What Are the Pros and Cons of Ablation for Atrial Flutter?

During an episode of atrial flutter, the upper chambers of the heart beat too rapidly. The underlying cause of atrial flutter is a malfunction of the heart's electrical system. Initial treatment for atrial flutter is daily prescription medication. For patients who cannot tolerate medication or when the medication is ineffective, ablation for atrial flutter is often used. Ablation is a surgical procedure aimed at permanently correcting the heart's electrical system.

The ablation process involves threading a thin, flexible tube to the heart through a blood vessel in the groin, neck, or arm. Electrodes are attached to the end of the tube. The electrodes deliver radiofrequency energy to destroy the area of abnormal heart tissue where atrial fluttering occurs. A pacemaker is sometimes put in place to regulate the heart rate in the future. Ablation for atrial flutter has an estimated 90-percent success rate.

Giving up medication is a primary benefit of ablation for atrial flutter. Possible side effects for heart rhythm medications include dizziness, fatigue, headaches, heartburn, nightmares, diarrhea, and constipation. More serious medication side effects include irregular heart rate, chest pain, and breathing difficulties. A successful ablation for atrial flutter eliminates the need for medication.

Another benefit of successful ablation for atrial flutter is reduced anxiety about the problem recurring. Not being near a medical facility is often a concern for patients with heart rhythm issues. A successful ablation makes travel, hiking, camping, and other outings more enjoyable.

Ten percent of patients who undergo ablation for atrial flutter experience a return of the condition following the procedure. Patients may then attempt to control it with daily medication. In addition, they may elect to undergo a second ablation procedure.

Vein damage during the procedure happens to one in 500 patients. A small surgery is required to repair the vein when this occurs. Another surgical risk during ablation for atrial flutter is the possibility of blood filling the sac around the heart. This occurs in approximately one out of 200 patients. Blood pressure drops when this happens, and a small tube inserted near the breastbone drains the excess blood and corrects blood pressure.

Approximately one out of every 1,000 ablation patients suffer from stroke due to the procedure. Atrial flutter itself also carries a small risk of stroke occurrence. One out of 100 ablation patients experience a permanently slowed heart rate that requires the patient to have an artificial pacemaker installed.

All heart rhythm medications are stopped three days before the ablation procedure. Typically, the procedure takes two hours to complete. Patients lie still for three hours afterward to prevent bleeding from the tube insertion site. Most patients are discharged the day after the procedure.