Have you been diagnosed with atrial fibrillation (commonly referred to as “AFib”)? If so, you may have begun researching treatment options and come across a surgical procedure known as “atrial fibrillation ablation” or “AFib ablation.” What does this surgery involve, and are you potentially a candidate for it? We have the answers you need below.

What Is Atrial Fibrillation?

Before discussing atrial fibrillation ablation, it may be helpful to provide some information about the condition itself. Atrial fibrillation is a type of irregular heart rhythm (arrhythmia) that occurs when the heart’s upper chambers (atria) beat irregularly and out of sync with its lower chambers (ventricles), inhibiting blood flow from the upper chambers to the lower chambers. According to the Centers for Disease Control and Prevention (CDC), atrial fibrillation is the most common type of treated heart arrhythmia, leading to more than 454,000 hospitalizations in the United States each year.

Atrial Fibrillation Causes

Normally, the heart’s sinus node acts as a natural pacemaker—it produces an electrical signal that travels through the two upper chambers and then to the two lower chambers, causing the upper and then the lower chambers to contract and pump blood throughout the body. But with atrial fibrillation, too many electrical impulses fire at once, preventing the sinus node from effectively controlling the heart’s rhythm. This is commonly caused by changes to the heart’s structure, often resulting from heart disease, high blood pressure, certain other medical conditions, previous heart surgeries or the use of stimulants.

Atrial Fibrillation Symptoms

Many individuals with atrial fibrillation don’t experience any noticeable symptoms. When symptoms do occur, they may appear consistently or intermittently and include:

• An irregular heartbeat
• Heart palpitations (a feeling of having a fast, fluttering or pounding heartbeat)
• Chest pain
• Shortness of breath
• Lightheadedness
• Dizziness
• Fainting
• Fatigue
• Weakness

Atrial Fibrillation Treatment Options

It’s important to promptly seek treatment for atrial fibrillation, since this condition can significantly increase a person’s risk of experiencing a stroke, heart failure and other serious complications. In many cases, cardiologists recommend beginning treatment using a conservative approach, possibly including:

• Taking medication to control how quickly the heart beats, maintain a normal heart rhythm and/or prevent blood clots from forming
• Undergoing cardioversion therapy to reset the heart’s rhythm
• Making certain lifestyle changes, such as eating a nutritious diet, exercising, managing blood pressure and cholesterol levels, losing excess weight, quitting smoking and limiting the consumption of alcohol

If conservative treatments don’t provide sufficient relief, then a cardiologist may recommend atrial fibrillation ablation.

What Does Atrial Fibrillation Ablation Involve?

During an atrial fibrillation ablation procedure, the surgeon uses heat (radiofrequency energy) or cold (cryoablation) to create scars within the patient’s heart, with the goal of blocking any abnormal electrical signals and restoring a normal heart rhythm. There are various types of ablation for atrial fibrillation, including:

• Atrioventricular node ablation – The surgeon applies heat/cold to the heart’s atrioventricular node, which is the pathway where electrical signals pass from the upper chambers to the lower chambers. With this type of atrial fibrillation ablation, the patient will have to use a pacemaker for the rest of their life.
• Maze procedure – The surgeon applies heat/cold (or a scalpel) to the heart’s upper chambers, creating a pattern of scar tissue that interferes with any irregular electrical signals.

Surgeons most commonly perform atrial fibrillation ablation using a minimally invasive approach—they insert a flexible tube (catheter) into one of the patient’s blood vessels, guide it to their heart and then use sensors located on the tip of the catheter to apply the heat/cold. In other instances—for example, when a surgeon is using a scalpel to perform a maze procedure—open heart surgery will be required.

What to Expect During Minimally Invasive Atrial Fibrillation Ablation

If it’s determined that you’re a candidate for minimally invasive atrial fibrillation ablation, your surgeon will most likely begin the procedure by administering either a sedative (in which case you’ll be awake) or general anesthesia (in which case you’ll be asleep). They’ll then proceed to use one of the techniques described above. If you’re awake during the procedure, you may feel mild discomfort at certain points, but you shouldn’t experience any pain.

Once your atrial fibrillation ablation has been completed, you’ll be moved to a recovery area, where you’ll be regularly monitored for any potential complications. Many patients are able to go home the same day, but some need to stay overnight. You’ll likely feel sore for up to a week following the procedure, and you should be able to return to your regular routine within a few days. With that being said, it’s important that you follow any instructions that are provided to you.

When to Consider Atrial Fibrillation Ablation

As was noted above, cardiologists often recommend that patients with atrial fibrillation first attempt to treat their condition using medication or other conservative methods, then turn to surgery if those techniques fail to provide sufficient relief. However, in certain situations, they may recommend atrial fibrillation ablation as a first-line treatment.

When determining which treatment approach is best suited to a patient’s needs, cardiologists often consider factors such as how long the patient has had atrial fibrillation, what’s causing the condition and whether the patient is experiencing any symptoms. After learning about your condition and ordering the necessary diagnostic tests, an experienced cardiologist will be able to recommend the course of treatment that’s most appropriate for your specific condition.

Performing Atrial Fibrillation Ablation Near You

Would you like to know more about atrial fibrillation ablation and find out whether you’re a candidate for this procedure? If you’re in the Tampa Bay area, you can turn to Cardiology expert, Paul Z. Gerczuk, MD at Florida Medical Clinic Orlando Health. He has several offices throughout the region, including WaterGrass in Wesley Chapel (at 7760 Curley Road), North Tampa near USF (at 14320 Bruce B. Downs Boulevard) and Wiregrass in Wesley Chapel (at 2352 Bruce B. Downs Boulevard). Click here to request an appointment with Dr. Gerczuk at one of these locations.

About Dr. Paul Z. Gerczuk, MD

A Toronto native, Dr. Gerczuk graduated from St. George’s University School of Medicine and completed an internal medicine residency at University of Southern California Keck School of Medicine. He went on to complete fellowships at The Heart Institute at Good Samaritan Hospital (cardiovascular research), Allegheny General Hospital (general cardiology) and University of South Florida (cardiac electrophysiology). Dr. Gerczuk specializes in the heart’s electrical system and abnormal heart rhythms, and has extensive experience treating atrial fibrillation.