Exploring Other Options: Catheter and Surgical Ablation

Medication cannot cure atrial fibrillation.  For those looking for a cure, Mellanie True Hills, Founder of the American Foundation for Women's Health and the patient’s resource StopAfib.org, suggest discussing the following options with your doctor.  (Information courtesy of StopAfib.org)

Catheter Ablation is done by an electrophysiologist (a cardiologist specializing in heart rhythms) in the electrophysiology (EP) lab rather than in an operating room as with surgeries.   

A small incision is made in the groin area and a device is threaded up into the heart.  A tiny device is used to create conduction blocks at the pulmonary veins that stop erratic signals from coming into the upper chambers of the heart.

“By making a physical separation they off the erratic signals,” says Mellanie.  “The success rates are improving, but there are still risks. And in some cases it may take more than one ablation.”   Also, the body can re-grow the electrical connection, sometimes in as little as four to five  months.

Success to date in curing afib has been very low, but has been improving at centers with large numbers of procedures accomplished. Some patients require two or three catheter ablations for a successful result. With catheter ablation there is less control by the EP because catheters are threaded through the blood vessels and thus there is no direct visibility of what is happening. That has resulted in a high level of complications to date, so catheter ablation risks are a significant factor in undertaking this procedure.

A Tip for Women having a Catheter Ablation:
Schedule a bikini wax!

“One of the most embarrassing things is to be strapped to that table and then have someone shave you ‘down there.’ Tell me, tell me that’s going to happen and I’ll go get the bikini wax!”

Eliz Greene continues, “I’d much rather take care of that myself, thank you very much, especially if they are going to use that nasty safety razor and you are going to get all kinds of ingrown hairs.  So many things are easier to deal with if you just know they are coming as opposed to being surprised.”

Maze (Cox-Maze III) surgery is the gold standard for curing atrial fibrillation. It is a cut-and-sew procedure that takes place in open-heart surgery. Success results are high, generally 96% or greater ten years after surgery, but it is a very complicated procedure with a more difficult recovery.

Maze Surgical Ablation, sometimes called Cox-Maze IV, is an open-heart surgery that uses the same open-chest procedure as Cox-Maze III, but uses an energy source to scar the tissue instead of using incisions, thus accomplishing the same thing in much less time. It is generally done in patients needing a valve replacement or coronary artery bypass (CABG) surgery, but may also be done on "lone atrial fibrillation." Maze surgical ablation has the same level of efficacy as Cox-Maze III, but also the same recovery time.

It is important to discuss all of your options, and their risks and benefits, with your doctor to choose the right one for you.

The Patient's Perspective is a series of recorded teleconferences and articles presented by the Embrace Your Heart Wellness Initiative and hosted by Eliz Greene.  Each teleconference focuses on a specific challenge facing women with heart disease.  For more information visit www.EmbraceYourHeart.com

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Eliz Greene is a heart attack survivor, author and nationally known speaker on a mission to encourage women to recognize heart disease as their most serious health threat and provide down-to-earth strategies for active and healthy lives.  Learn more about Eliz and the Embrace Your Heart Wellness Initiative at www.EmbraceYourHeart.com