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Cardiac ablation, or simply ablation, is a treatment that may control atrial fibrillation (afib) when medication and other afib treatments are not successful.
Afib ablation is a catheter-based procedure. An interventional cardiologist threads a catheter from an artery in your groin up to your heart. The procedure creates scar tissue in certain areas of your heart. These scars keep the signals that are causing the abnormal rhythm of your heartbeat from moving through your heart.
Cardiac ablation for atrial fibrillation has success rates as high as 90%. However, doctors usually try other afib treatments first.
Good Candidates for Cardiac Ablation
Likely candidates for the cardiac ablation procedure include:
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People who cannot have a procedure called cardioversion. One type of cardioversion uses medication, but some people cannot take these drugs. Others experience severe side effects from them. Cardioversion using electric shocks to restore your heart rhythm usually works initially, but afib often returns. You might have to repeat the procedure several times. In these cases, doctors often suggest ablation.
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Professional athletes. People who do intense exercise have an increased risk of developing afib. However, medications may not be a good option. Many athletes avoid taking afib drugs because the medication can affect their performance. Also, people taking the drugs may be banned from competing. Ablation is often the afib treatment that athletes prefer.
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People with heart disease. Doctors may recommend ablation for people who are at high risk for afib complications, like sudden cardiac arrest.
People who may not be ideal candidates for cardiac ablation for afib include:
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People whose heart has become very enlarged. Cardiac ablation is less effective when that's the case.
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People who've had afib for a long time — it doesn't work as well for those who've had it several months or longer.
Other Things to Consider
What about age? Older people are less likely than younger people to undergo an ablation. However, research shows older age does not make the cardiac ablation procedure less effective.
Afib Ablation vs. Afib Surgery (Maze Surgery)
How does ablation compare with surgery for afib? Afib surgery refers to maze surgery, during which a heart surgeon makes small cuts in the heart’s atria in order to create scar tissue and force a specific electrical pathway through the heart. It’s usually performed in people who need open heart surgery for another reason, such as coronary artery bypass.
Ablation is much less invasive than maze surgery. Maze surgery is usually performed during open heart surgery, although a minimally invasive technique, and even robotic-assisted maze surgery is an option for some people and at certain medical centers. Also, recovery times are faster for afib ablation. Some people go home from the hospital on the same day. Most return to their normal routine after a few days.
The chances of success are very good with ablation, but they're also very good with surgery. Both have a success rate of about 90%. However, doctors usually consider surgery a "last resort"—when nothing else has worked. For most people, doctors suggest trying ablation first.
