Atrial fibrillation (AF, or A-fib) is a common form of cardiac arrhythmia (abnormal heart rhythm) characterised by irregular, and usually faster, beating of the heart. Although AF is not life-threatening, it should be treated to prevent damage to the heart.
The abnormality usually resolves itself; however, in some cases medication and/or cardioversion (electric shocks) are used to stop the arrhythmia. If your arrhythmia cannot successfully be controlled this way, you will be eligible for ablation. Ablation involves inserting a catheter into the heart via the groin, and creating a barrier of scar tissue to stop the abnormal electrical signals.
Often one ablation is enough, although sometimes multiple treatments are necessary. If the arrhythmia has been present for some time or if it persists after multiple ablations, the best next step in the treatment of atrial fibrillation is a hybrid ablation.
The hybrid ablation will take place in the hybrid OT, a combination of an operating theatre and imaging equipment (radiography) that enables operations to be performed using x-ray imagery. Once the general anaesthetic has taken effect, the heart surgeon will make three small incisions on the right and left-hand sides of your chest. Next, using a small camera and a surgical clamp, scars will be created on the outside of your pulmonary veins and the atrium of the heart. This creates a ‘barrier’ of scar tissue that blocks the abnormal electrical signals.
In the meantime, the cardiologist will puncture your veins in the groin area. As soon as the heart surgeon is finished creating the scars, catheters will be inserted into your heart via the groin to detect straight away whether the scars have been effective. The arrhythmia often stops while the scars are being created. If not, the cardiologist can further investigate the arrhythmia in order to expand the scar area. The operation will stop as soon as a normal heart rhythm has been established. Two drain tubes will be left in your chest afterwards. The operation normally lasts 4-6 hours.