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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 52531
Experience:  Cardiology Expert
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My wife has persistent afib. She had a failed catheter pvi

Customer Question

My wife has persistent afib. She had a failed catheter pvi ablation 5 months ago. She is in heart failure, NYHA Class III, ejection fraction 35%. A biventricular pacemaker and AV node ablation has been recommended. I am told on one hand it works very well, but when we went for a second opinion it was a "last resort." I am trying to get objective information. What percentage of the time does it improve quality of life through measureable means such as ejection fraction, exercise tolerance, NYHA class, etc. What are projections at five years after procedure? Is it last resort because you try medication, cardioversion, catheter ablation first, or is it because it often fails to help but the situation calls for desperate measures?
Submitted: 9 months ago.
Category: Cardiology
Expert:  Dr. Phil, MD replied 9 months ago.

Thanks for this question.

How well can she function now? Can she get around pretty well or no given the NYHA class III?

Is her quality of life good?

Customer: replied 9 months ago.
Quality of life has diminished over the last year. This time last year she could walk about 2 blocks, now she can walk maybe 150 feet before resting. She sleeps a lot, although not very well, and dozes a lot. Her mental ability seems to be compromised.
Expert:  Dr. Phil, MD replied 9 months ago.

Thanks for this question

I think this is going to be the right move.

The pacemaker will synchronize both sides of the heart and improve her exercise tolerance and capacity.
I would do it

Customer: replied 9 months ago.
How often does this procedure fail to produce intended results i.e. improving exercise tolerance. We are weighing it against a second catheter ablation or a surgical ablation.
Expert:  Dr. Phil, MD replied 9 months ago.

75% efficacy

You could try another ablation

Then do this if it doesn't work

Expert:  Dr. Phil, MD replied 9 months ago.

Please don't forget a positive rating

Expert:  Dr. Phil, MD replied 9 months ago.

Thanks for this question.

Please don't forget a positive rating. I appreciate it :)

If you have more question, just reply.

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