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What treatments are available to prevent Atrial Fibrillation?

1. MEDICATION. Atrial fibrillation can be treated with medication. In some people these medicines can be very effective. In others however, the medications are ineffective and may produce side effects. Your doctor will discuss the different options and the possible side effects of these medications.

2. CATHETER ABLATION. Over now more than a decade, a procedure has been developed for cure of atrial fibrillation. This procedure termed RADIOFREQUENCY or CATHETER ABLATION has been available for other types of heart rhythm disturbances for more than 25 years. Radiofrequency is a type of energy that causes a small burn (ablation) at the tip of the catheter thereby turning the abnormal tissue that was causing the short-circuit into a small scar.

What is involved in a Radiofrequency Ablation procedure?

You will be transferred to the Electrophysiology Laboratory (EP lab) from your ward. Usually before leaving the ward your groin will be shaved.

The EP lab has a patient table, X-Ray tube, ECG monitors and other equipment. The staff in the lab will all be dressed in hospital theatre clothes.

Many ECG monitoring electrodes will be attached to your chest area and patches to your chest and back. These patches may momentarily feel cool on your skin.

The anaesthetist will insert an intravenous cannula usually into the back of your hand and a second cannula into the artery. The entire procedure will be performed while you are “asleep” under general anaesthetic.

 

What happens during a Radiofrequency Ablation procedure?

During and after the procedure, blood thinning medication will be administered. During the procedure the heart will be monitored with a special ultrasound probe that is inserted into the oesophagus (swallowing tube). This is called a Transesophageal Echocardiogram. This takes clear pictures of the heart before, during and after the procedure. It will be removed before you wake up.

Transesophageal echocardiogram

Placement of the Catheters

When you are under General Anaesthetic, special wires (termed electrical catheters) will be inserted into the heart via a vein in the groin area and occasionally also by a vein in the side of the neck. This is routine. The electrical catheters are positioned using X-Rays, ultrasound and computerized mapping systems to guide placement. These electrical catheters first enter the right atrium. Because atrial fibrillation begins in the left atrium a long needle will be used to cross from the right to the left side through the thin membrane that divides the 2 top chambers. This will be performed twice using both ultrasound and XRay control. This is a routine procedure called trans-septal puncture. Because the short circuits can originate from any of the pulmonary veins we will electrically isolate all 4 of these veins by performing circumferential ablation.

Usually approximately 30-40 minutes of ablation is required. This part of the procedure usually takes approximately 90 minutes. The entire atrial fibrillation ablation procedure may take 3-4 hours on average. If you have persistent atrial fibrillation, additional ablation may be required.

 

 

 

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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.