If you are among the more than 2.7 million people in the U.S. who have atrial fibrillation (AFib), you know how frightening that fluttery, quivering sensation in your chest can be. The dizziness, shortness of breath, anxiety, and chest pain can be uncomfortable. It can also increase your risk of stroke.
For a long time, medication was the primary treatment option for atrial fibrillation. But treating AFib with medication can sometimes be ineffective or lead to risky side effects, such as increased bleeding.
Another potentially more effective, long-term treatment option to consider is catheter ablation.
This procedure is minimally invasive, decreasing the potential impact on the body. It uses radiofrequency energy — electric and magnetic energy similar to that of a microwave — to destroy tiny areas of the heart tissue that cause the irregular heartbeat.
Here’s what you should know about treating atrial fibrillation with ablation.
- Atrial Fibrillation, or AFib is a quivering or irregular heartbeat, known as an arrhythmia. Arrhythmias can lead to blood clots, stroke, and heart failure.
- An electrophysiologist is a physician who specializes in understanding, diagnosing, and treating issues related to the heart’s electrical activity. An electrophysiologist is often part of the AFib ablation treatment team.
- Ablation destroys the abnormal heart tissue that contains abnormal cells causing the arrhythmia.
- Electrode catheters are long, thin tubes containing wires that provide radiofrequency energy. These wires are guided up to the heart to heat and destroy the abnormal cells causing AFib.
- Anticoagulant drugs — or “blood thinners” — are medications that you may be prescribed before or after the procedure to decrease your risk of stroke.
Treatment Options For Atrial Fibrillation
There are several treatment options for atrial fibrillation. Your cardiologist will work with you to determine the best course of treatment for your needs. Treatment options include:
- Blood thinners (such as Warfarin) to prevent blood clots
- Heart rate controlling medications, such as beta blockers and calcium channel blockers
- Heart rhythm controlling medications, such as sodium channel blockers and potassium channel blockers
- Pacemaker: small electrical device that is implanted near the collarbone to regulate your heartbeat
- Open-heart maze procedure: a complex surgery that involves making small cuts into the upper part of the heart and then stitching them up to create scar tissue — which then interrupts the electrical impulses that can lead to atrial fibrillation
- Electrical cardioversion: delivering an electrical shock outside (using paddles or patches) the chest to reset your heart’s rhythm
- Catheter ablation: inserting a thin, flexible tube (called a catheter) through a blood vessel into the heart and using radiofrequency energy to scar the heart tissue that is causing the abnormal rhythm
Treating Atrial Fibrillation: What Medication Can’t Do
Your heart contains cells that create electrical signals. These signals allow the heart’s upper and lower chambers to beat properly. When the heart beats properly it can pump blood throughout the body. If you have atrial fibrillation, some of those cells have not developed normally. This can cause the heart to beat faster or irregularly.
While medicine can be used to treat the symptoms of AFib — and in turn lower your risk of stroke — the underlying abnormal heart tissue is still there.
AFib Ablation and Its Recent Success
As ablation has become a more widespread treatment option in the past 20 years, it’s successes have increased.
In the past 5 years alone, medical centers — including Stormont Vail Hospital — have reported high success rates and few complications with catheter ablations for AFib. In general, this procedure has been found to have success rates of up to 70%.
Is Ablation Right for Me?
Ablation may be right for you, but ask yourself the following questions first:
- Has medication not worked or caused undesirable side effects in the past?
- Is your AFib a standalone condition, meaning it’s not the result of another heart condition or disease?
- Does your age cause concern about the long-term effects of AFib?
- Are you an athlete and concerned about the potential impact of your exercise on your AFib?
- Are you committed to working with your physician to closely monitor your health after the procedure?
- Are you willing to avoid triggers such as smoking, alcohol, and obesity?
If you’ve answered yes to any of these questions, you may want to talk to your doctor about AFib ablation.
Preparing for AFib Catheter Ablation
Your physician may perform some cardiac imaging with magnetic resonance imaging (MRI) or computerized tomography (CT) to see the anatomy of your heart. You may also be prescribed a blood thinning medication for about a month leading up to the procedure. On the day of the procedure, you may have one last test to make sure there are no blood clots in the area.
The Atrial Fibrillation Ablation Procedure — in 5 Steps
AFib catheter ablation is a multi-step procedure that typically takes 2 to 4 hours to complete. During this procedure:
- You will be awake. But, you’ll be given anesthesia so you don’t feel pain. You may also receive a sedative to relax.
- Your physician will insert the catheter and sheath into a blood vessel in your groin. You may feel some pressure, but you should not feel any pain during this process.
- Next, your physician will insert electrode catheters with wires into the sheath and guide them up to your heart. These catheters will provide the radiofrequency energy to kill the abnormal tissue cells.
- Your physician will send small electrical impulses through the electrode catheter to find the abnormal tissues that are causing the arrhythmia.
- Finally, the electrode catheters will zap the abnormal heart muscle cells with radiofrequency energy. This area is usually very small — around ⅕ of an inch wide.
Recovery: What to Expect After Ablation
After the procedure, the catheter will remain in your leg for several hours. You will need to lie flat and keep your leg straight for several hours, even after the catheter has been removed. You may be able to go home that same day, or you may need to stay overnight.
Your physician will give you specific recovery instructions. Generally, during recovery:
- For 24 hours following the procedure, you should not drive.
- You should not drink alcohol in the first 24 hours either.
- For 3 days, you should not engage in heavy physical activity. Ask your physician when you can return to strenuous physical activity.
- For 2 to 4 weeks, you may be prescribed aspirin to minimize the risk of a clot forming at the ablation site.
The swelling and inflammation in your heart will heal in the weeks following the procedure. If your AFib returns and continues for more than a few weeks, your physician may decide to perform a second procedure, which is sometimes needed for up to 40% of patients.
Long-term, you and your physician will need to closely monitor your health. Similar factors that contribute to AFib also contribute to the recurrence of AFib. You will need to be extra conscious of triggers, including having high blood pressure or high cholesterol, being overweight or obese, not following a healthy diet, smoking, and not getting enough physical activity.
You may also be prescribed antiarrhythmic drugs or anticoagulation drugs in the months afterward to continue to decrease your stroke risk.
Why Choose Stormont Vail Health
Located in Topeka, Kansas, Stormont Vail Health is a community-focused healthcare organization. It offers health care services close to home making it easier for you to get the care you need.
Stormont Vail Hospital has also received several accreditations from The Joint Commission, including Advanced Primary Stroke Center and Chest Pain.
Stormont Vail has the experienced and skilled medical team to help you explore whether AFib ablation is right for you.
Make an Appointment
To make an appointment at the Cotton O’Neil Heart Center, call (785) 270-4000.
See a Primary Care Provider
- Call (785) 270-4440 to schedule an appointment with your Stormont Vail primary care provider.
- Not a Stormont Vail patient? Call (785) 270-4440 to set up your first appointment with one of our primary care providers.