The Challenge With AF Ablation Therapy

Atrial Fibrillation (AF) from an ablation therapy standpoint is the proverbial good news bad news challenge. The good news is AF is a quick and certain diagnosis once documented via an ECG and the specific location in the left atrium to ablate or "short circuit" the AF arrythmia can be determined with a high degree of certainty. The not so good news is navigating the ablation catheter ( device that delivers the radio frequency energy) to this specific spot is difficult and can be very time consuming. Why? The electrophysiologist (cardiologist that specializes in cardiac arrythmia) encounters a few daunting challenges while navigating the ablation catheter along its' journey. To reach the chosen destination in the left atrium, the physician has two routes that the ablation catheter can follow. The longer route is called the retrograde approach. This route has a few hair pin turns the catheter must follow which can pose some catheter handling problems once it has reached its' destination, but has been considered a safer and more sure route. The second, more direct route, requires the physician to "build a tunnel" from the right side of the heart directly to the left atrium. The clinical term for this procedure is trans-septal puncture.  To build the tunnel, the physician "pokes a hole" or puntures the septum which is the heart structure seperating the right and left sides of the heart. Follow the link above to get an idea of the two routes. The trans-septal puncture raises the risk of certain complications. This procedure has been utilized for several years now and most certified electrophysiologists have performed hundreds of successful left sided ablations using the trans-septal approach. In deciding on an EP physician to perform your AF ablation, it is a good idea to talk with them and learn their chosen route to the left atrium and if they do take the shortcut, how many trans-septal punctures have they performed? Next time, I will give an overview of the essential technology that is used by the electrophysiologists to assist in navigating the abalation catheter.
If anyone, particularly a post AF ablation patient, would share personal experiences regarding catheter navigation approaches their physician utilized, it would benefit all of us.

Thanks,
Jim Accord