Atrial fibrillation ablation
Learn how hot or cold energy can treat irregular and chaotic heartbeats, also known as atrial fibrillation (A-fib).
Overview
Atrial fibrillation ablation is a treatment for an irregular and chaotic heartbeat called atrial fibrillation (A-fib). It uses heat or cold energy to create tiny scars in the heart to block the faulty electrical signals and restore a typical heartbeat.
Atrial fibrillation ablation may be used if medications or other treatments don't work. Sometimes it's the first treatment for certain patients.
Atrial fibrillation ablation is most often done using thin, flexible tubes called catheters inserted through the veins or arteries to the heart. Less commonly, ablation is performed during cardiac surgery.
Why it's done
Atrial fibrillation ablation is done to reset the heart's rhythm. A health care provider may recommend this type of ablation if you have A-fib symptoms, including a fast, fluttering heartbeat, that hasn't improved with medication or other treatments.
In a typical heart, a tiny cluster of cells at the sinus node sends out an electrical signal. The signal then travels through the atria to the atrioventricular (AV) node and passes into the ventricles, causing them to contract and pump out blood. In atrial fibrillation, electrical signals fire from multiple locations in the atria (typically pulmonary veins), causing them to beat chaotically. Since the atrioventricular (AV) node doesn't prevent all of these chaotic signals from entering the ventricles, the heart beats faster and irregularly.
Risks
Possible atrial fibrillation ablation risks include:
- Bleeding or infection at the site where the catheters were inserted
- Blood vessel damage
- Heart valve damage
- New or worsening irregular heartbeats (arrhythmias)
- Slow heart rate that could 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 the lungs and heart (pulmonary vein stenosis)
- Damage to the kidneys from contrast dye used during the procedure
- Death, rarely
Discuss the risks and benefits of atrial fibrillation ablation with your health care provider to decide whether it's right for you.
How you prepare
Your health care provider may order several tests to get more information about your heart condition before your atrial fibrillation ablation.
You'll need to stop eating and drinking the night before your procedure. Your care provider will tell you how or if you should continue any medications before atrial fibrillation ablation.
What you can expect
Before
Atrial fibrillation ablation is done in the hospital is done in the hospital. A care provider will insert an IV into your forearm or hand and give you a medication called a sedative to help you relax.
The amount of sedation needed for the procedure depends on your specific arrhythmia and other health conditions. You may be fully awake or lightly sedated, or you may be given general anesthesia (fully asleep).
During
One of the following ablation techniques is used to create small scars in the heart and block the irregular heartbeats:
- Heat (radiofrequency energy)
- Extreme cold (cryoablation)
You may feel some minor discomfort when the catheter is moved into your heart or when the dye is injected and when energy is being delivered. If you have severe pain or shortness of breath, let your care providers know.
The procedure usually takes three to six hours. Complicated procedures may take longer.
After
Following your procedure, you'll be moved to a recovery area to rest quietly to prevent bleeding from the site where the catheters were inserted into the blood vessels. Care providers will continuously monitor your heartbeat and blood pressure to check for complications.
Depending on your condition, you may be able to go home the same day as your procedure. If you go home the same day, plan to have someone drive you.
You may feel a little sore after your procedure, but the soreness shouldn't last more than a week. You'll usually be able to return to your daily activities within a few days after atrial fibrillation ablation.
During cardiac ablation, catheters are passed through a vein in order to reach the heart. Catheters may be inserted in the groin, shoulder or neck.
Results
Most people see improvements in their quality of life after cardiac ablation. But there's a chance that the irregular heartbeats may return. If this happens, the procedure may be repeated or your health care provider might recommend other treatments. The procedure hasn't been shown to reduce the risk of a stroke. Blood thinners may be needed to reduce stroke risk.