Laser ablation helps keep AFib at bay
- Atrial fibrillation, when the heart's rhythm and electricity are irregular, brings unpleasant symptoms and an increased stroke risk.
- One treatment is laser ablation, where a cardiologist makes a precise scar.
- Know the signs of AFib: irregular heartbeat and sudden fatigue. See a provider if you have these symptoms.
Atrial fibrillation, or AFib, when the heart’s rhythm and electricity are irregular, is not only common, it’s “serious business,” says Abraham Kocheril, MD.
Notably, there is an increased risk of stroke. There are several ways to combat this, including a procedure known as ablation. Dr. Kocheril, the director of cardiac electrophysiology at OSF HealthCare Cardiovascular Institute in Urbana, Illinois, calls the minimally-invasive procedure a long-term fix to irregular rhythm.
“We put a ring of scar around the pulmonary vein so the AFib triggers don’t make contact with the rest of the atrial muscle,” Dr. Kocheril says.
Like any procedure, ablation has evolved. The “newcomer,” as Dr. Kocheril puts it, is to perform ablation with a laser balloon. Advantages include getting a better look at the pulmonary vein.
“As the balloon expands, it pushes away the blood,” Dr. Kocheril says. “You can see the vein all the way around.
“That’s our target.”
Normally, health care providers say scarring is a bad thing. Less cells can do their job. Don’t lump ablation in. Dr. Kocheril says the procedure produces a very controlled, precise scar.
The ablation procedure
Dr. Kocheril says a cardiologist will send two catheters to the heart via the femoral vein. That starts with a small incision near the person’s groin. Once the precise area is located, the cardiologist delivers laser energy.
The person can be under general anesthesia (completely unconscious) or moderate sedation. During moderate sedation, the person does not need a breathing tube and can talk to the provider. Medication is given to help with pain during the procedure. People under moderate sedation can get anxious and fidget, though, making things more difficult for the cardiologist. Those people may opt for general anesthesia.
After the procedure, providers will monitor the person for a few hours. If all is well, they can go home that day. Recovery that the person can control is simply waiting for the incision site near the groin to heal. In the heart, the process keeps going.
“When we’re ablating AFib, we want to give the atrium time to heal,” Dr. Kocheril says. “We want the inflammation to resolve. We want to give it time to heal and shrink.
“That process can take up to three months.”
An ablation procedure can reduce symptoms such as palpitations, shortness of breath and fatigue.
Talk to your primary care provider or cardiologist to see if laser ablation is right for you and which OSF hospital near you offers it.
September is AFib Awareness Month, a good time to educate yourself on the signs and treatments. If you feel your heartbeat is irregular or if you have sudden fatigue, see a health care provider. Your smart watch may also track heart rhythm, although Dr. Kocheril cautions not to rely on that alone.
“Generally speaking, the younger you are, the more likely you are to feel an irregular heartbeat,” Dr. Kocheril says. “Older folks sometimes don’t feel it.”
Another test: Can you do everything this year that you did last year? You walked a mile last year with no problem. This year, you get halfway done and are spent. That’s a sign to see a doctor.
Learn more about heart care on the OSF HealthCare website.
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