Tips for Before and After an Ablation to Improve Odds of Success
March 22, 2023
The prospect of an atrial fibrillation / Afib ablation procedure can feel daunting, especially if this is your first major interventional procedure. But let’s get right to it: cardiac catheter ablations are very safe, effective (in the properly selected patient), and do not require significant downtime after the procedure. They are also excellent options because they do not preclude other therapies, like medication if you need additional treatment to address a particularly stubborn arrhythmia.
Tune Out the Noise
You may have heard from a friend or family member that their Afib ablation did not work. This is possible in certain patients, especially those who have allowed Afib to progress or those not carefully selected for the procedure according to best practices (I.e., some patients with persistent Afib and most patients with long-standing persistent Afib).
We have excellent data showing that ablation is very effective (70%+) when it is still in its paroxysmal or random/occasional stage. Once it progresses to a more persistent state, the success rates tend to drop significantly. However, ablation can still be effective in the properly selected patient, even in persistent Afib – the results are just less predictable.
There’s plenty in the lead-up to your ablation and even after it to maximize its results and lower the chance of the recurrence of your irregular heartbeat. Of course, for some, structural heart defects or genetics will make Afib more challenging to control. However, we can make plenty of lifestyle modifications to improve the situation.
Improve Your Diet
There are two sides to this equation. We want you to improve your diet to lose weight, if necessary, which will involve calorie restriction, and you could also employ time-regulated eating, known as intermittent fasting. By reducing your overall caloric intake, several metabolic benefits will follow. And while you may have your procedure in just a few weeks or months from now, even losing 10 or 15 pounds can make a significant difference to your heart and markers of metabolic disease. Losing weight can also improve sleep apnea which has been shown as a significant risk factor for atrial fibrillation and cardiovascular disease more generally.
Improving your diet means more quality, complex carbs versus empty carbs like sugar, white grains, and other processed foods. The same goes for fats. While fat has been given a bad rap, they are essential for our bodies’ continued functions. However, there are different kinds of fats. Saturated and trans fats cause atherosclerosis, or the narrowing of the arteries due to plaque buildup on their walls.
On the other hand, unsaturated fats like those you get from olive oil, avocados, fatty fish like salmon, and some nuts and seeds are beneficial. The same goes for sugar – and the cells in our body need glucose to function correctly. However, how we get our sugar makes a big difference. Eating whole fruits versus fruit juices and removing sodas from our diets are significant first steps.
Exercise is an activity that some patients are wary of, especially if they have significant cardiovascular disease. Patients should consult with their cardiologist before starting any new exercise program; however, regardless of cardiovascular issues, exercise is critically important for some of the abovementioned reasons, including weight loss. Cardiovascular exercise helps the heart pump more efficiently and strengthens the muscle for longer-term health. Weight training, which should never be ignored, also helps maintain muscle mass and has many benefits, including burning more calories at rest and maintaining bone density. Exercise also has many psychological benefits, including improving mood and helping treat underlying anxiety or depression.
While most of us think of smoking-related problems relating to cancer, especially lung cancer, smoking also causes many cardiovascular issues. For example, smoking constricts the blood vessels, increasing the risk of atherosclerosis and eventually causing a heart attack. It can also make Afib worse and more challenging to treat. We all know quitting smoking is difficult, but it can be the difference between good and great results.
Excessive alcohol consumption is correlated with increased incidence and severity of atrial fibrillation. As with most things, moderation is key. However, in the weeks leading up to your ablation and for as long as possible afterward, we encourage you to avoid alcohol. For most, light alcohol consumption will not trigger atrial fibrillation, but even one daily drink increases the risk of an Afib episode by up to 16%. This risk increases with the number of drinks consumed each day.
What About Caffeine?
For years, it was suggested that caffeine consumption was a risk factor for new or worsened Afib. A stimulant such as caffeine should theoretically make the heart beat faster or more irregularly. However, recent research has shown that caffeine not only doesn’t have a direct correlation to Afib but may even be somewhat protective.
As you can see, the best practical advice we can offer to make your procedure as safe and successful as possible revolves around improved habits and positive lifestyle changes. Your overall physical and psychological health influences your heart health, so taking care of yourself is the best way to see ideal results before and after your procedure.
A Note on “Failure”
One of your most important Afib decisions revolves around the electrophysiologist you choose. Electrophysiologists with extensive experience treating atrial fibrillation using advanced cardiac catheter ablation know how to best select patients for the procedure. If you have been diagnosed with paroxysmal Afib, you should get checked out by your primary care physician and an electrophysiologist as soon as possible. Doing so can offer the best opportunity for early diagnosis while it is still very treatable. In fact, in well-selected patients, ablation can be successful in upwards of 70% of people, and this success rate drops to about 40% once the patient reaches persistent Afib.
Needing a second ablation is also possible if your primary procedure doesn’t fully address the issue. There is no universal manifestation of Afib – every patient experiences it differently. As such, be reassured that if Dr. Tordini recommends a second ablation, it is either as a touch-up, as we call it, or to address a different area of heart tissue that may not have been creating errant signals when we first evaluated you.
We look forward to discussing any heart rhythm issues you have been experiencing so we can get you on a path to an appropriate solution.