What Is an Ablation for AFib?

Atrial fibrillation (AFib) is a common heart rhythm disorder. AFib occurs when the upper chambers of the heart (the atria) beat very fast in a disorganized way. When this happens, the lower chambers of the heart (the ventricles) do not work correctly.1 Atrial fibrillation can cause symptoms like shortness of breath, fatigue, and palpitations. It also increases a person’s risk of stroke.1

Ablation is a minimally invasive surgery used to treat AFib. During an ablation, the surgeon burns or freezes some of the heart muscle tissue to scar it. These scars interrupt the heart’s electrical signals so that the heart beats correctly again.1-3

How does AFib affect the heart?

There are four chambers of the heart, two on top (atria) and two on the bottom (ventricles).2 Each time the heart contracts, it receives a signal that begins in the upper right of the heart. With AFib, the signal doesn’t begin where it is supposed to. This prevents the atria from contracting normally and interferes with the way blood moves through the heart.2 The result is that the atria start to quiver, or fibrillate. This can prevent the heart from pumping enough blood out to nourish the body.2

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How is AFib treated?

There are 3 basic ways to treat AFib: Drugs, ablation, or shocking the heart back into rhythm. Research has shown that ablation is more effective than drug treatment in people with paroxysmal AFib (AFib that lasts less than 7 days) and persistent AFib (AFib that lasts a week or more).1

Different ablation techniques

Ablation is a procedure that uses radiofrequency current (heat) or cryo energy (cold) to scar a small area of the heart by burning or freezing.1 Ablation destroys the tissue causing an abnormal electrical pathway and forms a scar.3 The scarred area cannot conduct electricity which prevents abnormal heart rhythms.3

During an ablation, catheters (thin hollow tubes) are inserted into a blood vessel in the groin and threaded up to the heart.2 Special tips on the end of the catheter produce energy that creates a scar. The specific area of tissue that is scarred depends on the structure of that person’s heart and the electrical changes present.1

Length and complications of ablation

Ablation usually takes two to six hours. The doctor who performs the surgery is called an electrophysiologist. Electrophysiologists are cardiologists who specialize in treating heart rhythms.2-3 The procedure might cause slight discomfort. Most people spend a night in the hospital to be monitored after the procedure.2

Complications can occur during ablation.1 These tend to develop in patients who are older, female, very thin or very heavy, or who have another heart disease. These conditions can generally be managed but in some cases require emergency lifesaving treatment.1

What are the benefits of ablation?

Ablation helps control symptoms and restores the normal electrical signals of the heart. The hope is that heart function, symptom relief, quality, and length of life improve. There is always the chance that AFib can recur after ablation. This can happen early, late, or very late after the surgery. Early is considered 1-3 months. Late occurs in the first two years. Very late happens after two years.1-2

Ablation procedures are performed more often today than years ago.1 Before, drugs were the first line of treatment, but in some patients, ablation can be considered before drug therapy.1 Success depends on selecting the right patients for the procedure. Researchers are trying to figure out who makes a good candidate for ablation. Currently, doctors believe that ablation remains the best choice for people who will achieve long-term heart rhythm control.1

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