AF is the most common heart rhythm disorder (arrhythmia) in the community and one of the leading risk factors for stroke and heart failure.
There are two main treatment aims when you are diagnosed with AF:
1) Reduce symptoms and improve quality of life
2) Reduce your risk of stroke
Symptoms of AF include:
The role of AF ablation has expanded significantly in recent years and is now often recommended early as part of your treatment. In some instances, your cardiologist may recommend AF ablation as an initial treatment option to manage your heart rhythm. AF ablation has a range of benefits including; reduction in symptom burden, improved quality of life; reduced long term complications and reduced disease progression.
We are highly experienced in a range of AF ablation techniques and will recommend the option best suited to your individual needs. SJOG Subiaco is a high-volume AF ablation centre, with low complication rates and high procedural success rates following first procedure.
There is strong evidence to show benefit of undergoing the ablation early in the course of your AF diagnosis, potentially reducing the likelihood of your AF becoming persistent and of you experiencing symptom recurrence following your procedure.
An AF ablation does not reduce your stroke risk, regardless of the outcome of your ablation, anticoagulation will remain part of your AF management plan.
An AF ablation uses energy (thermal, pulsed field or freeze) to create scars within your heart to block or prevent the electrical signals causing your heart to beat irregularly, thereby restoring the normal rhythm of your heart. Specialised mapping systems and technologies are utilised, which have improved the safety and reduced the duration of the procedure in recent times.
Western Cardiology follows a sub-specialisation model of care. This means that your procedure will be performed by a cardiologist who has undertaken extensive additional training in one area of cardiology. In this case a cardiac electrophysiologist. This style of practice has been shown to offer improved outcomes for patients, including:
At Western Cardiology all our procedures take place at St John of God in Subiaco. The procedure takes place in a specially designed cardiac procedure room (known as ‘the cath lab’) under a general anaesthetic. There will also be nurses and specialist technicians assisting with the procedure.
Your cardiologist will then:
You should expect the procedure to take between 1-2 hours.
The success of an AF ablation depends on many factors including age, cardiac structural changes, the duration of the AF (paroxysmal versus persistent) and patient co-morbidities.
In patients with structurally normal hearts and no significant co-morbidities the success rates at one year are up to 80% for one ablation. In patients with more persistent AF the success rates are less and in the order of 50-70% at one year for one ablation.
AF can recur in the 3-month post ablation period (“blanking period”) in which the procedure is not deemed a failure, due to the resultant oedema and inflammation as the scar settles. If AF occurs after this period, a further ablation may be required. The requirement for a further procedure is in the order of one in three. It is uncommon for patient to need more than 3 ablations for AF.
Your cardiologist may organise a cardiac CT to examine the structure of your heart prior to your ablation.
Your cardiologist may request that you stop taking some of your medications before the procedure, especially blood thinners or diabetic medications.
You will be asked to fast for 6 hours prior to your procedure.
Before the day of the procedure, please register with St John of God Subiaco Hospital admissions at www.sjog.org.au/myadmission and complete the online Admissions Form and follow their instructions. If you require any assistance please call 1300 863 566.
On the day of your procedure please bring in your Medicare card, private insurance details, and all your current medications. You will have receive further details about where to present to on the day.
AF ablation is the commonest ablation procedure performed.
Commonly you may experience bruising or swelling at the puncture site in the groin used to access your blood vessel.
Uncommonly an AF ablation may be associated with:
Following your ablation, you will be admitted to the coronary care unit for observation and monitoring overnight. You may feel a little tender at the site of the catheter insertion and have some temporary bruising.
You will not be able to drive for the following at least 48 hours hours so it is advisable that you arrange to be collected from the hospital.
You might feel a bit of chest discomfort in the first day or so following the procedure.
You will be required to continue the anticoagulation for at least 3 months post procedure and potentially longer even after a ‘successful’ ablation. This will be advised by your treating cardiolog
Avoid strenuous physical activity for two weeks after your discharge