What is Atrial Fibrillation (AF)?

Atrial fibrillation (AF) is an irregular and often rapid heart rhythm (arrhythmia) that originates in the upper chambers of the heart (atria). This can lead to symptoms such as palpitations, breathlessness, dizziness, and fatigue. AF can increase the risk of stroke and heart failure if left untreated.

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What is Catheter Ablation?

Catheter ablation is a procedure designed to treat AF by isolating the abnormal electrical signals in the heart that cause the irregular rhythm. It is performed using thin tubes (catheters) inserted into the heart through the veins in the groin. The aim is to create small scars in the heart tissue to disrupt faulty electrical pathways.

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Who is Suitable for Ablation?

Ablation may be recommended if:

• Medications have not effectively controlled your AF symptoms

• You experience significant symptoms that affect your quality of life

• You prefer a non-medication approach to rhythm control

• You have paroxysmal (intermittent) or persistent AF that has not responded well to other treatments

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Types of Ablation for AF

1. Radiofrequency (RF) Ablation – Uses heat energy to create scar tissue and block abnormal electrical signals

2. Cryoablation – Uses extreme cold to achieve the same effect

Both techniques aim to isolate the pulmonary veins, where most AF triggers originate

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What Happens During the Procedure?

• The procedure is performed under local anaesthetic with sedation or general anaesthetic

• A catheter is inserted into the vein in the groin and guided to the heart

• Radiofrequency  energy or cryotherapy is applied to specific areas of the atria

The procedure usually takes 2–4 hours

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Risks and Complications

While catheter ablation is generally safe, risks include:

• Bleeding or bruising at the catheter insertion site

• Small risk of stroke (medications are given to minimise this)

• Rare complications such as cardiac tamponade (fluid around the heart) or narrowing of the pulmonary veins, or damage to the heart extending to the gullet

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What to Expect After the Procedure

• You may need to stay in hospital overnight for monitoring

• Mild chest discomfort, fatigue, and palpitations are common in the first few weeks

• It can take up to three months for the heart to settle into a normal rhythm

• Blood thinners may still be required depending on your personal stroke risk

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Success Rates and Follow-up

1. Ablation has a 60–80% success rate for maintaining normal rhythm, but some patients may need a second procedure

2. Lifestyle changes, such as weight management and reducing alcohol intake, can improve long-term success

3. Follow-up appointments will monitor your heart rhythm and symptoms

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When to Seek Medical Help

Contact your doctor if you experience:

• Severe chest pain or breathlessness

• Persistent dizziness or fainting

• Signs of stroke (e.g., sudden weakness, speech difficulty, vision loss)

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Conclusion

Atrial fibrillation ablation can significantly improve symptoms and quality of life for many patients. However, it is not a cure, and ongoing management with lifestyle modifications and medications may still be required.

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For more information, consult your cardiologist or visit reputable sources such as the British Heart Foundation (BHF) or the  Arrhythmia Alliance.