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What are the risks of an atrial flutter ablation procedure?

The Radiofrequency ablation procedure is a very low-risk procedure and should a complication arise, it will be dealt with at once.

The world wide complication rate for Electrophysiology studies and radiofrequency ablation procedures is less than 0.5%.

Although most people undergoing radiofrequency ablation procedures do not experience any complications, you should be aware of the following risks:

  • Local bleeding, blood clot or haematoma (blood collection) - this may occur at the catheter insertion site.

  • Rapid abnormal heart rhythm - this may actually cause you to pass out for a very short period of time and in some cases a small electric shock may be required to restore your normal rhythm.

  • Perforation or damage - very slight chance that this may occur to either a heart chamber or to the wall of one of the arteries.

  • Heartblock - depending on the location and type of your atrial flutter, there is a very small chance of damage occuring to the heart’s normal electrical system. This may be temporary, but permanent damage would result in a pacemaker being inserted at the time of the procedure.

Major complications - stroke, heart attack, death are very rare.

What Special Precautions will be taken?

As discussed above, atrial flutter carries a very small risk of stroke due to the risk of blood clot formation in the left atrium. This is one of the reasons to cure the rhythm disturbance. This risk increases slightly at the time that the heart reverts from the atrial flutter to the normal rhythm. This increased risk is present whether the rhythm is reverted with medication, with a DC shock on the chest or with a radiofrequency ablation procedure.

In order to prevent this occurring the following precautions will be taken:

(i) At the time of the procedure you will have a special ultrasound study of your heart termed a transoesphageal echo. This involves passing a small probe into the oesophagus (the swallowing tube). This gives clear pictures of the heart and ensures that no blood clots are present. This study will be performed while you are asleep.

(ii) During the procedure you will be given blood thinning medication.

(iii) After the procedure you will be started back on blood thinning medication (warfarin) for 6 weeks. The warfarin may take approximately 1 week to reach the required levels and during this time you will also be receiving daily injections of heparin. These can usually be given by your local doctor.

Radio-frequency ablation is an effective and safe way to cure patients suffering from atrial flutter.

Please do not hesitate to discuss any aspect of the procedure including potential complications with your doctor prior to your procedure.

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Melbourne Heart Rhythm is the arrhythmia service at the Department of Cardiology at the Royal Melbourne Hospital. We are comprised of a team of highly trained and dedicated health care professionals specializing in heart rhythm management. We have a strong focus on patient education and patient centered care. Our arrhythmia specialists have an international reputation of excellence in arrhythmia research and clinical arrhythmia management.