Who can have Ablation for Atrial Flutter?
Almost anyone can undergo ablation for typical atrial flutter. Patients must be able to lie flat without discomfort. Some patients may need to be able to tolerate a general anaesthetic. Most patients will have the ablation performed whilst taking blood thinning medications such as warfarin, usually for at least a month beforehand and so a previous history of bleeding may preclude this.
What are the Pros and Cons of Atrial Flutter Ablation?
Atrial flutter ablation is helpful as it completely cures the abnormal heart rhythm, meaning that there are no further symptoms of palpitation, breathlessness or dizziness. Curing atrial flutter also reduces a patient’s risk of stroke to where it was before they had the heart rhythm problem.
The cons are the small risk of the procedure, which is much less than 1%. I quote a 1 in 500 risk of serious complication, principally that of damage to the normal wiring of the heart requiring pacemaker insertion, or making a small hole in the heart requiring drain insertion.
Is Atrial Flutter Ablation New?
No, ablation for typical atrial flutter has been performed for over 20 years. Ablation for atypical flutters are newer, according to where they occur in the heart, but none are recent or experimental.
Is Pain Relief given if General Anaesthetic is not used?
Yes, intravenous drugs are administered for pain relief and for sedation to make patients as relaxed and pain free as possible. Local anaesthetic is also used at the top of the leg before the wires are inserted.
Is Surgery Required?
No, the wires (catheters) are inserted through small holes at the top of the leg, but a general anaesthetic is sometimes necessary.
Can Ablation be Repeated if unsuccessful the First Time?
Yes, ablation can be performed as many times as necessary to cure the atrial flutter and does not cause significant damage to the heart. In fact, by maintaining normal heart rhythm, it significantly improves heart function and reduces the risk of stroke.
Will I need to take Blood Thinning medication after Ablation?
In most cases of ablation for typical atrial flutter, blood thinning medication can be stopped one month after a successful procedure. However, if there is another reason for taking blood thinning drugs, then they will continue. For instance, it is not uncommon for patients to have both atrial flutter and atrial fibrillation. If ablation is only performed for the flutter, then blood thinning drugs will continue according to a patient’s CHADS-VASc score.
How soon can I do Physical Exercise after Ablation?
It usually takes a couple of days for the small holes at the top of the leg to heal. Light exercise can then be resumed. Strenuous exercise is best delayed until a week after the procedure.
How long am I unable to Drive after Ablation?
If you are a Class 1 license holder (not HGV/passenger vehicles), then you cannot drive for 48 hours after ablation
What Post Treatment follow-up is required after Ablation?
Patients are usually seen once more after typical flutter ablation and an ECG is performed to check that they remain in normal rhythm. Sometimes it is appropriate for patients to wear a heart rhythm monitor for a few days (or sometimes longer) after the ablation to check the flutter has been cured.