Atrial Fibrillation Ablation
Someone with atrial fibrillation will tell you it feels like the heart is fluttering with uneven and sporadic beats. The most common type of arrhythmia, atrial fibrillation occurs when the heart’s electrical impulses misfire in the atria or upper chambers, sending a barrage of impulses to the ventricles and resulting in heartbeats of up to 150 beats a minute. This can lead to chest discomfort and symptoms including palpitations, fatigue, shortness of breath, and dizziness and feeling faint.
Atrial fibrillation is usually not life-threatening if treated early, but can increase the risk of stroke. An uneven heartbeat does not pump blood as efficiently, possibly causing clots that could travel to the brain. While it can occur in normally healthy people, it can also be triggered by several heart conditions including coronary artery disease, heart failure, valvular disease, high blood pressure, congenital heart disease, heart muscle thickening (cardiomyopathy), and lung diseases. Past heart attack victims and heart surgery patients are also prone to more frequent bouts.
When drug therapy is not effective in treating atrial fibrillation, radiofrequency ablation is an option. Minimally invasive, the procedure involves heart catheterization to selectively destroy heart tissue with abnormal electrical pathways that cause the heart to flutter. A thin and flexible catheter enters the body, usually in the groin area, and is gently guided into the heart with the help of x-ray fluoroscopy or three-dimensional mapping systems. On the tip of the catheter is a sensor that records the heart’s electrical activity and that can deliver radiofrequency energy to perform the ablation. Radiofrequency ablation is performed after an electrophysiology study (EPS) which identifies the heart tissue emitting the abnormal electrical impulses. Ablation, however, isn’t always as successful in treating atrial fibrillation as it is with other arrhythmias.
MDCA cardiologists are employing new and innovative research in atrial fibrillation ablation with much success. The latest procedures involve the use of robotics to manipulate the catheter tip, and the use of three-dimensional mapping systems (like a GPS inside your heart) to help track catheter position without the use of an x-ray.
Still another procedure is ablation of the atrio-ventricular (AV) node in the heart, thus limiting and slowing the electrical impulses from the atria to the ventricles. In this case, the patient needs a permanent pacemaker.