Atrial fibrillation, once a rarity, is now quite common with approximately 6,000 cases being seen a year in the UK.
It can be successfully treated with drugs, however, ablation therapy, is now seen as a procedure for patients whose atrial fibrillation is causing palpitations or breathlessness, and who haven’t responded to drugs or don’t want to take them.
Ablation reduces symptoms and improves a patient’s quality of life.
The word ablation means destruction and entails destroying the part of the heart which is causing abnormal electrical currents in the heart muscle.
The procedure takes anything from one to four hours and may be performed under local anaesthetic.
Catheters are inserted into the heart via veins in the groin. Your cardiologist identifies the area of the inner surface of the heart generating abnormal electrical activity and ablation is used to form scar tissue that no longer conducts electricity.
Before having the procedure your cardiologist will discuss what happens, the results and possible side effects.
Further discussion should cover advice on anticoagulation with warfarin or a direct oral anticoagulant to reduce the risk of stroke during the procedure. These medications should be taken for at least four weeks beforehand.
There are two main forms of ablation, either using heat (radio frequency ablation) or freezing (cryoablation) to destroy tissue. Most patients are discharged the day after the procedure, but those whose ablation was uncomplicated may be discharged the same day.
Here are some things you’re advised NOT to do. There’s a two-day legal driving restriction after the procedure. Sexual intercourse may be resumed after two days.
You should avoid flying for one week and take showers instead of baths for the first week and do no heavy lifting for two to three weeks. Keeping the wound clean and dry is paramount.
You should continue your anticoagulation medication for two months after the procedure or possibly longer.
Your cardiologist will probably want to see you after three months and your GP at least annually for a check-up, more often if you get any symptoms.
Get in touch with the centre that performed the procedure if the groin becomes painful, swollen or red, or a lump is found.
Ablation is a successful treatment, keeping the heart beating regularly in four out of five patients.
One in three patients need more than one procedure and although recurrence of atrial fibrillation may occur, it’s usually associated with older age, diabetes, high blood pressure, obesity, heart failure or sleep apnoea.
Common side effects include bruising around the groin and occasional chest pain.