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Atrial fibrillation is a condition where the heart beats abnormally due to mixed up signals that originate in the atria, the two upper chambers of the heart. This can be paroxysmal, with short periods of arrhythmias, or it means arrhythmias may last for much longer periods of time. When atrial fibrillation ablation is discussed, it is often discussed in context of its effectiveness in treating paroxysmal atrial fibrillation. Increasing studies suggest methods of ablating (or getting rid of the tissues that create arrhythmias in a cath lab via radiofrequency) in people who experience longer runs of abnormal heartbeat.
Ablation deserves more explanation. This is a procedure performed by electrophysiologists: cardiologists who specialize in treatment heart rhythm dysfunction. It works very well on other conditions that affect heart rhythm, though it is not 100% successful. Using catheterization, doctors locate or map areas of the heart that create specific arrhythmias and then destroy these using radio frequent (RF) energy. In paroxysmal atrial fibrillation ablation, this procedure has been relatively successful, and doctors locate the area in the atria sending out mixed signals and then destroy it. Once RF has been applied to the area, it’s hoped that the mixed signals are gone and the heart goes back to beating as normal.
It turns out that it’s quite different when people have atrial fibrillation that causes arrhythmias of long duration. To battle this, doctors have frequently relied on open-heart surgery methods for scarring the inside of the atria and reducing the chance of arrhythmia. In imitation of this surgery, electrophysiologists are continuing to develop methods that replicate surgery without resorting to it. One of the atrial fibrillation ablation practices to treat more difficult cases involves using RF to scar several areas of one of the atrium. Such areas are typically right next to pulmonary veins.
In the early 2010s there is preliminary evidence that atrial fibrillation ablation of this second type may prove effective for some people, and help forgo surgery. There are some risks including damage to the pulmonary veins, which have not been fully assessed. Additionally, there are not that many hospitals that perform this type of atrial fibrillation ablation, though if the procedure continues to have success, more hospitals are likely to offer it.
In any form of atrial fibrillation ablation there are risks. These include damage to the heart’s rhythmic system that is so severe that people will instead require a pacemaker or defibrillator. The effects of a surgery don’t always last, and some people might undergo more than one ablation or need to remain on medications that regulate heart rhythm. Nevertheless, that electrophysiologists continue to look at ways of improving atrial fibrillation ablation is encouraging. This condition increases risk for stroke and having a reliable and proven method for eliminating it is greatly desired.