Laser balloon ablation FAQs

By
University College Hospital London, The Wellington Hospital
Published November 23rd, 2011  |  Last updated February 2nd, 2012

This article answers the most frequently asked questions regarding laser balloon ablation treatment for atrial fibrillationA common abnormal heart rhythm causing a rapid, irregular pulse and failure of the upper chambers of the heart (atria) to pump properly. Abbreviated to AF. and includes questions such as "Are all patients suitable?" and "Will I be able to come off my medication?"

Contents

What is laser balloon ablation?

It is a treatment for atrial fibrillationAbnormally fast and uneven contractions of the muscle of the atria in the heart, so that blood cannot be pumped efficiently, an irregular heart rhythm, using catheters inside the heart to ablate tissueA group of cells with a similar structure and a specialised function. using a laser guided by a camera.

Is the laser balloon new?

Yes, the laser balloon technology is new but it is simply the latest version of technology designed to electrically isolate the pulmonary veins at the back of the heart. AF ablation procedures have been performed for about 10 years.

Is surgery required?

No, the catheters are inserted through tiny holes at the top of the leg, but a general anaestheticAny agent that reduces or abolishes sensation, affecting the whole body. is necessary.

What are the advantages over other types of AF ablation?

Electrical isolation of the pulmonary veins (or creating a barrier around the vein entrance) achieved by the laser balloon persists in 90% of cases, compared to only 20% with other technologies. So far, the laser balloon hasn’t caused a single strokeAny sudden neurological problem caused by a bleed or a clot in a blood vessel., which affects about 1% of traditional AF ablation patients.

Are all AF patients suitable?

No, only patients with paroxysmal, or intermittent AF, or those with recent persistent AF are suitable for the laser balloon. Patients with more longstanding AF require more extensive ablation procedures that are performed with radiofrequency ablation catheters.

Does this mean I can come off my anticoagulants?

Patients with AF (intermittent or persistent) may have to take anticoagulants long term if they are at increased risk of having a stroke. Common risk factors include high blood pressureThe pressure of blood within the arteries., age >65, heart muscleTissue made up of cells that can contract to bring about movement. damage or previous heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction., previous stroke or TIATransient ischaemic attack; a brief interruption of the blood supply to part of the brain, which causes temporary impairment of vision, speech, sensation or movement.. and diabetesA disorder caused by insufficient or absent production of the hormone insulin by the pancreas, or because the tissues are resistant to the effects.. For those patients, cure of their AF with the laser balloon can mean they can stop their medication, but only when it is clear the procedure has been successful. In some cases this can mean waiting a year or two.

Will I be able to come off anti-arrhythmic drugs?

Yes, if the laser balloon procedure is successful, you would be able to stop taking anti-arrhythmic drugs and sometimes also beta-blockersA group of drugs that block beta-receptors to slow the heart rate, or constrict the airways and arteries..

What happens if the procedure doesn’t work first time?

If AF returns after the first procedure, you will almost certainly be offered another attempt and then the chances of a cure would be higher.

Is there a limit to the number of ablations that can be performed?

No, in theory you can have an unlimited number of ablations. However, it is uncommon to perform more than two procedures and very rare to perform more than three.

I have paroxysmal (intermittent) AF. What happens if I just leave things and don’t have an ablation?

If you leave things, there is a very high chance your AF will stop being intermittent and become persistent or permanent one day. Although ablation is still possible at that stage, the success rate falls. It is not possible to predict when you might change from paroxysmal to persistent AF but for most patients the window is several years.
 

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