Atrial fibrillation
Overview:
Atrial fibrillation ablation is a procedure used to treat an irregular heart rhythm (arrhythmia) that starts in the heart's upper chambers (atria). It's a type of cardiac ablation, which works by scarring or destroying tissue in your heart to disrupt faulty electrical signals causing the arrhythmia.
Atrial fibrillation ablation may be used if medications or other interventions to control an irregular heart rhythm don't work. Rarely, it's the first choice of treatment for atrial fibrillation.
Types of atrial fibrillation ablation:
The type of atrial fibrillation ablation procedure you have depends on what's causing your irregular heart rhythm and whether you have other heart conditions. Three types of atrial fibrillation ablation are:
- Catheter ablation: The doctor threads long, thin tubes (catheters) into the heart and applies heat or extreme cold. This causes tiny scars in certain parts of the heart muscle, which disrupt or eliminate the erratic electrical signals in your heart. You may also hear the procedure called pulmonary vein isolation, which is a type of catheter ablation.
- Maze procedure: Maze is an ablation technique done during open-heart surgery. Your doctor creates a pattern (maze) of scar tissue in the upper chambers of your heart, using a scalpel or an ablation device. As with catheter ablation, the scarring disrupts the stray electrical signals that cause some types of arrhythmia.
The maze procedure may be right for you if your atrial fibrillation doesn't respond to other treatments or if you're also undergoing other necessary heart surgery, such as coronary artery bypass surgery or heart valve repair. - AV node ablation: With atrioventricular (AV) node ablation, your doctor uses catheters to create scarring in an area of your heart called the AV node. This is the point connecting the upper chambers (atria) and lower chambers (ventricles). The scar tissue prevents the atria from sending faulty electrical impulses to the ventricles.
AV node ablation may be a good option for you if your atrial fibrillation doesn't get better with other treatments. You may also need a pacemaker to regulate your heart rhythm after an AV node ablation.
Each beat of your heart is triggered by an electrical impulse normally generated from special cells in the upper right chamber of your heart (pacemaker cells). These signals are faulty in people who have atrial fibrillation, firing so rapidly that the upper chambers of your heart quiver (fibrillate) instead of beating efficiently. These rapidly discharging triggers are called hot spots. To restore a normal heart rhythm, the sources of these hot spots must be isolated from the rest of the heart.
The most common technique for treating atrial fibrillation is catheter ablation. In this procedure, your doctor threads one or more long, thin tubes (catheters) through blood vessels to your heart. He or she uses a mapping catheter to determine where the triggers are located and then applies extreme cold or heat with the catheter tips to destroy (ablate) these spots. This causes scarring that disrupts the faulty electrical signals and restores normal heart rhythms.
The use of extreme cold to cause scarring (cryoablation) is a newer technique. The doctor runs a catheter from the groin to the area of the heart where the arrhythmia originates. He or she then uses it to deploy and inflate a tiny balloon that freezes the area. The result is scar tissue that stops the firing pathway of the faulty signals. This technique takes less time than heat ablation and may have similar risks and complications.
Atrial fibrillation ablation is used to reduce signs and symptoms and improve quality of life. It may be an option for people whose heart quiver (fibrillation) can't be corrected with medication or other treatments. Your doctor might even suggest this procedure before trying medications if, for example, you want to correct the problem without the risk of medication side effects.
During atrial fibrillation the heart's two upper chambers (atria) beat chaotically and irregularly — out of coordination with the two lower chambers (ventricles). People with this heart condition may feel pounding in the chest (palpitations), shortness of breath and weakness. This condition can also put them at increased risk of a stroke. The condition often gets worse over time if left untreated.
- Bleeding or infection at the surgical site or where your catheter was inserted
- Damage to your blood vessels
- Puncture of your heart
- Damage to your heart valves
- Damage to your heart's electrical system, which could worsen your arrhythmia and require a pacemaker to correct
- Blood clots in the legs or lungs (venous thromboembolism)
- Stroke or heart attack
- Narrowing of the veins that carry blood between your lungs and heart (pulmonary vein stenosis)
- Death in rare cases
Your doctor will examine you and order several tests to evaluate your heart condition. He or she will discuss with you the risks and benefits of your atrial fibrillation ablation procedure. Let your doctor know about allergies or reactions you've had to medications. And tell him or her if you're pregnant or planning to become pregnant.
You'll need to stop eating and drinking the night before your procedure. If you take any medications, ask your doctor if you should continue taking them before your procedure. In some cases, you'll be instructed to stop taking medications to treat a heart arrhythmia several days before your procedure.
If you have an implanted heart device, such as a pacemaker or implantable cardioverter-defibrillator, talk to your doctor to see if you need to take any special precautions.
Atrial fibrillation ablation may reduce the signs and symptoms of your heart rhythm problem and improve your quality of life. But it hasn't been shown to reduce your risk of a stroke, so your doctor may recommend that you continue blood-thinning medications.
Your irregular heart rhythm may recur, sometimes as long as three years later. Recurrence is more likely in older people and in those with other heart conditions, high blood pressure or a history of difficult-to-treat atrial fibrillation.
You'll likely have a follow-up appointment with your doctor about three months after surgery. If your atrial fibrillation does come back, you may now be able to control it with medications. Some people need another ablation procedure. The Heart Rhythm Society and American College of Cardiology recommend that you heal for at least three months before having a repeat procedure.
Even after successful ablation, your doctor may suggest that you use a continuous heart rhythm monitoring device, such as an implantable loop recorder. If you continue to have heart rhythm problems, your doctor may recommend a permanent pacemaker.
Copyright - MeetsUp 2020 All rights reserved.
