Ablation for AFib

Atrial fibrillation (AFib), is the most common type of heart arrythmia. While AFib can cause serious complications, the good news is that cardiologists can treat it with medications and procedures, including cardiac ablation. The specialists at Methodist Le Bonheur Healthcare are dedicated to finding the right treatment for patients with AFib in the Memphis area.

Understanding AFib

AFib occurs when the heart’s upper chambers, called the atria, beat irregularly due to problems with the heart’s electrical signals. This causes the atria to quiver, or fibrillate, and prevents the lower chambers from filling with blood completely and pumping blood properly.

When AFib occurs, blood can pool in the chambers of the heart and possibly clot, leading to a stroke. To lower the risk of clots forming, people diagnosed with AFib are often prescribed blood thinners. Other risks of AFib include new or worsening heart conditions, such as heart disease, heart failure and cardiac arrest, and increased risk of dementia.

What Is Catheter Ablation for Atrial Fibrillation?

A catheter ablation is a minimally invasive procedure that stops the abnormal electrical signals in your heart that cause irregular heart rhythms. An ablation procedure is done through cardiac catheterization, in which a doctor threads thin flexible tubes called catheters through blood vessels and guides them to your heart.

First, a catheter that is sensitive to electric signals is used to locate the area of the heart sending extra currents. Then, the doctor uses a catheter with a special device on the tip that applies energy to, and scars, the problematic area of heart tissue. The scarred area will no longer send the electrical signals that cause AFib.

The most common ablation techniques for AFib include:

• Pulmonary vein isolation ablation. For some people, extra electric signals in the pulmonary veins trigger AFib. During the procedure, the doctor destroys the tissue sending the extra signals. Normal heart rhythm is restored for most people.
• AV node ablation with pacemakers. In other patients, the trigger for AFib happens in the atrioventricular (AV) node, which is the area where the electrical signals travel from the atria to the ventricles. During this procedure, the doctor destroys tissue near the AV node and then implants a pacemaker to maintain normal heart rhythm.

Success rates for catheter ablation are around 75%. For some patients, AFib returns after the procedure, and they need a second ablation. The success rate for second ablations jumps to nearly 90%.

What to Expect When You Have an Ablation for AFib

Doctors perform ablation for AFib at the hospital. To prepare, you will:

• Avoid eating or drinking for at least six to eight hours before the procedure.
• Follow your doctor’s instructions for taking medications on the day of the procedure.
• Leave all jewelry at home.
• Plan for someone to stay at the hospital with you and drive you home after the procedure.

At the time of the procedure:

• You will receive anesthesia through an IV in your arm or a sedative to help you relax. In some cases, you may be awake during the procedure, but you will not feel pain.
• A nurse will clean and shave the area where the catheter will be inserted, which is usually in the groin.
• The nurse will give you a shot of anesthetic to numb the puncture site.
• The doctor inserts a small tube called a sheath into the blood vessel that will be used. Next, the doctor will guide catheters into the blood vessel through the sheath to perform the procedure.

The entire procedure can take four hours to complete. Your doctor will tell you if you can go home the same day or if you will spend the night in the hospital. Immediately after the procedure:

• You will be monitored in a recovery room. The sheath will remain in your leg, and you will need to lie flat.
• After the sheath is removed, you will need to keep your leg straight for several hours. During this time, your vital signs will be monitored.
• Your surgery team will give you instructions for at-home care. You may receive medications, such as antiarrhythmic drugs, while the procedure takes full effect.

Catheter ablation is generally very safe. However, small risks exist, including:

• Blood clots
• Blood vessel or heart damage from the catheter
• Heart attack
• Infection
• Pulmonary vein stenosis
• Stroke

If you notice swelling or fluid drainage from the puncture site, your leg feels numb or tingly, or you have chest pain, dizziness, fever or an irregular heart rate, contact your doctor right away.

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