In this video, we will discuss the ablation procedure for Afib, who has the best results with Afib ablation and who has the worst results.
Ablation for Afib is a procedure done in the hospital where a doctor threads a thin catheter into the heart and creates scars in the heart tissue with either heat or cold to alter the electrical signals in the heart.
The typical Afib ablation creates scars around the pulmonary veins in the left atrium (called pulmonary vein isolation) but also can create other areas of scar where there are electrical signals that may be causing Afib.
Who Afib ablation works best for
The best candidate for Afib ablation is someone with Afib that comes and goes (which is called paroxysmal Afib) and has symptoms when they are in Afib. They may have already tried medication, which didn’t work for them either because it didn’t help with the Afib or caused side effects. Some people may choose ablation without trying medications first.
Afib ablation may also be a good option:
- For people with long-standing, persistent Afib who continue to have symptoms and medications aren’t helping.
- For younger people with Afib, even if they don’t have symptoms.
- For those with heart failure and a reduced ejection fraction. Some studies show that these individuals live longer after ablation, improve their ejection fraction, and have fewer hospitalizations.
Article continues after video
Who should not have an ablation
If those are the patients that do best with Afib ablation, who are the patients who are not good candidates for ablation?
People who should NOT undergo Afib ablation include:
- Patients with no symptoms, a preserved ejection fraction, and adequate rate control.
- Older individuals who are too frail to safely undergo the procedure.
- Patients with a left atrial appendage thrombus.
- Individuals who cannot receive blood thinners around the time of the procedure.
People with long-standing persistent atrial fibrillation (over one year) have the lowest odds of success.
They should have a thoughtful discussion with their doctor to understand the pros and cons of such a procedure.