Atrial Fibrillation Ablation

What is Atrial Fibrillation Ablation?

Atrial fibrillation ablation (AFib ablation) effectively interrupts faulty electrical signals in the heart by burning or freezing them, restoring the heart’s natural rhythm. AFib ablation offers an effective solution by targeting and eliminating the abnormal heart tissue responsible for irregular rhythms.

How is AFib Ablation Performed?

AFib can theoretically originate from any part of the atria. However, the most common sites are the mouths and junctions of the veins leading to the left atrium called pulmonary veins. Atrial fibrillation originates from these sites in 90% of patients. Therefore, these are the main target tissues for ablation. In 10% of patients, there may be other sites other than these that cause the rhythm disturbance.

AFib ablation is performed in two ways. One is called cold (Cryo) ablation and the other is called hot (RF) ablation due to the energy source used.

Cold AFib Ablation: It is the process of freezing the mouths of the veins called pulmonary veins. A balloon that can cool down to -80 degrees Celsius is opened in the left atrium and frozen by contacting the mouth of the target vein. Ice crystals form inside the cells that the balloon touches and these cells then exhibit a self-killing behavior called apaptosis. There are 4 vessels and the mouth of each vessel is frozen.

Atrial fibrillation ablation - Cold (Cryo) ablation
Atrial fibrillation ablation - Cold (Cryo) ablation

Hot AFib Ablation: It is a procedure in which the atria are mapped three-dimensionally and the mouths of the veins are burned. Maps are created showing both tissue viability and anatomy. Using a catheter whose tip heats up to 50 to 70 degrees Celsius, the mouths of the vessels that bring blood from the lungs to the left atrium are burned point by point. The aim is to destroy rhythm disturbing areas where these vessels open into the left atrium.

Atrial fibrillation ablation - Hot (RF) ablation
Atrial fibrillation ablation - Hot (RF) ablation

I have prepared a video on how to ablate atrial fibrillation for you to get detailed information.

Does AFib Return After Ablation?

AFib ablation is a highly effective treatment. Your life comfort improves significantly. In the first year after ablation, 85% of patients do not experience atrial fibrillation attacks. Afterwards, the chance of recurrence increases slightly. Another thing to note is that the first 3 months after AFib ablation is called the window period. During this period, episodes of atrial fibrillation may sometimes occur. These do not indicate that the procedure has failed. The main effect of AFib ablation starts after 3 months.

Is AFib Ablation Painful?

AFib ablation is a painful procedure. Therefore, it is performed under anesthesia. The procedure called deep sedation is applied or your doctor may prefer to perform your procedure under general anesthesia. This way you will be put to sleep and will not feel pain.

Rest after AFib Ablation?

You usually need to rest for a few days after AFib ablation. This period may be longer if you have concomitant diseases or depending on your complaints after ablation.

Is it necessary to take medication after AFib ablation?

You need to take blood thinners for at least 3 months after AFib ablation. If you have risk factors for stroke, this period can also be lifelong. Your doctor will decide on blood thinners based on factors such as blood pressure, diabetes, having had a previous stroke, vascular diseases, age or medication use. Some patients may also need to use rhythm regulators after ablation.

Reference: Atrial fibrillation ablation

Update: Feb 13, 2024

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Picture of Prof. Dr. Taylan Akgün
Prof. Dr. Taylan Akgün

He is a cardiologist specialised in the diagnosis and treatment of heart rhythm problems (ablation), pacemaker procedures.
He works in Istanbul province.

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