Understanding Atrial Ablation

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ATRIAL FIBRILLATION, also known as A-Fib. “It’s a disease of the aging heart, occurring frequently in individuals over the age of 65,” explains Frank Haugland, MD, of Baptist Heart. “It results from abnormal, chaotic electrical signals in the upper chambers, or atria, of the heart.”

The disease causes highly variable symptoms resulting in an irregular or rapid pulsation in the chest in some patients. Other patients may have symptoms of heart failure, shortness of breath, or chest discomfort due to the abnormal hemodynamics of the rapid rates; while still others may have no symptoms at all. Unfortunately, even without other symptoms, all patients can succumb to its most serious outcome, which is a stroke.

What causes A-Fib?

Normally, the contraction of your heart requires precise timing of the electrical signals in a highly orchestrated manner with one signal completely travelling through the heart before the next begins. In atrial fibrillation, the upper chambers of the heart beat irregularly due to very rapid, disorganized electrical signals (like waves on a lake on a windy day), disabling the heart’s normal timing of contraction.

This irregular heartbeat has a number of consequences, but the most feared is that it can allow blood to slow down or pool in normal outpouchings of the heart, increasing the risk of clotting. If a clot then breaks loose, enters the bloodstream, and lodges in an artery leading to the brain, a stroke results. “People with A-Fib must be evaluated for their risk of having a stroke. Those at high risk warrant being on a blood thinner to reduce that risk back to normal levels,” says Dr. Haugland.

What is atrial fibrillation ablation?

For some people with significant symptoms due to the atrial fibrillation, an ablation procedure is recommended to attempt to eliminate the abnormal rhythm. In an atrial fibrillation ablation procedure, doctors ablate (selectively destroy) areas of heart tissue that are responsible for initiating the faulty electrical signals that cause atrial fibrillation in most people.

This can be done in several ways:

:: Cryoablation (using extreme cold)

:: Laser energy

:: Radiofrequency energy (using heat)

The most common technique—radiofrequency-based ablation— allows three-dimensional computer mapping of the inside of the heart to selectively target the areas necessary to achieve isolation of the errant electrical signals in order to restore normal rhythm.

Treating your atrial fibrillation

Personalization of the treatment for each patient is paramount to improving a patient’s chances of preventing a stroke as well as optimizing quality of life while living with atrial fibrillation. While an ablation is not for everyone, the treatment of atrial fibrillation must be individualized based on the degree and type of symptoms experienced. Consultation with a cardiac rhythm specialist is recommended to assess your risk and develop a treatment plan that restores and maintains your quality of life.

Reducing your risks

If you’ve been diagnosed with A-Fib, follow your doctor’s recommendations:

:: Get regular physical activity

:: Eat a heart-healthy diet that is low in saturated fats, trans fats and cholesterol

:: Manage high blood pressure

:: Avoid excessive amounts of salt, alcohol, and caffeine

:: Control cholesterol

:: Maintain a healthy weight

:: Quit smoking

Sources: Heart.org, Healthgrades.com

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