Atrial Fibrillation Ablation

Atrial fibrillation (AF) is a chaotic heart rhythm that occurs due to erratic electrical behaviour originating from the pulmonary veins at the back of the left atrium or entry chamber of the heart.

This often results in symptoms of dizziness, fatigue, breathlessness, chest pain or heart failure. AF increases the risk of stroke due to clots forming in the left atrium during the chaotic rhythm.

AF often starts as intermittent or paroxysmal in nature but over time may become persistent or permanent. Sometimes AF responds to medications and can be held in check.

Recent studies have shown that an AF ablation procedure where the AF can be isolated in the pulmonary veins can help prevent progression of AF to then persistent or permanent type. People with heart failure and AF also may benefit following AF ablation.

Preparation

Prior to the procedure you will be fasted, your groin and chest may be shaved. Upon arrival from the ward to the EP laboratory you will meet the anesthetist who will insert an intravenous cannula for delivery of the anesthetic.

How is it done?

AF ablation procedures are performed in an EP laboratory ( similar to an angiogram suite) in a hospital whilst you are asleep under general anesthesia.

EP laboratory contains specialised Electrophysiology Laboratory equipment used to map the electrical activity of your heart.

Once you are placed under general anesthesia, blood thinning medication will be administered. During the procedure the heart will be monitored with a special ultrasound probe that is inserted into the oesophagus called a transoesophageal echocardiogram. This is used to makes sure there are no clots in the heart and guides the catheter placement inside the heart. It will be removed before you wake up. Electrical catheters will be inserted into the heart via the groin area.

The electrical catheters are guided into place using X-Rays, ultrasound and computerised mapping systems. These electrical catheters first enter the right atrium of the heart and under the ultrasound and Xray guidance cross the wall between the atria into the left atrium.

AF can occur from any of the four pulmonary veins and as a result circular superficial burn is placed around each one.

Duration

The entire atrial fibrillation ablation procedure may take 3-4 hours on average. If you have persistent atrial fibrillation, additional ablation may be required.

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