![]() ![]() The epicardial ablation is performed by the surgeon using the Epi-Sense (EP) catheter with energy directed toward the heart and away from the esophagus. The convergent hybrid ablation procedure combines both endo- and epicardial ablation to isolate both the pulmonary veins and the posterior wall. Because endocardial energy is directed posteriorly (i.e., toward the esophagus) the amount of energy that can be delivered is limitedĪdditionally, an endocardial approach normally involves treatment with a box lesion from a small catheter with high rates of lesion failure.There can exist an endo- and epicardial dissociation.It is also the most common site of reentrant AF drivers.Īchieving transmural lesions on the posterior wall with an endocardial approach is challenging for a couple of reasons: The posterior left atrial wall has the highest portion of non-pulmonary vein triggers. ![]() Several studies of patients with persistent and longstanding persistent AF treated with catheter ablation have shown successful outcomes in the one- year range from 35 to 50 percent, and those outcomes often require several procedures to obtain.Īs opposed to paroxysmal AF, where triggers come from the pulmonary veins in persistent and longstanding persistent AF, the triggers and drivers often come from elsewhere, most commonly the posterior left atrial wall. Pulmonary vein isolation has been shown to be an effective treatment of paroxysmal AF however, outcomes for this treatment in patients with persistent and longstanding persistent AF are not as good. As a group, patients with persistent or longstanding persistent AF are more difficult to treat. Seventy percent of these patients have persistent or longstanding persistent AF. It covers the rationale for the procedure, the surgical components that make up the procedure, as well as existing related data.ĪF infection affects 33,000,000 people worldwide. This video focuses on the convergent hybrid ablation procedure, which recently received FDA approval for the treatment of longstanding persistent atrial fibrillation (AF). All rights reserved.Disclosure: The author of this video is a consultant and proctor for Atricure-the company that makes the Epi-Sense catheter used in this procedure. © 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). If this happens, the procedure may be repeated or you and your health care provider might consider other treatments. Most people see improvements in their quality of life after this type of cardiac ablation, but there's a chance the atrial flutter may return. ResultsĪfter atrial flutter ablation, you'll need regular checkups to monitor your heart. ![]() Afterward, you'll be taken to a recovery area where care providers will closely monitor your condition.ĭepending on your condition, you may be allowed to go home the same day or you may spend a night in the hospital. The scarring helps block the electrical signals that are causing the atrial flutter.Ītrial flutter ablation typically takes two to three hours. Heat (radiofrequency energy) is applied to the target area, damaging the tissue and causing scarring. This information is used to determine the best place to apply the ablation treatment. Sensors on the tip of the catheter send electrical impulses and record the heart's electricity. The doctor inserts a long flexible tube (catheter) into the vein and carefully guides it into your heart. Once the sedative takes effect, a small area near a vein, usually in your groin, is numbed. You'll likely receive a medication to help you relax (sedative). What you can expectĪtrial flutter ablation is done in the hospital. Atrial flutter ablation may restore a typical heart rhythm, which may improve quality of life. Why it's doneĪtrial flutter ablation is done to control the signs and symptoms associated with atrial flutter. The goal of atrial flutter ablation is to stop the irregular electrical signals and restore a typical heart rhythm. Atrial flutter ablation is a procedure to create scar tissue within an upper chamber of the heart in order to block the electrical signals that cause a fluttering heartbeat.Ītrial flutter occurs when the heart's electrical signals tell the upper chambers of the heart (atria) to beat too quickly. ![]()
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