Keyhole Atrial Fibrillation Ablation
Catheter Atrial Fibrillation Ablation Treatment
This treatment involves the advancement of catheters into the heart via the groin vessels. These catheters are placed at the orifices of the pulmonary veins, and can detect abnormal electrical activity in these zones. Any detected abnormal activity can be destroyed with radiofrequency energy. This treatment is only really effective in patients with Paroxysmal Atrial Fibrillation. The immediate result can be very good. Recurrence occurs in as many as 30% of patients within one year and repeat therapies may be required. Catheter ablation is not an effective therapy for permanent Atrial Fibrillation. When the rate of atrial fibrillation cannot be controlled with drugs a different strategy is sometimes used where the conduction system that connects the fast beating atrial chambers (AV node) can be disconnected from the big muscular ventricles. The heart rate must be restored using a permanent pacemaker but the efficiency of the heart cannot be restored using this therapy. This is called AV node ablation, and is generally not recommended without first considering a surgical strategy for Atrial Fibrillation ablation.
Keyhole Surgical Atrial Fibrillation Ablation
Keyhole atrial fibrillation ablation is performed through small holes between ribs and is very effective in patients in whom other treatments such as catheter (through the groin) treatments have failed or are not effective. The principle of this procedure is to isolate the left and right pulmonary veins using a clamp that is designed to interrupt the electrical continuity between the pulmonary veins and the heart, just like the catheter ablation strategy.
The advantage of surgical based therapies lies in the fact that a more visually guided and thorough ablation can be performed. In addition, obliteration of clot forming zones within the heart such as the left atrial appendage can be performed very safely using a left atrial clip. Access is via small telescopic incisions placed on either side of the chest. For the treatment of paroxysmal atrial fibrillation, a heart lung machine is not required. When atrial fibrillation becomes more persistent in nature, or in patients in the early phase of permanent atrial fibrillation, a more aggressive keyhole therapy may be considered using the heart-lung machine. This is called The Maze Procedure. The Maze procedure includes further ablation lines in addition to pulmonary vein isolation and is extremely effective.
The risk of atrial fibrillation ablation in experienced hands is not high, considering that atrial fibrillation ablation itself has a recognized morbidity and mortality associated with its continued presence.
If you wish to discuss treatment of atrial fibrillation you should speak to your GP or cardiologist. Alternatively, you can contact us at The Keyhole London Heart Clinic using the BOOK AN APPOINTMENT button or visit the CONTACT page using the main menu at the top of the page.
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Tue 28 February 2017
Although I had some misgivings about my age and medical history, and my suitability for keyhole surgery, I was extremely...Read the full story