Atrial Flutter Ablation

What Is Ablation for Atrial Flutter?

Atrial flutter is a heart rhythm disorder that occurs when the heart’s electrical signals cause the heart’s upper chambers (atria) to beat too quickly. Atrial flutter ablation is a treatment that interrupts the arrhythmia circuit, restoring the heart’s normal rhythm. The ablation procedure uses heat (radiofrequency ablation) or extreme cold (cryoablation) to create tiny scars in the heart’s upper chambers to block the faulty electrical signals causing the abnormal heart rhythm.

• Before atrial flutter ablation, follow all instructions, including medications, as indicated by your provider. Certain medications may need to be stopped before your procedure. Please contact your provider to discuss any questions or concerns about the current medications you are taking. Do not eat or drink anything after midnight before your procedure, with the exception of water. You may drink water up to two hours before your scheduled arrival time, unless otherwise instructed. The hospital will notify you the day before your procedure to confirm your arrival time.
• During atrial flutter ablation, you will be closely monitored to assess your vital signs, heart rhythm, your body’s response to sedation and any arrhythmias. An IV will be placed in one of your arms so that your care team can give you medicine during the procedure. Most patients are given conscious sedation. Some patients may need general anesthesia, which is medication that puts you in a sleep-like state.
  Your doctor will insert a long, flexible tube (catheter) into a blood vessel through your groin and guide the catheter to your heart, without cutting your skin. Sensors at the tip of the catheter will receive electrical signals from your heart that help your doctor identify abnormal heart rhythm. Once the critical area is located, heat (radiofrequency ablation) or extreme cold (cryoablation) is applied to destroy a small area containing the abnormal tissue causing the atrial flutter.
  Atrial flutter ablation takes approximately two to three hours.
• After atrial flutter ablation, you’ll be moved to a recovery room where you’ll be monitored for a few hours. Following the procedure, you may have some bruising and discomfort at the groin area. When it’s time to be discharged from the hospital, you’ll be given detailed instructions about at-home care. Most patients are sent home two to three hours after the procedure. If needed, you may spend a night in the hospital.

What Are the Risks Associated With Atrial Flutter Ablation?

Most people who undergo atrial flutter ablation and other cardiac ablation procedures do not experience complications. However, possible complications include:

• Vascular damage/bleeding: During insertion of the catheter, damage to your blood vessels can occur that may result in bleeding. Manual pressure, pressure dressings, bed rest, or rarely, surgery may be needed to stop the bleeding.
• Rapid abnormal heart rhythm: The procedure could cause you to pass out for a very short period of time. In some cases, a small electric shock may be needed to restore your normal heart rhythm.
• Cardiac perforation: Rarely, the procedure can result in an unintended puncture to the heart chamber or heart valve.
• Heart block: Depending on the type and location of the atrial flutter, there’s a slight chance of heart block occurring, which is when the heartbeat signal has trouble moving from the upper to lower parts of the heart. This could be temporary, but permanent damage would require implantation of a pacemaker at the time of the procedure.
• Blood clots, stroke and heart attack: Major complications such as stroke, heart attack and death are very rare. Blood thinners (anticoagulants) are used during the ablation procedure to prevent blood clotting that could lead to stroke.

Recovery & Outlook

You should be able to return to your normal activities the day after you go home. Your provider will let you know when it’s safe to resume physically demanding activity and driving. If your job does not involve heavy lifting or other physical labor, you should be able to return to work two to three days after your ablation procedure.

To prevent the formation of harmful blood clots, you’ll be required to take anticoagulant medicine for at least a short time after your procedure. If there’s evidence you still have atrial flutter or another abnormal rhythm, you may need to take anticoagulants on a longer-term basis.

Complete healing from your ablation may take several weeks. During this time, you may continue to have arrhythmias while your heart tissue heals. This is normal. You’ll have follow-up visits with your provider, usually for a year after your procedure. If your symptoms return, you may need to have another ablation or a different procedure to correct your abnormal heart rhythm.