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Atrial Fibrillation Surgery Success Rate

What To Expect After An Ablation:

What is the success rate for atrial fibrillation ablation procedure?

Once your surgery is complete, you will be moved to the recovery room to wake up and rest. While there, you will also receive any medical care that you need post-operatively. Your doctor may order additional tests to assess any changes to your heart rhythm and function. In most cases, patients can return home the same day as the procedure.

As a minimally invasive procedure most patients experience a relatively short recovery after a catheter ablation. This being said, it is common for patients to experience some mild discomfort after the procedure, such as the following:

  • Mild soreness and bruising along the point of entry in the groin

  • Mild chest pain. Chest pain is usually inflammatory in nature . This pain usually responds well to anti-inflammatory medications.

  • Mild shortness of breath. Sometimes patients retain fluid after a catheter ablation and experience shortness of breath. At times, your doctor may prescribe a diuretic medication to help remove fluid.

  • If at any time during your recovery you experience severe pain, bleeding from the catheter insertion site, or develop crushing chest pain, please be sure to contact your provider ASAP for additional support.

What Questions Should I Ask My Doctor

Questions you may want to ask your provider include:

  • How often do I need follow-up appointments?
  • How long will it take for lifestyle improvements to show results?
  • Which medicine do you recommend and why?
  • Should I undergo a procedure such as cardioversion, ablation or a maze procedure?

A note from Cleveland Clinic

The feeling of an unusual heartbeat is unsettling, but treatments are available to help you manage A-fib with RVR. Your healthcare provider can guide you in deciding which treatments are best for you. You can play an important role in your health by keeping your follow-up appointments and taking the medicines your provider prescribed.

Last reviewed by a Cleveland Clinic medical professional on 01/06/2023.

References

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy

What Happens After Ablation

Talk with your doctor about what to expect after your ablation. In the hospital after the procedure:

  • You will spend several hours in a recovery room.
  • The team will monitor your vital signs, such as your heart rate and breathing.
  • You will need to lie flat for several hours after the procedure. You should not bend your legs. This will help prevent bleeding.
  • Most people spend the night in the hospital.
  • You may feel some chest tightness after the procedure.
  • Your doctor will review which medicines you need to take, including blood thinners.

At home after the procedure:

  • Most people can return to normal activities within a few days after leaving the hospital.
  • Avoid heavy physical activity for a few days.
  • Avoid driving for 48 hours after the procedure.
  • You may have a small bruise from the catheter insertion. If the insertion site starts to bleed, press down on it and call your doctor.

After you leave the hospital, it is important to follow all the instructions your healthcare provider gives you for medicines, exercise, diet, and wound care. Be sure to keep all your follow-up appointments.

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When Should You Have An Ablation For Afib

In general, the earlier someone undergoes an ablation procedure for atrial fibrillation, the better the success rate of the procedure. Patients in earlier stages of AFIb, called Paroxysmal AFib usually have the best success rate with an ablation procedure. Recent literature has also suggested that patients who undergo an AFib ablation procedure within the first year after diagnosis have the best results.

Complications And Recovery Of A Convergent Procedure

Catheter ablation for atrial fibrillation

In addition to the normal risks of surgery, some patients experience chest pain, trouble breathing, or fluid retention after this procedure. A recent study reports the complication rate of a convergent procedure is 10%.

Like the Mini Maze, the expected hospital stay after the procedure is 3-4 days. On the first day after the procedure, you may be admitted to the ICU for additional monitoring.

During the first 2-4 weeks while at home, strenuous activity should be avoided. Once healed, normal activities can be resumed.

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Measuring Catheter Ablation Success

The HRS Expert Consensus Statement set guidelines for catheter ablation trials. Immediately after the procedure, there is a three-month blanking period during which time atrial fibrillation episodes can occur due to the inflammation that the body produces in response to the procedure. Any afib activity during that blanking period is not counted in a studys results.

After the blanking period, the HRS Expert Consensus Statement defines success as freedom from afib, atrial flutter or tachycardia greater than 30 seconds and discontinuation of antiarrhythmic medication as the gold standard for reporting the success rates of afib ablation. The HRS Expert Consensus Statement also states that all ablation trials should report the success rates following a single ablation procedure without using antiarrhythmic medications, using a minimum of 12 months follow-up.

Not all doctors involved in clinical studies follow the HRS Expert Consensus Statement guidelines, so when looking at treatment success rates, its important to look at these three factors:

While clinical success is defined above, only you can decide what defines treatment success for you. Success may mean freedom from atrial fibrillation and the ability to stop antiarrhythmic medication after one catheter ablation for some people. Still, for others, alleviating symptoms, even though they have to remain on antiarrhythmic drugs, may mean success.

Recovery From Ablation Procedure

The entire catheter ablation procedure usually takes three to five hours, and most patients are discharged home within a few hours after the procedure.

Some patients may continue to experience episodes of AFib while healing after an ablation. It may take two to three months before AFib symptoms go away completely. During this time, patients will continue to follow up with their referring physician and with the electrophysiologist who performed the ablation.

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Afib Surgery Vs Catheter Ablation

So, if these surgical options have a high level of success, why would anyone get a catheter ablation instead?

While the surgical procedures have been proven to be more effective at treating the symptoms of atrial fibrillation in some studies, they also come with additional risks. In addition, the results of various studies are inconsistent on whether surgical or catheter ablation is more effective in treating AFib.

At the same time, there have also been studies that have shown that a catheter ablation procedure can be as equally as effective as a surgical ablation in patients with paroxysmal or early stage atrial fibrillation. Meanwhile, another study demonstrated the results in long-standing persistent atrial fibrillation were similar between catheter and surgical ablation procedure.

As reported above, the complication rates from surgical ablation procedures can be anywhere from 10-25%. Meanwhile, a recent systemic review of over 80,000 catheter ablation procedures found a complication rate of 2.9%.

For those who do not require surgical intervention, a catheter ablation is a safer and still effective option for treating AFib.

Also keep in mind, many patients with atrial fibrillation have additional medical conditions that may increase the associated risks of a surgical ablation procedure such as, coronary artery disease, congestive heart failure, or chronic obstructive pulmonary disease.

What Is Atrial Fibrillation

What is the success rate of cardiac ablation for atrial fibrillation?

Before I share our latest study showing how effective atrial fibrillation ablations have become in getting rid of atrial fibrillation and cardiac medications, let me explain what atrial fibrillation is. Atrial fibrillation is a condition where the upper chambers of the heart are in complete electrical chaos thereby causing the heart to beat fast and irregular.

The fast and irregular heart rate of atrial fibrillation causes palpitations, shortness of breath, chest pain, fatigue, and other symptoms. Sadly, atrial fibrillation leads to strokes, heart failure, dementia, and other medical problems. Clearly, this is a medical problem that you want to quickly get rid of if possible.

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About Your Cardiac Catheter Ablation Or Device Implant At Umhs

Electrophysiology is the name of the branch of cardiology that deals with heart rhythm disorders. Catheter ablations are performed by an electrophysiologist . The University of Michigan electrophysiology program has been a national and international leader in catheter ablation of arrhythmias over the last three decades. Weve been at the forefront of catheter ablation of atrial fibrillation during the last eight years and played a key role in understanding the mechanisms of atrial fibrillation and developing new treatment strategies.Doctors at the University of Michigan have performed crucial studies that have helped to perfect the tools used in ablation. We handle large volumes of patients and have conducted extensive studies to prove that ablation is effective long term.

What Is Involved In A Radiofrequency Ablation Procedure

You will be transferred to the Electrophysiology Laboratory from your ward. Usually before leaving the ward your groin will be shaved.

The EP lab has a patient table, X-Ray tube, ECG monitors and other equipment. The staff in the lab will all be dressed in hospital theatre clothes.

Many ECG monitoring electrodes will be attached to your chest area and patches to your chest and back. These patches may momentarily feel cool on your skin.

The anaesthetist will insert an intravenous cannula usually into the back of your hand and a second cannula into the artery. The entire procedure will be performed while you are asleep under general anaesthetic.

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High Rates Of Success For Both Early

For patients in the early stages of AFib, with symptoms that come and go , catheter ablation has an 80 to 90 percent success rate. Even in patients with more advanced AFib, there is still about an 80 percent success rate when using adjunctive ablation strategies. If the first ablation is unsuccessful, most patients experience significant improvement with a second ablation procedure.

There is more and more evidence that ablation can be performed as a first-line treatment for early stage AFib with excellent outcomes. In addition, ablation may be the best option for patients with AFib and heart failure, Dr. Arruda says.

Catheter ablation has similar success rates to surgical procedures for AFib, such as Maze surgery. Maze, or surgical AFib ablation, is a more complex procedure than catheter ablation and is often performed in conjunction with open-heart surgery for a co-existing heart condition. Certain patients with very advanced AFib may benefit from a hybrid procedure utilizing a less invasive surgical approach followed by catheter ablation.

Impact Of Ablation Techniques

CircEP on Twitter: " Catheter ablation for atrial fibrillation appears ...

Whereas a consensus has been reached on the suitable approach forablation of patients with paroxysmal AF, no such consensus existsfor patients with persistent and long lasting persistent AF regardingthe optimal technology of treatment.

Numerous clinical trials demonstrated that the main mechanism of AF recurrence after PVI in the paroxysmal population is theresumption of electrical conduction between the veins and left atrialmuscle. This statement is true for either the short or the long termrecurrences . Based upon these observations we shouldassume that at least in PAF, the durability of venous isolation andtherefore permanent electrical disconnection plays a crucial role inmaintaining procedural effectiveness in the long term. Accordingly,any kind of procedural tool or technique which can facilitate the durable isolation of pulmonary veins can be useful.

As mentioned earlier, in patients with persistent and longstandingpersistent AF the data concerning the outcomes are considerably lessfavorable than for PAF. The wide contrast in PVI success rates betweenparoxysmal and persistent AF suggested that the mechanisms can besubstantially different, and probably related to electrophysiologicaland structural remodeling of left atrial substrate. Not surprisingly,current approaches designed to target persistent AF are mainlybased on modification of the atrial substrate, but exhibit remarkabledifferences, and a widely accepted uniform strategy is missing.

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Ablation Procedure Helps 3 Out Of 4 Afib Patients

But results may not be lasting, and patients may still need to take medications

HealthDay Reporter

WEDNESDAY, Jan. 25, 2017 — Just how successful is the procedure called catheter ablation at fixing irregular heartbeats that can be potentially fatal?

Pretty successful, a new study found, but there are caveats.

Burning or freezing specific areas of the heart can alleviate the common irregular heart beat called atrial fibrillation in 74 percent of patients. However, the procedure doesn’t work for everyone and there are risks of complications, researchers report.

Atrial fibrillation increases the risk of early death by two times in women and 1.5 times in men. It causes 20 to 30 percent of all strokes and can decrease quality of life due to palpitations, shortness of breath, tiredness, weakness and psychological distress, the study authors explained.

About 2.7 million Americans suffer from atrial fibrillation, according to the American Heart Association.

For those whose atrial fibrillation can’t be controlled with medications, catheter ablation may be recommended.

“Catheter ablation is a valid alternative for the management of atrial fibrillation with a satisfactory success rate,” said study lead researcher Dr. Elena Arbelo.

But the procedure can have complications, which should be considered carefully by doctors and patients, said Arbelo, a senior specialist in the Cardiovascular Institute at the Hospital Clinic of Barcelona in Spain.

Show Sources

European Heart Journal

The Potential Risks And Complications Of A Catheter Ablation

Just like any other surgery or medical procedure, deciding to undergo a catheter ablation is not without risks. Despite being a minimally invasive procedure option that most patients recover from quite quickly, it is important to know that you may experience a potential complication if you choose to undergo a catheter ablation for your atrial fibrillation. In most centers, risks for major complications are less than 1%. If you have any questions about the procedure and its risk, you should speak to your doctor before your surgery date to ensure that you make the right choice for your needs.

Some of the most common risks and complications of a catheter ablation include:

  • Bleeding or getting an infection from the catheter insertion site

  • Damaging the lining of the vein or vessel used during the procedure

  • Puncturing the heart tissue, resulting in bleeding around the heart, sometimes requiring emergency drainage.

  • Post-operative blood clots

  • Narrowing or scarring of the vascular vessel used during the procedure

  • Complications from radiation exposure during surgery

  • Allergic reactions to the anesthesia medications

  • Damage to the esophagus

To minimize the potential risks of choosing this treatment option, be sure to talk to your provider to ensure that you are physically fit for surgery and that the benefits of the procedure outweigh the risks to ensure your safety. Also, ask your doctor what precautions they take to minimize these risks.

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What Happens During Ablation

Talk with your doctor about what to expect during your ablation. The procedure usually takes 3 to 6 hours. A cardiologist and a special team of nurses and technicians will do the ablation. During the procedure:

  • You may have a local anesthetic applied to your skin where the team will make a small incision .
  • Or, you may receive a general anesthetic with a breathing tube inserted to make you sleep through the surgery.
  • Your doctor will make several small holes in a vessel here. He or she will put a few tapered tubes called sheaths through this hole.
  • Your doctor will put a series of electrode catheters through the sheaths and into your blood vessel. The team will then advance the tubes to the correct place in your heart.
  • Next, the doctor will locate the abnormal tissue using special technology. He or she will do this by sending a small electrical impulse through the catheter. Other catheters will record the hearts signals to find the abnormal sites.
  • The doctor will place the catheter at the site where the abnormal cells are. He or she will then scar the abnormal area . This might cause slight discomfort.
  • The team will remove the tubes. They will close your vessel with firm pressure.
  • The team will close and bandage the site where the doctor inserted the tubes.

Managing After A Catheter Ablation

AFib Ablation – Improve Your Success Rate

Recovery from catheter ablation is usually fairly straightforward. In the days after the procedure, you may experience mild symptoms such as an achy chest and discomfort, or bruising in the area where the catheter was inserted. You might also notice skipped heartbeats or irregular heart rhythms. Most people can return to their normal activities within a few days.

Contact your doctor immediately if you have unusual pain or swelling, excessive bleeding or consistent irregularities in your heartbeat.

Depending on the type of arrhythmia being treated, catheter ablation can have a success rate of more than 90 percent, but some people may need to have the procedure again or other treatments for heart arrhythmias. Your doctor may want you to remain on medications to help control your heartbeat.

After the catheter ablation, be sure to follow all instructions from your doctor, especially regarding follow-up visits, medication schedules and safe levels of physical activity.

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Catheter Ablations Work Long

Catheter Ablation: Long Term Success

Great news for A-Fib and catheter ablation patients! The research results are in from a ten-year follow-up of Atrial Fibrillation patients receiving catheter ablations . Doctors at the Texas Cardiac Arrhythmia Institute in Austin, TX, ablated for paroxysmal A-Fib. After ten years 87% were still A-Fib free, though some needed two ablations.

Note: The doctors in Austin performed more extensive ablations than most centers at that time, and also performed empiric isolation of the superior vena cava in all patients.

Of the 513 patients, 59% needed only one ablation, while 28% required two. Reconnection in the pulmonary vein antrum was the main reason for having a repeat ablation. This reconnection was found in 31% of patients at the time of their first repeat procedure and in no patients who underwent a second repeat ablation.

What about patients who had recurrent A-Fib after two ablations? They were given a high-dose isoproterenol treatment to identify non-pulmonary vein triggers, which were then targeted with a second repeat ablation.

Ten-Year Follow-up & Monitoring Follow-up, including Holter monitoring, was performed every 3 months during year 1 and every 6-9 months thereafter. The rate of recurrent A-Fib was 21% at 1 year and 11% during years 1-3. During years 3-6 of follow-up, there was a low 4% recurrence rate. Between years 6-10, the recurrence rate was 5%.

Editors Comments:
What does this mean for todays A-Fib patients?

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