This catheter-based procedure helps find the areas in the heart that cause atrial fibrillation (afib) to occur and spread throughout the atria, the blood collection chambers of the heart.
Doctors find these areas in and around the pulmonary veins in the left atrium (the four large veins that bring blood back to the heart from the lungs).
To find them, a doctor inserts a flexible catheter into blood vessels in the groin and under the collarbone. A fluoroscope (similar to an X-ray machine) monitors the catheter as it moves to the heart. This procedure might require one or two punctures in the atrial septum in order to get the catheters into the left atrium.
How Catheter Ablation Works
Once in place, your doctor records your heart's electrical signals and maps the pulmonary veins and other areas in the atrium. To do this, your doctor uses navigational tools and computers that construct a 3D image of the heart.
Electrical current passes through the catheter and heats the tissue at the source of the issue. This inactivates or scars the tissue.
Your doctor may create a ring or circle around the pulmonary veins that enter the left atrium, called pulmonary vein isolation (PVI).
For patients with paroxysmal afib, PVI may be all that is necessary, especially if there is no other heart disease. However, patients with more persistent afib may need additional ablation to change or modify the atrial tissue to prevent irregular heart rhythms.
Cardiac Catheter Cryoablation
Cryoablation uses extremely cold temperature to destroy selected cells.
In cases where the area causing the abnormal beat is found outside the heart, your doctors may perform an epicardial ablation. This procedure is considered minimally invasive and usually involves inserting a catheter through the skin under the ribs.
At UVA, we can perform surgical ablation as a standalone procedure in a less invasive surgical approach or together with an open-chest procedure for another medical reason (such as a coronary artery bypass or heart valve replacement).
To do this, we'll either use radiofrequency energy, ultrasound energy, microwave energy or cryoablation (creating an ablation by freezing tissue) applied to the outside of the atria around the pulmonary veins.