Catheter ablation is a minimally invasive procedure used to treat atrial fibrillation, relieving symptoms, improving quality of life and ultimately a cure of the arrhythmia.
During an ablation, your electrophysiologist destroys areas of tissue in the heart that fire off abnormal electrical impulses which trigger episodes of atrial fibrillation. Some doctors prefer to give a local anaesthetic and sedation to help ease any discomfort you may feel during the procedure. However, the process may take a few hours so it can still be an uncomfortable experience as you may need to lie flat and keep still. I prefer to give patients a general anaesthetic so there is no discomfort at all. You may need to swallow a probe into the gullet at the start of the procedure to check there are no clots in the heart. If you have a general anaesthetic, this will be done when you are asleep.
Your electrophysiologist will carefully manoeuvre the catheters through the blood vessel to your left atrium. The catheter in the left atrium can map the abnormal electrical pathways in the heart tissues or very often ablation is performed routinely just at the entrances to the pulmonary veins, the blood vessels which carry blood back from the lungs to the heart. When the targeted area is located, ablation is performed depending on the chosen technique and then the catheters are removed. Ablation can be performed using cryo-energy (freezing) or radiofrequency energy (burning).
After the procedure, you’ll need to stay lying flat and rest for a few hours and you will need to stay in hospital overnight. You’ll likely feel tired afterwards with some soreness in the chest and throat/gullet for 24-48 hours, but you should feel back to normal within a few days. Most people can start driving again after 2 days if the leg puncture wounds have healed completely but your doctor will confirm this.
It is not uncommon to experience episodes of AF in the first few weeks after ablation – this is an effect of the heart adapting to the effects of the new ablation lesions. This should settle by 6-8 weeks. Recurrences of AF after this imply the procedure has not been successful. Sometimes AF won’t recur until anti-arrhythmic drugs are stopped. In either case, repeat ablation is the preferred option. If AF does not recur after stopping medication, monitoring is continued with periodic heart monitors and ECGs. AF can return at any time after ablation, even years later and so further ablation may be indicated at that time but a good proportion of people are still cured long term.
For more information about Catheter Ablation for Atrial Fibrillation take a look at our AF Ablation page. If you want to discuss this further or book an appointment, please click here to get in touch.