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What is catheter ablation?
Catheter ablation is a procedure to restore the heart’s incorrect electrical signals which cause an abnormal heart rhythm.Catheter ablation is recommended by the American College of Cardiology, the Heart Rhythm Society and the American Heart Association for patients when medication proves to be unsuccessful.
How is the ablation procedure performed?
The ablation procedure is performed by a heart rhythm specialist called an electrophysiologist (EP). An EP is a cardiologist (heart doctor) who has had specialized training in diagnosing and treating heart arrhythmias. Your primary care physician or cardiologist can refer you to an EP, or you can search for an EP in your area using the below.
During the procedure, a thin tube called a catheter is placed through a small incision in a patient's leg where it is then weaved up through a vein to the heart. Aided by 3-D imaging technology, an EP uses a catheter to produce a small scar on a specific part of the heart tissue. The procedure is done by either radiofrequency or cryoablation.
There are two phases during a radiofrequency ablation: mapping and ablation.
An EP creates a ‘map’ of your heart is made using catheters to identify the location of the abnormal electrical signal that is causing your arrhythmia. The mapping catheter has a tiny electromagnetic sensor in its tip that communicates with a 3D electroanatomical mapping and ablation system to create a picture of your heart. The resulting map gives your EP detailed information about how your heart looks and where the electrical circuit is broken.
Once the EP has created a 3D map of your heart, the catheter is maneuvered to the areas identified by the map. The EP then uses radiofrequency waves to neutralize these small parts of your heart tissue that generate and conduct abnormal electrical activity. Ablation therapy blocks the faulty electrical impulses that cause your irregular heart rhythm.
Watch this video to learn more about catheter ablation:
What are the benefits of catheter ablation?
Catheter ablation is more effective in preventing AFib recurrence than drug therapy, and is equally as safe. Patients receiving catheter ablation have been shown to be up to 73% more likely symptom-free at 4 years when compared to patients receiving drug therapy.3,4 Catheter ablation may result in the following benefits:
- Improvement in quality of life1
- Permanent symptom relief1
- Elimination of long-term risk of stroke and death normally associated with AFib5
Will catheter ablation improve my quality of life?
Treatment of AFib can restore quality of life, with the latest research showing that quality of life is improved significantly more after catheter ablation of AFib than with drug therapy.7 At the European Society of Cardiology (ESC) 2018 Congress, results from the CABANA Trial regarding health-related quality of life improvements after catheter ablation were released. The study used five different quality of life surveys to assess several areas such as AFib symptoms, general health perception, physical functioning, psychological well-being, role and social functioning. The CABANA Trial results show that ablation provided incremental, clinically meaningful and significant improvements in AFib-related symptoms and quality of life compared to drug treatment for AFib.7
What are the success rates of catheter ablation?
There are many different factors that may predict the success of a catheter ablation procedure. These include disease progression, sleep apnea, obesity, increased LA size, age, and hypertension.1 Talk to your doctor about these factors prior to your procedure.
Ablation Success Stories
Catheter ablation can be life changing. Meet AFib patients who have undergone successful catheter ablation procedures after drug therapy failed or was ineffective.
* Success defined as freedom from any atrial arrhythmia (atrial fibrillation, atrial flutter, atrial tachycardia) 12 months post-procedure when operator remained in the preset contact force range. Further sub-analysis showed that when the contact force was within investigator-selected range ≥85% of time, success was increased by 21% to 88% (≥85%: n = 32; <85%: n = 73).
1. Hugh Calkins, Gerhard Hindricks, Ricardo Cappato, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter ablation and surgical ablation of atrial fibrillation. 2017.
2. Muthalaly RG, John RM, Schaeffer, B, et al. Temporal trends in safety and complication rates of catheter ablation for atrial fibrillation. https://www.ncbi.nlm.nih.gov/pubmed/295709000
3. Wilber, David J., et al. "Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial." Jama 303.4 (2010): 33-340.lt;/br> 4. Carlo Pappone, MD, et. al. "Radiofrequency Catheter Ablation and Antiarrhythmic Drug Therapy: A prospective, Randomized, 4-Year Follow-Up Trial: The APAF Study. Circ Arrhythm Electrophysiol. 2011).
5. De Greef Y, Schwagten B, Chierchia GB, De Asmundis C, Stockman D, Buysschaert I. Diagnosis-to-ablation time as a predictor of success: Early choice for pulmonary vein isolation and long-term outcome in atrial fibrillation: Results from the Middelheim-PVI Registry
6. Natale A, Reddy VY, Monir G, Wilber DJ, Lindsay BD, McElderry HT, Kantipudi C, Mansour MC, Melby DP, Packer DL, Nakagawa H. Paroxysmal AF catheter ablation with a contact force sensing catheter: results of the prospective, multicenter SMART-AF trial. Journal of the American College of Cardiology. 2014 Aug 19;64(7):647-56.
7. Mark, Daniel B., et al. "Effect of catheter ablation vs medical therapy on quality of life among patients with atrial fibrillation: the CABANA randomized clinical trial." Jama 321.13 (2019): 1275-1285.
THERMOCOOL® Catheters are approved for drug refractory recurrent symptomatic paroxysmal atrial fibrillation, when used with CARTO® 3 Systems (excluding NAVISTAR® RMT THERMOCOOL®Catheter).
Caution: US law restricts this device to sale by or on the order of a physician. Important information: Prior to use, refer to the instructions for use supplied with this device for indications, contraindications, side effects, warnings and precautions.