How Is Atrial Fibrillation Treated With Radiofrequency Ablation?

— -- Question: How is atrial fibrillation treated with radiofrequency ablation?

Answer :Over the last 10 years, a technique called catheter ablation has been developed to treat atrial fibrillation. And this is now a very commonly performed procedure around the world with hundreds of thousands of these procedures having been performed over the last 10 years.The way catheter ablation works -- or also surgical ablation -- is catheter ablation works to prevent atrial fibrillation from starting.

As it turns out when an episode of atrial fibrillation begins, it's triggered by a runaway pacemaker in a muscle fiber in a pulmonary vein. So when an electrophysiologist goes in to do catheter ablation of atrial fibrillation, they cauterize the tissue around the pulmonary veins in your heart. This puts up a roadblock that prevents that runaway pacemaker from triggering atrial fibrillation. And that's the mechanism by which it works.

Now atrial fibrillation can be treated with a catheter ablation in many patients. But the results of the procedure depend in a large measure on the type of atrial fibrillation you have. And certain aspects of your heart function in other heart conditions you may have.

So if you're young, we'll say 55 years of age, your heart size is normal, you're otherwise healthy, and you have paroxysmal atrial fibrillation, it starts and stops on it's own, you're a very good candidate for catheter ablation. Particularly if you've tried anti-arrhythmic medications and those haven't worked. In that kind of patient, if you're like that patient, the success rate of catheter ablation is about 70 percent. So that's reasonably effective. We would like to think it was 90 or 95 or 100 percent effective, it's not. It's about 70 percent effective.

Now if you have a different type of atrial fibrillation. If you're in atrial fibrillation all the time, and you've been in atrial fibrillation all the time for three years or more, particularly if you're elderly, have a weak heart or a dilated upper chamber of your heart, or you have hypertension or obesity -- In conditions like that, the success rate of catheter ablation drops significantly to perhaps 30 or 40 percent.

So it will be important for you to chat with your cardiologist or an electrohysiologist to determine if you may be a candidate for catheter ablation of atrial fibrillation. This is certainly something you should be aware of but it's not something that every patient should or should undergo because it also has important risks to undergoing catheter ablation.