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Ablation therapy for atrial fibrillation - What happens during an ablation?

Whenever medical treatment is not successful, ablation therapy might be the method of choice. 

If a drug therapy approach is not effective, under certain conditions ablation treatment can be performed. The goal of any treatment of atrial fibrillation (atrial fibrillation ablation) is the electrical isolation of the entry points of the four pulmonary veins from the tissues of the left atrium (pulmonary vein isolation). This is because the cause of atrial fibrillation is usually found in the tissue behind these entry points. This location is the source of the electrical impulses that upset the regularity of the heartbeat.
Atrial fibrillation therapy is primarily for patients with significant symptoms, who are unable to maintain their usual level of performance, and for whom there exists a high probability of regaining a sinus rhythm due to an ablation. The different approaches to treatment aim to produce an area of scars between the pulmonary vein tissues and the actual atrial tissue
 
Catheter Ablaltion: ablation catheter (blue, below) and diagnostic lasso catheter (light blue, above) at the entrance to the pulmonary vein. Image: Medtronic   Pulmonary vein isolation: The red markings indicate the individual ablation areas.

These form an impenetrable barrier for the disruptive impulses. For a successful treatment it is important that no gaps remain between the point-like scars zones, only a contiguous scar line ensures a continual electrical disconnection of the pulmonary vein.

On whom may or should ablation be performed?

According to the latest guidelines (recommendations) of the European Societies of Cardiology (ESC), catheter treatment of atrial fibrillation is an option for paroxysmal (occasional) atrial fibrillation in patients with no or minimal structural heart disease. It is also an important treatment option after an unsuccessfully attempted medication therapy.
 

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