Atrial flutter ablation

Overview

Atrial flutter ablation is a medical procedure that creates scar tissue in the heart’s upper chamber to block the electrical impulses causing irregular heartbeats. While many practitioners use radiofrequency ablation, which applies heat, some prefer cryoablation that freezes the problematic tissue. In atrial flutter, the heart’s upper chambers beat irregularly due to faulty cells sending inconsistent impulses, leading to symptoms such as palpitations and potential long-term heart damage.

Reasons for undergoing the procedure

If traditional treatments like medicine or cardioversion prove ineffective, a healthcare provider might suggest atrial flutter ablation. This procedure aims to manage the symptoms of atrial flutter, potentially restoring a normal heart rhythm and enhancing the patient’s quality of life.

Risk

Atrial flutter ablation carries a complication rate of under 1%, with rare complications including heart block, stroke, unintended cardiac perforation, infection, and bleeding. Should one experience excessive bleeding, persistent weakness, confusion, slurred speech, or an overwhelming sensation of lightheadedness, it’s vital to contact a doctor immediately.

Before the procedure

• Fasting: Refrain from eating and drinking for 6-8 hours before the procedure.
• Medications: Some may need to be stopped temporarily. Always consult your provider.
• Anticoagulants: Do not miss a dose unless specifically instructed by your cardiac electrophysiologist.

During the procedure

• Anesthesia administration: You’ll receive either a light sedation, making you drowsy but not fully asleep, or general anesthesia, under which you’ll be completely asleep. If given general anesthesia, a breathing tube will be inserted.
• Accessing the heart: A doctor will insert a needle into your groin area and then place multiple tubes, known as catheters, into the veins there.
• Mapping the heart: An electrode catheter is guided through the tubes from your blood vessel to your heart, sending signals to identify the abnormal heart cells causing the flutter.
• Ablation: Radiofrequency energy is used to heat and safely damage these abnormal cells, stopping the flutter.

After the procedure

Atrial flutter ablation is a hospital procedure where a patient is given a sedative for relaxation. Once sedated, a numbed area near a vein, typically in the groin, allows for the insertion of a catheter, which is guided into the heart. This catheter has sensors that emit and record electrical impulses to identify the optimal location for the ablation. By applying heat, usually via radiofrequency energy, the target tissue is damaged, leading to scarring that blocks the problematic electrical signals responsible for the atrial flutter. The procedure usually lasts two to three hours, followed by a recovery period, after which patients may either be discharged the same day or required to stay overnight for monitoring.

Outcome

After undergoing atrial flutter ablation, regular heart checkups are essential. While most individuals experience an enhanced quality of life post-ablation, there’s a possibility that atrial flutter could recur. In such cases, a repeat procedure or alternative treatments might be considered. Typically, patients can resume their regular activities a day after returning home, but should avoid physically strenuous tasks for three days. Short-term adherence to anticoagulants without skipping doses is vital to prevent potential blood clot formation. In the long run, continuation of anticoagulants may be necessary if signs of atrial flutter or other irregular rhythms persist, but the final decision rests with the cardiologist.