There are several types of cardiac arrhythmias that can now be routinely cured using catheter ablation. For example, a type of tachycardia (rapid heart beat) called the Wolff-Parkinson-White syndrome, which used to require life-long drugs or open heart surgery, can now be cured in a relatively simple, low-risk procedure that involves threading catheters into the heart from the groin.

Indeed, there is a surgical cure for atrial fibrillation. The maze procedure is an open heart surgery in which a "maze" of incisions are made in the atria, blocking the flow of excess electrical impulses within the chambers. This prevents the development of the chaotic atrial rhythm and allows only the impulse from the SA node to get to the AV node. The maze procedure has a high success rate for sustaining normal heart rhythms, but obviously comes with the risks and potential complications of having open heart surgery.

Currently, a much less invasive technique resembling the maze procedure is being investigated. Linear ablation involves making lesions in the right and/or left atrium by the use of a special radiofrequency catheter inserted from the groin. The goal of this therapy is the same as its surgical counterpart: To limit the amount of connected electrical activity in the atrial muscle so that the chaotic rhythm cannot develop or sustain itself. Focal and segmental AF ablation, which involves catheter ablation for patients with a specific site for the beat which triggers the onset of atrial fibrillation, is being performed at UCSF. This is a particularly promising approach, as this may be a simpler type of procedure than that requiring linear lesions.

Doctors at the UCSF Atrial Arrhythmia Center can determine if you would be a candidate for either the linear ablation or focal ablation therapy for your atrial fibrillation.

Another common arrhythmia of the upper chambers of the heart is called atrial flutter. It is related to atrial fibrillation in the sense that many patients will have both. Both of these arrhythmias involves the atrium, and risk factors for one may be risk factors for the other. However, it is a different disorder and should be treated as such. Remember that atrial fibrillation has many waves, like little tornadoes. Atrial flutter, on the other hand, occurs as the result of a single wave of reentry in the atrium, producing a pattern much more organized than atrial fibrillation. Atrial flutter is usually confined to the right atrium, while atrial fibrillation involves both right and left atrium. The rate in the atrium is about 250 to 300 beats per minute, but the AV node blocks many of the impulses, just as it does in atrial fibrillation. Like atrial fibrillation, patients with atrial flutter can have palpitations, shortness of breath, fatigue, etc., or no symptoms at all. They also may be at risk for stroke.

Treatment possibilities include electrical or chemical cardioversion and chronic drug treatment. An important mode of treatment, pioneered at UCSF, is catheter ablation for atrial flutter.

This consists of placing a small lesion in the bottom of the right atrium using standard catheter techniques as described earlier. The success rate is well over 90%. If you have atrial flutter, ask your doctor if you are a candidate for atrial flutter ablation.

Unfortunately, getting rid of atrial flutter with catheter ablation may not prevent atrial fibrillation. You may still need treatment for the atrial fibrillation if this is also a problem for you.

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