Catheter Ablation for Atrial Fibrillation
What is it?
Catheter ablation is a procedure to treat the abnormal electrical impulses that cause heart rhythm problems (arrhythmias). In people who experience atrial fibrillation, the treatment is directed towards the most abnormal electrical impulses that trigger episodes of atrial fibrillation.
Why perform ablation for atrial fibrillation?
Catheter ablation is a treatment which is effective in curing atrial fibrillation in certain patients. It is predominantly used in patients who have continued to have atrial fibrillation despite medications or who cannot take medications because of side effects.
How successful is the procedure?
The success rates of ablation for atrial fibrillation varies according to a number of factors including your age, the size of your atria (chambers at the top of your heart) and the severity of your atrial fibrillation. The initial success rate varies between 50-90%. The Electrophysiologists at Heart Care Victoria have experience and success rates that match the world's best cardiology centres. Your Electrophysiologist will let you know the likelihood of success. If the procedure is not successful a second attempt may be considered.
What are the risks?
Your Electrophysiologist will explain the risks of your particular procedure with you. As with all procedures there are risks, but in the hands of your experienced Electrophysiologist these occur in less than 1% of cases. Possible complications may include bleeding or bruising in the groin, a hole in the wall of heart, stroke, a narrowing of the pulmonary vein, nerve injury to the diaphragm or in rare cases, death.
Prior to the procedure
Most patients will require warfarin (a blood thinning medication) for at least 6 weeks before the procedure. This is stopped 4 or 5 days before the procedure. An image of your heart using an MRI or CT scan may be taken just prior to the procedure and this is incorporated into the computer equipment used during your procedure.
You will be required to fast 6 hours prior to the procedure. If you have diabetes and take insulin, you will receive separate instructions about your insulin.
What does the procedure involve?
The procedure is usually performed under a general anaesthetic. Small incisions are made in your groin and catheters are passed through sheaths up through the veins into the heart. A needle puncture inside the heart is usually required to enter the left
atrium at the back of the heart. Information is collected via the catheters from the inside of the heart, and then ablation treatment is performed on the abnormal electrical impulses which are causing atrial fibrillation.
At the completion of the procedure, pressure will be applied to seal over the incisions. You will first be taken to the Recovery Room and then back to your ward for monitoring overnight.
What should I expect?
In the first 24 hours after your procedure it is common to have some minor bruising and discomfort at the incision sites in the groin. Some chest discomfort is also common following the procedure and relates to the ablation performed in your heart. You will generally be discharged from hospital the morning after your procedure.
You will often be required to continue your warfarin and other medications for a period of a few weeks or months after the procedure. In certain patients, palpitations and even episodes of atrial fibrillation may be experienced shortly after the procedure. Palpitations in this early period after an operation may not necessarily represent a failed procedure. If these episodes are distressing you should see your local doctor or go to the Emergency Department of a hospital to obtain an ECG and medical advice.
You should avoid exercise and heavy lifting for the first few days, and then resume normal activities after the first week.
You should read the consent form and understand the risks involved with this procedure. Please clarify any concerns or queries about this procedure with your Cardiologist before signing the form.