Successful treatment of atrial fibrillation requires looking at it from comprehensive standpoint. So there’s really three pillars of treatment – number one, the prevention of the risk factors, number two, the treatment of the symptoms, and number three, prevention of stroke. Treating, identifying, and reducing the risk factors associated with atrial fibrillation are crucial. Those risk factors include high blood pressure, diabetes, a condition called obstructive sleep apnea, as well as being overweight. Part of the treatment plan for treating atrial fibrillation is also treating the symptoms. Those symptoms can be treated sometimes simply by medicines, but other times more complex procedures, such as an ablation, are required to successfully treat and/or eliminate atrial fibrillation.
An ablation is an minimally-invasive procedure, where small flexible catheters are placed through the groin into the heart and areas in the heart where the atrial fibrillation is coming from are targeted. Here at Spectrum, for the majority of AFib ablations, we perform the cryoballoon procedure. We have found that to be very effective and successful in eliminating atrial fibrillation for the vast majority of patients.
In a cryoballoon ablation, the balloon is inserted into the heart chamber, inflated, and then a very cold gas gets sent to that balloon. As a result, the tissue interface with the balloon and the pulmonary vein causes a ring of scar tissue to be formed so the abnormal electrical circuits can no longer conduct to the heart. And in most patients that serves as a way to eliminate atrial fibrillation. Not all patients are treated the same way. It’s a very tailored approach. And in some patients who have more advanced form of atrial fibrillation, it may be a combination of cryo therapy as well as radiofrequency ablation. And a radiofrequency ablation, the tissue heats up, rather than getting cold. And we use that catheter to target different areas within the heart that may be causing the atrial fibrillation.
So if ablation is determined to be the appropriate treatment plan for that patient, patients come in usually the morning of the procedure. The procedure can take anywhere from 1 to 4 hours, depending on the complexity of the case. And they spend the night in the hospital and go home the next day. The procedure is typically performed under general anesthesia. And the recovery period for a patient is usually just a few days. So we tell patients after they’ve had an ablation, to take it easy, with no strenuous exercise or heavy lifting for a few days. But usually they’re resuming normal activities within a week.
Today ablation is a safe procedure with very few complications. However, just like in any invasive procedure, there are some risks. Complications that could occur include bleeding, damage to other structures around the heart, and in very rare cases, strokes.
In our AFib program, we have a multi-disciplinary team approach that really focuses on the risk factors and other conditions that lead to atrial fibrillation. So I wouldn’t just do an ablation on a procedure and not treat the other causes of atrial fibrillation. So if a patient has untreated sleep apnea, we’re going to get that patient to a sleep doctor to get appropriately treated. If a patient has uncontrolled diabetes, we’re going to get them to get those risk factors and disease treated better. It’s not just doing the procedure; it’s looking at the patient as a whole.
I’m very proud of the AFib program that we’ve developed here at Spectrum. Doctors have trained at some of the best institutions in the country, working collaboratively to treat this disease. The volumes that we have at Spectrum Health are some of the highest in the country in terms of procedures. And as a result, practice makes perfect. Just like anything else in life, the more you do something, the better you get. We’ve developed specialized protocols, so patients get the best state-of-the-art care. And as a result, have some of the best outcomes in the country.
