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Medical Video: Catheter Ablation For Atrial Fibrillation (AFIB)
Atrial fibrillation (atrial fibrillation / AF) is a type of cardiac arrhythmias. Arrhythmia is an irregular heart rhythm. AF is caused by chaotic electrical impulses originating from the right side of the heart, called the right atrium. Inappropriate electrical signals may cause the atrium to fibrillate, or contract, quickly and irregularly. During an episode of AF, the heart can beat too fast, or with an unpredictable pattern.
Definition of "ablation"
The term "ablation" comes from the English verb "ablate", which means "eliminate or destroy". In AF, ablation refers to treatment options if drugs are not able to control irregular electrical activity in the heart. Ablation is an operating procedure that scratches a very small area of heart tissue. The area that is scratched is the source of irregular electrical impulses that cause AF. When living tissue is damaged or destroyed, tissue is no longer able to produce erroneous electrical signals that result in arrhythmias.
A number of terms are used for procedures, all of which refer to the same type of treatment:
- Ablation of atrial fibrillation
- Kateteer ablation
- Lung vascular ablation
- Radio frequency ablation
Preparation of catheter ablation
Ablation of atrial fibrillation is carried out in the hospital. You will follow special instructions before the procedure, including:
- Blood work to make sure you are healthy enough for surgery
- Blood thinning medication for a month before surgery to prevent blood clots
- CT scan or MRI to check the blood vessels used in the procedure
- Fasting after midnight the day before ablation
Talk to your doctor about any other medication or dietary supplement you are taking. You may need to stop taking temporary medication before ablation as a precaution.
During the ablation procedure
Catheter ablation is carried out under the influence of local anesthetic, meaning you stay awake and conscious, but don't feel pain. After giving you anesthesia and local anesthesia, the doctor will insert a catheter - a thin and flexible tube - into a blood vessel in the groin. Sometimes the blood vessels in the neck are used rather than in the groin. Using a special X-ray called fluoroscope to see the location of the catheter placement, the doctor will move the catheter to the heart.
When the catheter is in place, the doctor will send radio waves through the hose. The catheter tip is installed with a device that heats up from radio frequency. Heating the damaged heart tissue directly destroys it. Ablation generally takes several hours.
Minimum invasion ablation
A newer, minimum invasion ablation procedure called "Mini-Maze" can also be an effective treatment for atrial fibrillation.
Minimum invasion surgery uses smaller incisions and generally does not require a long time like conventional procedures. Mini-Maze ablation requires between 3 and 4 hours. The operation is performed with a small incision on the side of the body, under the armpit. The incision must be large enough for the camera and catheter to enter. For standard catheter ablation, the radio frequency turns off the atrial tissue that causes AF.
Recovery
Recovery is relatively fast with one type of ablation for atrial fibrillation. You may stay in the hospital for 1 or 2 days so the medical officer can monitor your heart activity. Symptoms of atrial fibrillation often recur during the first few weeks after surgery. This is a normal part of the recovery process. Blood thinning medications help prevent problems such as blood clots. You may also take anti-arrhythmia medication to control irregular electrical activity. Most likely you can move as before in a few weeks.
Complications
Although catheter ablation is safe and effective, any type of surgery carries risks. Blood clots, accidentally pierced hearts, and strokes are possible complications. According to the journal Circulation, this condition only affects 1-2% of the population. Esophageal damage is also a risk because the left part of the heart atrium is behind the esophagus. Lung vascular stenosis is another side effect of ablation. This narrowing of the arteries can result in blood clots and other problems associated with blockage of the arteries.
Prospect
The success rate of atrial fibrillation ablation varies greatly, depending on the type of AF you experience. Ablation is effective in 30-90% of AF patients. People who experience rare and intermittent episodes of arrhythmia but do not have other heart problems recover faster. Other patients may experience partial recovery with reduced symptoms but not completely disappear.
