If you have atrial fibrillation (Afib or AF), then you have probably had discussions with your care team about how your condition can be treated to control your symptoms and help prevent stroke. In addition to recommending heart-healthy lifestyle changes, your care team has probably prescribed medications that manage your heart rate and rhythm, and they may have also prescribed blood-thinning medications (anticoagulants) that have been shown to prevent stroke. Your care team may also have discussed other treatment options, such as having a pacemaker implanted or undergoing a minimally invasive procedure. These procedures may include catheter ablation or cardioversion. Here we review information about catheter ablation.
What Is Catheter Ablation?
Catheter ablation is a procedure used to help control the symptoms of Afib. Catheter ablation is not recommended for most people unless they cannot tolerate their medications and cardioversion has been unsuccessful. If you decide to have a catheter ablation procedure, your doctor may also recommend implanting a pacemaker during the procedure. You can learn more about pacemakers here.
Who Benefits From Catheter Ablation?
Catheter ablation works better for some patients than others. The success of the procedure may depend on what type of Afib you have. People who have paroxysmal atrial fibrillation, where Afib symptoms usually last for seven or fewer days, tend to benefit from catheter ablation more than people who have persistent atrial fibrillation, where Afib episodes typically continue more than seven days. If you are considering a catheter ablation procedure, you will want to talk with your doctor about the type of Afib you have and how effective catheter ablation usually is for people like you.
How Does Catheter Ablation Help with Atrial Fibrillation?
Under normal circumstances, the heart’s own natural pacemaker is the sinoatrial node (or SA node). Its job is to trigger the electrical impulses that stimulate the heart to beat normally (known as normal sinus rhythm). However, for some people, the heart has “triggers” or “hot spots” that also fire electrical impulses, often in a rapid and erratic manner. The heart is affected by these signals. Instead of beating normally, the heart begins to quiver (fibrillate). It may beat too quickly and then slow down so much that you feel weak and dizzy, or you may even lose consciousness. These episodes are called cardiac arrhythmias. The most common type of cardiac arrhythmia is atrial fibrillation, where the upper chambers of the heart (the atria) quiver. The American Heart Association estimates that about 2.7 million people are living with Afib.
During a catheter ablation procedure, slender tubes (catheters) are guided through the blood vessels and into the heart. Once in the heart, a specially trained care team, led by an electrophysiologist, will locate the tiny “hot spots” in the heart muscle that are sending out abnormal electrical impulses. The hot spots will then be treated with either tiny pulses of painless, low-level energy or with a freezing device. Either way, the heart tissue that is causing the problem will die. In its place, scar tissue will form. Scar tissue cannot transmit or react to electrical signals, which means that it cannot cause atrial fibrillation.
It is important to remember that an ablation procedure is focused on very small areas of heart tissue. The rest of your heart will still function normally despite the ablation of this relatively small amount of heart tissue. You do not need this tissue for your heart to do its job pumping blood to your body.
As mentioned previously, some people who undergo catheter ablation also receive a pacemaker – a small, battery-powered device that is implanted in the upper chest to monitor the heartbeat and help the heart keep beating as it should. You can learn about pacemakers here.
What Are the Benefits & Risks of Catheter Ablation?
The main benefit of catheter ablation is that it can stop atrial fibrillation from occurring and allow you to go through your days without the tiredness, lightheadedness, shortness of breath and other disconcerting symptoms of an irregular heartbeat. In this respect, ablation may bring peace of mind.
Another benefit of ablation is that it does not require open-heart surgery. A catheter ablation procedure is performed while you are sedated so you will not feel any pain. Recovery also takes less time than open-heart surgery. Learn more about how catheter ablation procedures are performed here.
Once your doctor has confirmed that your body has recovered from the catheter ablation procedure, he or she can give you permission to return to normal activities. Many people whose routines included regular exercise are able to return to their previous activities without worry and without fear about their symptoms interfering with their workouts. After the procedure, you do need to wait for your doctor to advise you on when to start exercising and how much exertion is right for you.
It is important to note that no medical procedure is without risks. Catheter ablation is no exception. Some of the complications of a catheter ablation procedure include:
- Infection at the site where the catheter was inserted
- Swelling, bleeding or bruising at the site where the catheters were inserted, particularly if you had been taking anticoagulant medications
- Bleeding at the catheter insertion site, or around the heart. If bleeding occurs around the heart, emergency surgery may be necessary. This is rare.
Complications are also possible during catheter ablation procedures. It is very rare, but heart attack, stroke or cardiac tamponade are possible. Cardiac tamponade is a serious condition where fluids buld up in the space between the heart and the sac that surrounds it. The fluids compress the heart, making it impossible for the heart to pump blood. While all of these complications are rare during catheter ablation, they are emergencies that must managed with immediate surgery.
It is also possible that the catheter ablation procedure will not work as you and your care team hoped. If this occurs, you and your doctor will need to review your treatment options. You may decide to have a second catheter ablation procedure to address additional “hot spots” that were not successfully treated during your first procedure.
Your medical team will discuss the benefits and risks of catheter ablation with you. It is always a good idea to have a family member with you when discussing a procedure. Together you can take notes and ask all of your questions.
Learn More About Catheter Ablation & Other Atrial Fibrillation Treatments
To learn more about catheter ablation and other procedures for treating Afib, check out these articles on SecondsCount: