Catheter Ablation | Atrial Fibrillation Ablation

As we have understood more about AF it has become clear that it requires a substrate and a trigger. These will be of varying importance in different patients. As with many other heart rhythm problems, doctors with an expertise in this area have tried to develop techniques to cauterise the problem areas so that AF will not recur. This procedure has gradually developed since the late 1990s and still continues to change.

Left Atrial Ablation

The procedure is very similar to other ablation procedures (see section) and is usually performed under sedation and using a local anaesthetic. Using a small hole made between the atria the wires are passed in to the left atrium. Using the ablation catheter it is possible to cauterise the areas inside the left atrium which appear to be the source of the problem. In general terms we try to burn around the pulmonary veins to stop extra beats from coming out to induce AF. We also add further burns to make the atria less irritable. This is a long procedure, taking several hours but may be successful in the majority of patients. A proportion may need more than one procedure to complete the job as it is extensive and difficult. There are risks which at times can be minor and at other times can be very serious. Perhaps 2-3% of patients may suffer a serious complication such as a blood leak around the heart (tamponade), a stroke, nerve damage, pulmonary vein narrowing or a hole forming between the atria and gullet (atrio-oesophageal fistula). Many of these can be treated but involve a longer stay in hospital. Patients can often go home the day after the procedure but if a complication has occurred may need to stay for a few days. There is a 1 in a 1000 risk of death. While this is a big procedure and there are risks, this procedure does offer the possibility of cure. It will continue to develop over the coming years.

London bridge hospital