In the United States, there are nearly 3 million people who are living with atrial fibrillation right now. This is often a difficult condition to treat because it causes the heart to begin beating in an irregular way. The symptoms of atrial fib when it happens can be quite debilitating: fatigue, shortness of breath, and weakness are common. Instead of taking drugs to manage symptoms, a procedure called abalation may be recommended.
Should those with atrial fib choose ablation as their first treatment option? Here are some pros and cons to consider before deciding if the procedure is the best available option to find relief.
The Pros of Ablation for Atrial Fib
1. There is a greater chance of reducing symptoms with this procedure.
Ablation works by destroying the abnormal heart tissues that are causing the muscle to beat in an irregular way. Through the use of radio frequencies, the tissue is either burned or frozen. This means it is very possible for someone to feel much better almost immediately after the procedure has been completed.
2. The procedure has a high success rate.
When all patients are considered, the success rate of ablation falls between 70-80% for reliving symptoms. When only patients who are younger and have no heart disease that could be causing the issue are considered, the chances of success rise to at least 95%. Older patients with heart disease may have a success rate as low as 40%. Experienced doctors who perform this procedure on a regular basis tend to see the best success rates.
3. There are few complications that result from ablation.
Fewer than 5% of people who undergo this procedure develop any problems after it has been completed. A catheter is used to reach the heart so the abnormal tissue can be destroyed, so the most common issue is to have vessel damage occur. This may cause bleeding or an infection. The chances of heart failure or stroke are listed as being lower than 1% during the procedure.
4. Recovery times are remarkably fast.
It may take up to 4 hours to complete an ablation on a patient with a difficult case, but most people are either discharged the same day as their procedure or the next day after being held overnight for observation. There is little discomfort during the procedure and only mild sedation and a local anesthetic is necessary to successfully complete it, which further reduces the risks of further complication.
5. There is clinical evidence that supports the success of ablation.
Over the last 10 years of ablation procedures, several studies have shown that ablation provides patients with more freedom from their symptoms of atrial fib than heart correction medications can provide at the 1 year and 3 year post-treatment points. This means long-term correction of the problem through this procedure looks very promising indeed.
6. Improved catheter designs make the procedure even safer than before.
Certain improvements to the catheter that is used for the ablation, like contact force measurements, help to improve the overall safety of the procedure. It may also increase the efficiency of the procedure as well, reducing the number of patients who must go through a second ablation later on in life.
The Cons of Ablation for Atrial Fib
1. It can be very costly.
Ablation is a procedure that has a hefty cost associated with it. This is a specialty surgery, so tens of thousands of dollars of medical debt may be incurred, even with health insurance covering the procedure. Add in the costs of recovery time, the prescription medications, and other care needs and ablation for atrial fib may fall outside the window of affordability for some folks, even if it could be the solution to their health issues at this time.
2. It is an invasive procedure.
Although there is a good chance of relieving symptoms through ablation, the fact remains that heart tissues are being destroyed during this procedure. That fact alone makes this an invasive process. It also means that it may not be right for everyone based on their medical history, overall health, and other individualized conditions that only a medical provider can determine.
3. There is a chance that it may need to be repeated.
Up to 3 in 10 people who receive an ablation discover that the procedure didn’t destroy enough abnormal heart tissue to relieve their symptoms, requiring a second procedure. The damaged tissue also has the ability to heal itself over time and resume its abnormal functioning, requiring it to be destroyed a second time. The good news is that success rates go up at least 10% when a second procedure is performed.
4. People with heart disease don’t generally benefit from ablation.
Heart disease patients may still experience relief from ablation, but those that do often only have temporary relief. Those who have had atrial fib going on for several years also have a reduced chance of success, even if there isn’t underlying heart disease affecting them. Many people with a heart disease diagnosis will likely receive a medication recommendation instead and that may not relieve their symptoms either.
5. Medication may still be needed after ablation.
Some patients need both ablation and medication in order to relieve their bothersome symptoms. Since it can take up to 3 months for an ablation procedure to fully take hold, it may take some time before a treatment plan can be developed for long-term care and treatment of the condition. This means it is not uncommon to still be taking medication that corrects the rhythms of the heart until the scar tissues on the abnormal tissues do their job. Most people need to be on blood thinners for a few weeks after the procedure as well.
6. There is always a chance that the procedure will not work.
Even when success rates are at 95%, that means there are 5 out of 100 people who are expecting to experience relief from the procedure and wind up receiving no benefit at all. Others may discover that their atrial fib symptoms change after ablation because a new arrhythmia is created after the older one has been corrected. There is also some evidence that shows ablation may lead to fibrosis in some patients, which creates a new set of potential health issues.
This Procedures Isn’t for Everyone
The pros and cons of ablation show that this procedure isn’t for everyone. An extensive consultation with a treatment team is often required to determine if a patient will have a high chance of success. If heart disease isn’t present and the atrial fib has just started, then ablation could be the answer to become symptom-free once again.