Atrial fibrillation is an abnormality of electrical activity in atrium. The myocardial fibers fibers in the atrium are uncoordinated and disordered, which leads to the loss of effective contraction. Blood stasis in the atrium is easy to form thrombus, leading to cerebral infarction if the thrombus falls off. AF mainly originates from pulmonary vein, and pulmonary vein isolation of electrical activity can treat most of AF.

Is catheter ablation suitable for all patients?

Catheter ablation therapy can cut off the focus of atrial fibrillation to treat atrial fibrillation by releasing a kind of current energy, acting on the myocardium to cause local necrosis, and then replacing healing with scar tissue. In order to treat AF thoroughly, two points are critical: the first is the accuracy of the location of the focus, which needs to be ablated for all the lesions that cause the onset of AF; the second is whether the energy of ablation can completely burn the focus and form the transmural injury, so as to prevent recurrence.

For AF patients in hypertrophic cardiomyopathy, dilated cardiomyopathy and heart failure, the effect of catheter ablation is not satisfied, and may even increase the discomforts and aggravate the condition. Because most of the patients with cardiomyopathy or heart failure have increased atrial pressure, local atrial muscle aging (fibrosis) is obvious, hence the energy of catheter ablation is difficult to form through wall damage. If local burn is not transparent, it may form another kind of arrhythmia - atrial flutter with faster heart rate, more difficult uncontrollable heart rhythm, more worse drug effects and much higher heart failure risk.

In addition, for patients with replaced mitral valve and aortic valve, catheter ablation for atrial fibrillation is also not recommended. In this population, ablation procedure may also cause atrial flutter; moreover. Moreover, due to the previous surgical thoracotomy, it’s impossible to perform open-chest surgical therapy for atrial flutter. Therefore this kind of patients is also recommended not to try catheter ablation in a hurry.