Atrial fibrillation is an irregular heartbeat which originates in the upper chambers of the heart called atria. The electrical signal in these chambers is very disorganized and very rapid. The usual heartbeat is 60 impulses per minute, in atrial fibrillation is up to 500 impulses per minute in the atria. The normal signal triggers a single smooth electrical wave that causes the heart to beat in an orderly fashion. In atrial fibrillation the wave is chaotic and does not allow the heart to beat in an organized fashion.
When medicines are not working to manage the symptoms or episodes of atrial fibrillation, ablation may be considered to treat atrial fibrillation. Not everyone with atrial fibrillation can be helped by an ablation. Your provider will help you know if atrial fibrillation ablation is right for you.
Electrophysiology and ablation strategies
Ablation for atrial fibrillation focuses on the pulmonary veins. Several tools are used to guide placement of ablation lesions around the pulmonary veins in an overlapping pattern (see Figure 3).
The tools used are:
- Live fluoroscopy (X-ray)
- 3-D mapping
- CT scan of the heart (obtained before the procedure usually in the office
- Magnetic steering of the catheters (Stereotaxis)
The ablation lines, when healed help prevent the electrical signal from leaving the veins. Blood continues to flow normally through the veins. The ablation creates scar tissue which “corrals” the electrical signal and prevents it from triggering atrial fibrillation.
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