Dr Simon Kennon MB ChB, FRCP, MD Consultant Cardiologist

AF Ablation

Pulmonary vein ablation (also called pulmonary vein isolation), is used to treat atrial fibrillation (AF) which is a condition which causes an irregular heart rhythm.

There are four pulmonary veins that carry blood from the lungs back to the left atrium or chamber of the heart and where the two types of tissue from the atrium and veins meet is where the extra electrical signals that cause AF originate. Pulmonary vein isolation uses radiofrequency energy (heat energy) to destroy this small area of tissue.

The procedure

Ablation typically uses catheters — long, flexible tubes inserted through a vein in your groin (or sometimes your leg or neck) and threaded to your heart — to correct structural problems in your heart that cause an arrhythmia. This is done under local anaesthetic and sedation.

Using X-ray and other imaging guidance, the electrical activity within the heart can be precisely located, following which a form of energy, usually radiofrequency, is delivered through the catheter to precise points within the heart to cauterise specific areas and prevent generation and spread of the abnormal heart rhythm. Because it takes several weeks for the lesions to heal and form scars, patients may continue to experience atrial fibrillation early during the recovery period. In rare cases, the symptoms become worse for a few weeks after the procedure and may be related to inflammation where the lesions were created. In most patients, these episodes subside within 1 to 3 months.

Risks

Cardiac ablation does carry risks, some minor and some serious, which need to be weighed against the perceived benefits from successful treatment. In straightforward cases, only an overnight stay in hospital is required.