Catheter Ablation For Atrial Fibrillation (AFIB)

What is pulmonary vein ablation?

Pulmonary vein ablation (also called pulmonary vein antrum isolation or PVAI), is a treatment for atrial fibrillation. Atrial fibrillation is an abnormal heart rhythm that originates in the top chambers of the heart (atria).

Atrial Fibrillation and the electrical system of the heart

Pulmonary Vein Ablation Procedure: Electrical System of the Heart

When the heart beats normally, the electrical impulse begins at the sinoatrial (SA or sinus) node in the right atrium. The SA node produces the electrical impulses that set the rate and rhythm of the heart beat. The electrical activity spreads through the walls of the atria and causes them to contract. The electrical impulse then crosses the AV node and spreads down to the ventricles, causing them to contract. This creates the heart beat.

Normal Heart Rhythm Electrocardiogram

The heart’s electrical system triggers the heart beat. Each beat of the heart is represented on the electrocardiogram (ECG) by a wave arm. The illustration to the right shows a normal heart rhythm (also called normal sinus rhythm).The electrical activity in the heart is following the normal pathway, and the rhythm is relatively slow and regular (about 50 to 100 beats per minute).

Atrial fibrillation

Pulmonary Vein Ablation Procedure: Atrial Fibrillation

In patients with atrial fibrillation, the SA node does not direct the heart’s electrical rhythm. Instead, many different impulses rapidly fire at once. This causes a very fast, chaotic rhythm in the atria. Because the electrical impulses are so fast and chaotic, the atria cannot contract and/or effectively squeeze blood into the ventricle.

Atrial Fibrillation Electrocardiogram

In patients with atrial fibrillation, many different impulses rapidly fire at once. This causes a very fast, chaotic rhythm. The heart beat is irregular and fast (100 to 200 beats per minute).

Treatment for patients with atrial fibrillation

Treatment goals for patients with atrial fibrillation include restoring a normal heart rhythm (sinus rhythm), controlling the heart rate, reducing symptoms, and reducing the risk of blood clots and stroke. Many treatment options are available, including lifestyle changes, medications, catheter-based procedures and surgery.

The type of treatment that is best for you depends on the severity of your symptoms, prior treatments, and other medical conditions you may have. Medications are the first step in treatment. These may include:

  • Medications to slow your heart rate
  • Medications to control your heart rhythm (antiarrhythmic drugs)
  • An anticoagulant (blood thinner) to reduce your risk of blood clots and stroke

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