week ago no problems flutters now and then butI started having continuous palpitations. Dr upt my meds from 2.5mg Bisoprolol to 5mg that was Wednesday this week but there's been no change. No diabetes, no smoking, 62 kilos.. scared.

Mostly the discussions were around paroxysmal afib. Would like to see another similar discussion on the challenges, risks and outcomes of treating persistent afib with ablation as I know many EPs do. Thanks

Sunjay you are the doctor, the other guy is merely a technitian, period,

Thank you so much for the informative video. My cardiologist requested me having this for SVT, however the idea of “burning” parts of the heart seems more invasive than they suggested. Your videos answered lots of questions and I’m incredibly grateful. Warm wishes from Miami 💓

Thanks Dr’s for that great video. I’ve had AF for 2 years and had 12 cardio versions and 2 Ablations and still have Afib. I’m a 69 yr old male and I guess I will have to live with AF. I am A symptomatic and otherwise very healthy. I feel better knowing that as long as I stay on Eliquise and Bystollic I should be ok. Thanks again for all the information you make available to us.

I have a friend who had an Ablation and she is happy she did. I have great admiration for this woman because she has had most of these heart problems, including a heart attack and just keeps going, living life like nothing is wrong with her heart. She's a work horse, very seldom complains and is always the first one to volunteer to help out. She doesn't worry about quality of life or length of life. She just accepts what is and LIVES each day. Not the typical AFIB/heart patient.

I take bisoperole by prescription , but listening to this wonderful Dr Gupta and watched so many of his brilliant videos over the years, the information on (magnesium and the heart) , I have been taking magnesium supplements every day, so the combo of both have diminished my ectopics to near zero considering I was having ectopics beats every few seconds all day which I hated so much ❤

Sir, the size of my ascending aorta is 4.3 cm and it was 4.2 last year. Is there any possibility of preventing this enlarging with meditation and lifestyle. I have reduced 18 kg of my weight by last one year. Please tell me if there is any hope.

Thanks, Docs appreciate your taking the time to do this.

THANK YOU both for all you do! ❤

What about the use of Pulse Field Ablation (PFA,) can you speak to that?

What about ablation for SVT ? I had a catheter ablation about a month ago and I am getting a lot of skipped hearts beats that make me feel like I have afib now. Any advice on this?

In the future,could Dr. Manssor have his own microphone?

Fantastic content ! very informative! thankyou both for your service ! 🙏🙏

Thank you so much Doctors for making this video, really helpful and informative, many thanks

thank you for such an informative interview about AF!

Thank you for this informative video. I am an ultrarunner who has recently had an ablation. So far Afib has not returned, but I have noticed my HRV (RR) had dropped to below 20ms. It seems to have flatlined since the operation. Do you know if this is likely to recover or if it is a side effect of the ablation? Also, as low HRV signifies poor health, does it mean I will not be as healthy as I was before the operation, or does it mean that after an ablation the link between poor health and low HRV is no longer significant? Many thanks Chris

Very interesting!!! Thank you so much Doctors!

Had that surgery but Dr had to stop it after 35 minutes because I felt my brain swelling

I have permanent AFib. Now consultant wants me to come off Edaxoban. Does this put me at risk of a blood clot developing ?

I was just discharged from the hospital after having a cardio conversion. My diagnosis was AFIB/AFlutter with RVR. I am an 84 year old woman. Do I need to see an EP? I take Flecainide (increased to 100mg twice a day) Metroprolol (12.5mg) and Xarelto (15mg). My rhythm is now normal. Thank you for the information!

Thank you so much for such a informative video. I’ve had AF off and on for about 40 years, had 2 AF ablation’s that weren’t successful. The Tambocor (150mg twice a day) seems to keep it under control most of the time, although usually every 2 months or so my heart goes into AF for around 12 hrs, then goes back into normal rhythm. One question I do have, is AF hereditary. I sincerely appreciate your RU-vid postings, they are so informative. Jim … Australia

This is amazing discussion. I had an ablation one year ago. I wish heard this duscusdion before Dr Gupta you are amazing. Thank you so much.

I came across your videos & I wish you were a Cardiologist in my area. :-) I have had chest pain for a few years now on and off during exertion (it comes & goes) it has definitely hindered my life because at one point if I did anything strenuous, I would get these pains where I had to stop & wait until they subsided. I had an echo stress test which was inconclusive so my doctor wants me to get a cardiac Catherization but I am afraid of the contrast. (my ekg was also not normal--but he was not too worried about this) 15 years ago I had a CT scan of my lower back/spine and I never will forget the feeling I had when they injected me with contrast. It was just not that hot feeling like you were going to pee your pants, it was this jolt I had thru my body, it was the worst feeling so I am petrified to get this contrast. I feel since this has been going on for awhile, I am so exhausted ALL the time, I am 67, my choloestrol is elevated the doctor thought since all the tests I had are inconclusive, the Cardiac Cath would be the way to go. I am wondering if the contrast has changed over the past 15 years. Not sure you have the time to response, but I would really appreciate it. Oddly enough, I am not afraid of the Cath, it is the contrast. Thank you!!

Fantastic update and in depth information surrounding AF causes and ablation techniques. Thankyou to you both! Faye ex CCU Nurse NZ.

Hello Dr. Gupta! So good to see you! This is so interesting . Thank you so much! Both of you. Your gracious to teach us. Love you sir! Have a wonderful day!

Highly informative, comprehensive discussion on AF ablation Thank you Dr Sanjay.

So much we have learned today. MANY THANKS DOCTORS.

Thoroughly enjoyed your video....I have pacemaker and AV Node ablation....20 years of proxysmal AF and after having Covid really bad, full on AF....I could feel every beat and they were so erratic and after watching one of your other video's on PM and Av Node ablation, finally went to Glenfield in Leicester and saw the EP's like Dr Manssor Nasir, amazing people, sometimes my heart would be going at 200+ bpm it was the best thing I ever did, 2 years later and not to have that erractic heartbeat and tablets that caused me to be more ill than the AF, now I hardly take tablets, not even blood pressure tablets my blood pressure is stable at around 115/76 cant remember a time when I never had to take BP tablets, thank you for your video's and EP's like Dr Nisir....

Thank you Doctors!

My AFIB has been under control with Flecainide and Antenolol. Recently, my doc reduced my Antenolol by half so my heart rate wouldn't drop so low. The tiny pils are hard to split and was still having very low heart rates... so, I thought - maybe I don't even need Antenolol since the Flecainide is what keeps my heart in rhythm. Well, after two days, I went into full blown AFIB. Went away after taking an Antenolol pill. So... was surprised that got me back in rythm since I believed it was the Flecainide that did it. Any thoughts?

💕Thank you both. Fantastic information. God bless from Australia 💕

I think I'm 'an old banged up Skoda!' But I'm really suffering. It's not always A Fib, sometimes it's Flutter, sometimes it's SVT, and sometimes it's ectopics. An exercise bike test caught all of them happening, and it's totally debilitating. But it's all paroxysmal and there's no telling when it will kick off or how long for. I'm on Apixaban, Bisoprolol and Flecainide, but I can't control it. It's becoming more frequent and lasts 46 hours sometimes. I hate it but I can't get them to change my meds or suggest an ablation. 😢 I don't understand why they haven't offered me an ablation. Thank you for all these videos, I'm so grateful for the info.

Can't hear the electro cadiologist very well

One week 24 hours monitoring found I have AFib 50% of time, and my i watch shows my heart beat rate from 69 to 160 and normal resting rate at 80. I don’t feel anything uncomfortable. I’m 67 and generally healthy -- with normal blood pressure, normal blood sugar, everything in annual blood test is fine with only LDL a little bit high at 135. I don’t drink, smoke, with regular exercise and healthy diet in normal body weight. I wonder how I got AFib, and if I need an Ablation procedure. I had congenital heart surgery 50 years ago when I was 17. I wonder if it was that caused my AFib now when I am older.

I'm curious as to why you didn't cover Pulse Field Ablation? it's said to only alter the electric pathway (not the tissue), be less complicated, have no risk to the oesophagus and no PV stenosis risk... OH and I am also curious as to why the "mini-maze" approach is so obscure?

No Ablation unless I have no other options! My Cardiologist suggested the Watchman for me and I said no. Don't want surgery of any kind and no foreign objects unless its life or death. How dangerous is AFIB, Ectopics, extra heart beats? Can you live indefinitely with it? Especially if you treat it naturally and with medications? I've never felt any of it and never had any chest pain. It is all rather strange and scary. Thanks Doctors! 💕

Dr.’s hopefully you or someone will answer. I take Nordic ultimate omegas. Have for sometime. I’m now 70. I am reading all over now how you’re at a higher risk of a-fib/stroke if you take omega’s???? This is the first I’m aware of this. Not only the Mayo, Cedars, and many others are saying this. Is this true??

The volume is very low. even turned up.

The conclusion, after hearing the electrophysiologist, is that cardiology has a long way to cure AF, as the possibility of new episodes after 3 years is high, so why would someone bother his system with such a burden of complications and medication during and post the prosedure,when he can manage equally well with life style changes, sorry doc, but after hearing this video I decided never to have an ablation.

Wow visiting the channel today. I don’t know why it took me too long but it’s so nice to see you Doctor again. You helped one time with my palpitations and Im just been doing really good. You are a very humble doctor. Today I’m been checking for information about low blood pressure, I’m at peace this moment after your explanation. Now I’m liar if to your Dr guess to keep learning. I’m a Colombian living in USA. I can’t wait to share all this information! Thank you for what you do!!

Dr. GUPTA and dr. NASIR : Do you have any experience with ablations in patients with hEDS or HSD? Due to theese connective tissue disorders I wonder (and worry) that the operation might have different and or lesser outcome?

I've had easily 15k burden a day for weeks, cut out all caffeine, stopped over eating and they've pretty much gone. if i eat too much or eat spice boom theyre back.

I stopped mine with intermittent fasting and the autophagy from longer fasts.Also a good magnesium supplement dampens down Cortisol response, especially in the morning when getting up.

I got paroxismal afib and diagnosed from an ep study. No longer have it. Still have skipped beats though. Not concerned thanks to your videos doc. Before I knew I had afib.

I had 13 ectopics in one minute. Now I use flecainide. Will I ever can live without this medicin? The ectopics stopped.

Very informative thanks to both of you dr Nazir amazing explanation thanks

My 7-yr old grandson has been diagnosed with SVT and wore a monitor for the last month to see how often he has episodes. He’s very aware of his increased heart rate, and they’ve suggested an ablation. Is this a good idea for such a small child? Or should he try vagal maneuvers for a while?

Bisoperole stopped my ectopics

Absolutely pleased to find 2 experts on same subject. I am a patient with fast heart beats. Thanks a lot for genuine videos by Dr Sanjay Gupta JAI HIND JAI BHARAT 🌱

What about the piercing of the septum, what are the consequences, especially if a second ablation is required?

Always fastening watching your videos.. thank You!! And to bring your teacher on and bouncing thoughts and knowledge around .. awesome 👌

For example, what is it about fatigue or alcohol that changes ones chemistry - to enable Afib to start? Again, we know the names of the standard Afib triggers - but it seems no one know why or how the triggers work.

Truly appreciate all your priceless information💗 I would love to hear your thoughts on ascending aortic aneurysms! Possible causes? Care? Beneficial supplements and activities? Restrictions? How best to live with one with or without surgery, Etc. THANK YOU🥰

Thank you for this video. I watched before having an ablation and came out of hospital yesterday. I also had a cardioversion and remapping, so I was treated under a general anaesthetic which I woke up and reacted badly to. I am now home but my blood pressure has dropped quite dramatically. Before ablation, I was showing a systolic figure of around 150 to 160. (Along with permanent af) My blood pressure is now consistent but low. 100 to 120. The result is a dizziness when I get up so I may refer back to hospital to see whether I need to reduce my blood pressure pills. Early days now. My AF has gone and so far, no episodes at all. Heart no longer races after walking up stairs. Just low blood pressure which I’ve never had before! Always been on high side. The entry point in the groin is a little sore but I am amazed at how the technology in this area has developed even over the past 5 years. The surgeon didn’t use heat or cold to carry out the ablation, but a new device that is supposed to leave less damage to the heart. Electronically zapping the artery edges into the heart. He also did what he called a ‘remapping’ of upper left chamber. Would love to know what that actually is. I’m thinking that it is getting at electrical sources in the heart to stop rogue signals. In my case, I have probably had af for a very long time and not noticed. Inherited from my Mum! The effects only started to show when I hit 65 and finally 4 years later, it seems to have been zapped away. What surprised me in hospital was how many younger people were being treated.

Amazing conversation and informative video. Thanks for putting this together.

Any chance of a video with him about ectopics please.

Really interesting as a retired ccu nurse good revision.

My ablation is now 5 weeks ago. i have had now an episode of 3 sec., one hour after a slow 45min walk. what can i do ?

Why, why, why does alcohol stimulate afib?

Can't hear this even with the speaker plugged in

Thank you so much for this video..I have learned so much and you have answered questions that I have needed answered .

My electrophysiologist here in the USA told me that AF ablation is 80% successful and many patients need a second ablation. Ive had one and still have afib. I felt much better before the ablation.

This was extremely helpful to someone like myself considering ablation. Thank you both so much for doing this.

What a great conversation. Thank you so much for sharing Dr Gupta. I’m a huge fan of the channel. I’m a 45yo male and I had a cryo-ablation 4 months ago for my (very symptomatic) paroxysmal AF. I feel my AF is worse now compared to before the ablation. I’m having almost daily episodes and I’m getting a lot of flutter which I didn’t have before. I know the blanking period is between 3-6 months so I’m still hoping things will improve but at what stage do I consider my AF ablation was a failure and how do I address it with my cardiologist/EP? I have read some research where they’ve said that it is normal post ablation to have new atrial arrhythmias and flutter, and that it can take longer than 6 months for the heart to settle. 🤷🏽‍♂️ is there any truth to this or should I push for another ablation asap? I should also mention that I have AVR & MVR when I was 17yo so an RF ablation is not on the cards.

Thank you both an excellent and informative conversation. I have learned more in this discussion than in all previous research and meetings with my cardiologist!

I would just like to educate people on the risks. I had an ablation in october 2022 for Ventricular ectopics and i suffered a cardiac arrest immidietly after the ablation, due to perivascular inflammation. These risk werent told to me enough, make your own decisions.

That was fascinating. Thank you for being so lucid and clear about the whole process. Much appreciated from someone who had a successful ablation early last year.

Thanks Dr Gupta, that was a very informative interview!

We need this doctor in Jacksonville Florida❤ you will listen to your patients

Thank you, I wanted to understand the ablation procedure a little more. I have Left Ventricular Dysfunction, and have 28% ectopic beats, which have only reduced by 3% with Bisoprolol and Ramapril. I've just had a 4th heart monitor, I will be having a 3rd Echocardiogram since having my meds doubled to 5mg if each daily. When I see my consultant in November the plan will be for an ablation. Will my ablation differ from the one explained in this video ?

Thank you Dr. Gupta and Dr. Nasir for the excellent lecture on AFib and Ablation. I wish I had the chance to watch this video before my cardiac ablation for post Covid AFib last June. I developed AFib 8 hours post ablation in the observation unit with a float RN who had no cardiac experience!!! I was a CCU RN before I became a Nurse Practitioner and had to tell her I was in AFib on the monitor. It was the most frightening experience not knowing AFib can result immediately after the procedure from "irritation to the tissues of the heart" as was explained to me the NEXT day. My question: I had 5 episodes of AFib in the 6 weeks post ablation and my EP informed me I was still in the blanking stage and that it could take 3 months to recover or improve. If you said the success rate of AF ablation has gone up to 80-85% (I was told only 60 %), how often do you see AFib post ablation within the 3 month blanking stage? Is this fairly common? or a sign of ablation failure? Second question: Dr. Wolf (cardiac surgeon) claims ablation never works because AFib is a nerve problem and not a muscle problem, and that the Mini-Maze procedure is far more superior with a 90-95% success rate. Please comment on this statement. Thank you.

24/7 afib for past few years. Cardioversion and meds worked for a couple of those years. Getting a "mini maze" this Fall to hopefully fix it for good. Skipping the ablation due to it's poor success rate for persistant afib. Getting the atrial appendage clip put on during the procedure to avoid having to take NOACs in the future. I don't "feel" my afib, but it's constant. Thanks for your informative videos. Maybe talk about mini mazes in a future video?

Thanks Doc

Sound very very low i have to skip the vedio

Can’t hear him very well!!!

I drive a skoda, not let me down yet.😊

I do have a question. My longtime diagnosis (a few years) is PAT. ECG: sinus rhythm, tachycardia plus extra beats. No tolerance for beta blockers. Have been on losartan, amlodopine . Just prescribed digoxin (0.125 mg) but possible ablation if that doesn’t help. Would appreciate discussion of. PAT because I can’t find much about it. I’m 80,short. Some possibly of undiagnosed heart defect (inability to run in childhood). I was this many years old when I learned from RU-vid that being “double jointed” is part of an actual diagnosis-HSD.

Thank you very much for your excellent questions, Dr Sanjay. I don't feel that the ones that I was most interested in, as a 'lone PAF' sufferer, were answered though. I have to question the blanket prescribing of anti coagulants based on....what? As a PAF sufferer (1 episode a month or several months which a PiP dose of Flecainide stops in about an hour) with no comorbidities, a healthy heart and good level of fitness I question why I should take a medication for the rest of my life (anticoags). I have had the figure of 5x increased risk of stroke mentioned multiple times but I eventually tracked down the source of this figure - from the Wolfe study done as part of the Framingham studies - and discovered that PAF sufferers were EXCLUDED from this study! How much evidence is there of increased stroke risk among a population with no comorbidities? I'm guessing very little because drug companies must make so much money from the huge number of people taking these meds. Same with statins. We are advised that the newer anticoags are perfectly safe....but NO medication comes without side effects and/or risks.

45:03 Interesting that the agreed blanking period for Catheter Ablation seems to be around 3-6 months. it’s discussed here that at 6 weeks any returning episode would be touching on a non successful procedure? It’s obviously coming from experience but it does seem a little disheartening. 6 weeks as a judgement call sounds incredibly hasty 😢 hair on shaven incision site hasn’t even grown back 😂 The question is: What’s doing the heavy lifting… The Lesion or The Scar ?🧐

Thank you for this important information!