What is atrial fibrillation (AF)?
Atrial fibrillation is a health condition that causes an abnormal and irregular heart rate. Typically the heart rate is abnormally fast, which can put sufferers at risk of various health conditions – including heart attack, blood clots and heart failure.
This condition can be effectively cured by pulmonary vein isolation ablation, and BMI Healthcare can offer a number of specialised technologies to address the problem in different types of patient.
An alternative to medical treatments
The initial treatment for atrial rhythm abnormalities is antiarrhythmic drugs. These drugs can slow the conduction of the Atrial fibrillation or can restore sinus rhythm. However, drugs cannot cure a heart rhythm disturbance. Many patients are unable to tolerate these drugs. Patients on these drugs require strict follow up care and checks, because antiarrhythmic drugs can sometimes cause abnormal heart rhythms.
Patients with atrial fibrillation are more at risk of stroke, heart failure and dementia, and so may be on warfarin; so careful monitoring of the blood is also required. In some patients successfully cured by catheter ablation for AF, long-term anticoagulation with warfarin may be avoided.
What is catheter ablation for atrial fibrillation?
In the last 10 years, more and more breakthroughs have been achieved in the understanding of atrial fibrillation, and how it can be treated. The most important breakthrough came in the understanding that the pulmonary veins are a very important source of extra beats that trigger AF. Moreover, it has become clear that ablation around the mouth of these veins can prevent the extra beats, and prevent the triggering of AF.
Over time, the catheter technologies for achieving this have developed. At the simplest level, a circular ablating catheter can be delivered through a keyhole in the groin, passed across to the left side of the heart, and placed around the veins for ablation. This is safe, effective and rapid. In more difficult cases a further range of catheters may be needed. The approach is guided by X-rays, but also by a specialised “mapping” system, which is like a mini-“sat-nav” guiding the movement of the catheters.
Curative treatment for atrial fibrillation
A revolutionary treatment for Atrial Fibrillation (AF) is available at many BMI hospitals. Over one million people in the UK have Atrial Fibrillation and for many individuals drug therapy is ineffective, as it produces side-effects or fails to slow the deterioration into permanent Atrial Fibrillation.
Who can benefit from atrial fibrillation ablation?
Symptoms of this disease can be quite different from individual to individual. Some may have no symptoms and their condition will go unnoticed until a physician detects it during routine examinations, others may have slight symptoms or are very sensitive to the slightest sensations.
The most common symptoms are shortness of breath, light-headedness, palpitations and / or chest discomfort. However, patients with atrial fibrillation have one thing in common. This is that AF tends to get steadily worse over time, with more AF, lasting longer, and finally becoming continuous. This is when we know that there is the greatest risk of stroke.
What happens during the procedure?
A 3D mapping system in used to provide a detailed 3D image of the left Atrial anatomy and pulmonary veins Several catheters are placed into the heart; the coronary sinus and the left atrium to access the pulmonary veins. The left side is accessed by a transseptal puncture.
The catheters used for the ablation are a circular mapping catheter, positioned in each pulmonary vein to detect pulmonary vein potentials and a thermocool ablation catheter. This allows adjustable saline flow through the catheter and gives a more precise and deeper lesion during radio frequency ablation.