Information for patients

Links

Wellington Hospital
Imperial College Healthcare NHS Trust
Clementine Churchill BMI (Harrow)
Lindo Wing, St Mary's Hospital

Patient testimonials

First, I can’t thank you enough for all your time, interest and care on Thursday.

Secondly, the one stop ‘plumb and sparks’ shop is seriously impressive, staffed by great, caring and efficient people who are fun. In about an hour to do an echo, treadmill test and take 49 blood samples etc. must be close to a W.R....

Seriously, from the patients point of view you are offering full diagnostics almost in the ‘golden hour’ whereas with most other approaches it takes more like a month! The expeditious approach apart from removing patients uncertainty which often weighs heavily means if necessary you are in to treatment almost immediately....

Patients will definitely feel that they and their quality of lfe is being put first.

Mr Y. (2010) Suffolk.

Atrial Fibrillation Ablation

Professor Nicholas Peters. Ablation procedures require complex equipment.

Catheter ablation is a procedure where one or more flexible, thin tubes (catheters) are guided via x-ray into the blood vessels and directed to the heart muscle. A burst of radiofrequency energy destroys very small areas of tissue that give rise to abnormal electrical signals.

Pulmonary vein atrium isolation: Research has shown that most atrial fibrillation signals come from the four pulmonary veins. During this procedure, special catheters are inserted into the heart. Two catheters are inserted into the right atrium and two into the left atrium. One catheter in the left atrium is used to map or locate the abnormal impulses coming from the pulmonary veins. The other catheter is used to deliver the radiofrequency energy to create lesions outside the pulmonary veins. The procedure is repeated for all four pulmonary veins.

The lesions heal and within 4 to 8 weeks, form a circular scar around the pulmonary veins. The scar blocks any impulses firing from within the pulmonary veins, thereby "disconnecting" the pathway of the abnormal rhythm and curing atrial fibrillation.

Ablation of the AV node: During this procedure, the doctor applies radiofrequency energy to injure the AV node. The end result is a permanent, very slow heart rate, since the electrical impulses from the top chamber of the heart cannot travel down to the lower chamber. Therefore, the patient needs a permanent pacemaker to maintain an adequate heart rate. This is rarely needed in the treatment of AF, but may be a last resort if drugs and pulmonary vein isolation have failed.

Surgical ablation: Procedures used for treating atrial fibrillation can be "minimally invasive" or traditional "open" surgery and may be combined with other surgical therapies such as bypass surgery, valve repair, or valve replacement. Surgical ablation procedures include:

The Maze procedure. During this traditional open-heart surgical procedure, the surgeon makes small cuts in the heart to interrupt the conduction of abnormal impulses and to direct normal sinus impulses to travel to the atrioventricular node (AV node) as they normally should. When the heart heals, scar tissue forms and the abnormal electrical impulses are blocked from traveling through the heart.
Minimally invasive surgical ablation. Unlike traditional heart surgery, there is no large chest wall incision and the heart is not stopped. These techniques utilize smaller incisions and endoscopes (small, lighted instruments that contain a camera).
The modified Maze procedure. The surgeon uses a special catheter to deliver energy that creates controlled lesions on the heart and ultimately scar tissue. This scar tissue blocks the abnormal electrical impulses from being conducted through the heart and promotes the normal conduction of impulses through the proper pathway. One of four energy sources may be used to create the scars: radiofrequency, microwave, laser or cryothermy (cold temperatures). The modified Maze procedure involves a single incision in the left atrium.