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Arrhythmia Surgery
Cardiac Conduction System
The Mini-Maze
  • Mini-Maze
  • Cox-Maze III
  • Thoracoscopic LV Lead Placement
  • Permanent Pacemaker Insertion
Catheter Based Ablation
Catheter Ablation - Pulmonary vein ablation (isolation)
Current PV ablation techniques are achieving partial success rates in curing paroxysmal AF. Those not "cured" of AF, may be significantly improved after an ablation. They may have fewer or less intense attacks of AF. Medications that didn't work before may now control the AF. But for some there may not be any noticeable improvement at all. Procedures may need to be repeated multiple times.

During PV ablation a soft, thin, flexible tube with an electrode at the tip is inserted through a large vein or artery in your groin and moved into your heart. The catheter then needs to be punctured across the atrial septum to pass from the right side of the heart to the left. This catheter is directed to the precise location(s) in your heart that are producing your AF. These points are burned off or isolated from your heart.

If you are in AF during the catheter ablation procedure, it's relatively easy for the doctors to determine where the A-Fib signals are coming from and to ablate (destroy) them.

However, if you have intermittent AF (Paroxysmal AF), it's harder to pinpoint exactly the source(s) of the A-Fib signals. The challenge for doctors is how to locate and eliminate AF signals when the patient is not in AF. Since research has shown that almost all A-Fib signals come from the openings (ostia) of the four pulmonary veins in the left atrium, one technique is to make circular radiofrequency (RF) Ablation lines around each pulmonary vein opening (called "Circumferential" or "Empirical Ablation"). This isolates the pulmonary veins from the rest of the heart and prevents any pulses from these veins from getting into the heart. However, it's difficult to make circular RF lesions and they aren't always successful. This technique can achieve good success rates with for people with paroxysmal AF. For people with chronic AF, success rates may not be as good. It is important to discuss with the doctor and understand what type of technique is intended to be used.

Complications can include, esophageal fistula, pulmonary vein stenosis, paralyzed diaphragm/phrenic nerve injury, cardiac perforation.

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Catheter Based Ablation