What if AF comes back after an ablation?

It is common for people who have had an AF ablation to have at least one episode of AF again in the future. Up to 50% of people who had an ablation for persistent AF (AF all the time) will have another episode of AF that requires treatment, a third or so of people in paroxysmal AF (AF which comes and goes) will have one. Usually, this is because of healing of the ablation, and the second procedure can be considered a “touch up job”, where specific areas that are key triggers or have healed can be targeted.

Around 10% of patients who have gone down the ablation route find that despite our best efforts the disease has progressed too far and it is impossible for ablation to be successful. We can usually tell if this is the case only after a second procedure where a mapping of the scar in the heart can be performed. In these patients usually medical treatment only or a pacemaker provides a reasonable solution.