Overview

Atrial fibrillation ablation is a treatment for an irregular and chaotic heartbeat called atrial fibrillation (A-fib). It uses heat or cold energy to create tiny scars in the heart to block the faulty electrical signals and restore a typical heartbeat.

Atrial fibrillation ablation may be used if medications or other treatments don't work. Sometimes it's the first treatment for certain patients.

Atrial fibrillation ablation is most often done using thin, flexible tubes called catheters inserted through the veins or arteries to the heart. Less commonly, ablation is performed during cardiac surgery.

Types

Why it's done

Atrial fibrillation ablation is done to reset the heart's rhythm. A health care provider may recommend this type of ablation if you have A-fib symptoms, including a fast, fluttering heartbeat, that hasn't improved with medication or other treatments.

Risks

Possible atrial fibrillation ablation risks include:

  • Bleeding or infection at the site where the catheters were inserted
  • Blood vessel damage
  • Heart valve damage
  • New or worsening irregular heartbeats (arrhythmias)
  • Slow heart rate that could require a pacemaker to correct
  • Blood clots in the legs or lungs (venous thromboembolism)
  • Stroke or heart attack
  • Narrowing of the veins that carry blood between the lungs and heart (pulmonary vein stenosis)
  • Damage to the kidneys from contrast dye used during the procedure
  • Death, rarely

Discuss the risks and benefits of atrial fibrillation ablation with your health care provider to decide whether it's right for you.

How you prepare

Your health care provider may order several tests to get more information about your heart condition before your atrial fibrillation ablation.

You'll need to stop eating and drinking the night before your procedure. Your care provider will tell you how or if you should continue any medications before atrial fibrillation ablation.

What you can expect

Before

Atrial fibrillation ablation is done in the hospital is done in the hospital. A care provider will insert an IV into your forearm or hand and give you a medication called a sedative to help you relax.

The amount of sedation needed for the procedure depends on your specific arrhythmia and other health conditions. You may be fully awake or lightly sedated, or you may be given general anesthesia (fully asleep).

During

One of the following ablation techniques is used to create small scars in the heart and block the irregular heartbeats:

  • Heat (radiofrequency energy)
  • Extreme cold (cryoablation)

You may feel some minor discomfort when the catheter is moved into your heart or when the dye is injected and when energy is being delivered. If you have severe pain or shortness of breath, let your care providers know.

The procedure usually takes three to six hours. Complicated procedures may take longer.

After

Following your procedure, you'll be moved to a recovery area to rest quietly to prevent bleeding from the site where the catheters were inserted into the blood vessels. Care providers will continuously monitor your heartbeat and blood pressure to check for complications.

Depending on your condition, you may be able to go home the same day as your procedure. If you go home the same day, plan to have someone drive you.

You may feel a little sore after your procedure, but the soreness shouldn't last more than a week. You'll usually be able to return to your daily activities within a few days after atrial fibrillation ablation.

Results

Most people see improvements in their quality of life after cardiac ablation. But there's a chance that the irregular heartbeats may return. If this happens, the procedure may be repeated or your health care provider might recommend other treatments. The procedure hasn't been shown to reduce the risk of a stroke. Blood thinners may be needed to reduce stroke risk.

Clinical trials

Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions.

Atrial fibrillation ablation care at Mayo Clinic

April 30, 2022
  1. Bonow RO, et al., eds. Therapy for cardiac arrhythmias. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Feb. 2, 2021.
  2. Catheter ablation. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/catheter-ablation. Accessed Jan. 21, 2021.
  3. Zipes DP, et al., eds. Catheter ablation: Technical aspects. In: Cardiac Electrophysiology: From Cell to Bedside. 7th ed. Elsevier; 2018. https://www.clinicalkey.com. Accessed Feb. 2, 2021
  4. Passman R, et al. Atrial fibrillation: Catheter ablation. http://www.uptodate.com/search. Accessed Feb. 5, 2021.
  5. Bonow RO, et al. Atrial fibrillation: Clinical features, mechanisms, and management. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Feb. 2, 2021
  6. January CT, et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in collaboration with the Society of Thoracic Surgeons. Circulation. 2019; doi:10.1161/CIR.0000000000000665.
  7. Wang R, et al. Sudden death and its risk factors after atrioventricular junction ablation and pacemaker implantation in patients with atrial fibrillation. Clinical Cardiology. 2017; doi:10.1002/clc.22600.
  8. Calkins H, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace. 2018; doi:10.1093/europace/eux274.
  9. Lee R. Surgical ablation to prevent recurrent atrial fibrillation. https://www.uptodate.com/contents/search. Accessed Feb. 2, 2021.
  10. Mulpuru SK (expert opinion). Mayo Clinic. Oct. 10, 2016.
  11. Noseworthy PA, et al. Atrial fibrillation ablation in practice: Assessing CABANA generalizability. European Society of Cardiology. 2019; doi:10.1093/eurheartj/ehz085.
  12. Arrhythmia. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/arrhythmia. Accessed Jan. 21, 2021.
  13. Al-Hijji MA, et al. Trends and predictors of repeat catheter ablation for atrial fibrillation. American Heart Journal. 2016; doi:10.1016/j.ahj.2015.10.015.
  14. Braswell-Pickering EA. Allscripts EPSi. Mayo Clinic. Oct. 25, 2021.
  15. Packer DL, et al. Effect of catheter ablation vs antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation. JAMA. 2019; doi:10.1001/jama.2019.0693.
  16. Ganz LI. Overview of catheter ablation of cardiac arrhythmias. https://www.uptodate.com/contents/search. Accessed Feb. 2, 2021.
  17. Noseworthy PA (expert opinion). Mayo Clinic. Feb. 5, 2021.
  18. Knight BP, et al. Long-term outcomes after ablation for paroxysmal atrial fibrillation using the second-generation cryoballoon: Final results from STOP AF Post-Approval Study. JACC Clinical Electrophysiology. 2019; doi:10.1016/j.jacep.2018.11.006.

Atrial fibrillation ablation