RF Ablation

My mother (age 58) has had ongoing problems with atrial fibrillation and CHF for several years due to Rhumatic fever as a child.  Last year she had her mitral valve replaced, and this did not improve the atrial fib.  She has been on many different anti-arrhythmics, the most recent one being amioderone.  She has had four cardioversions since her surgery last September, and nothing seems to be working.  Her liver enzyme count was beginning to increase so she was taken off of the amioderone, and now the cardiologist would like her to have RF ablation.  The last time she was checked, the Dr. told her she had atrial flutter.  My questions are: What is the difference between A-fib and atrial flutter, and is ablation the right thing to consider at this point?  What is the success rate?  If it doesn't work, what is the alternative?  Can it be done a second time?  She was referred to a Dr. here in Columbus at Mt. Carmel Medical Center.  Is this a difficult procedure that she should consider having done at the Cleveland Clinic?  (She had a valvuloplasty done at the C.C. several years prior to her valve replacement surgery.)

Thanks in advance for any suggestions you can give!

[CCF CARDI MD - DLB]

Dear Betsy

Radio frequency ablation for atrial flutter is a successful cure in the majority of cases. RF for atrial fibrillation is a long complicated procedure that is not nearly as successful. Actually, it is still somewhat experimental as a cure for atrial fibrillation. What can be done in cases of severe atrial fibrillation is RF ablation of the conduction system linking the atrium to the ventricle; this can help control the symptoms of atrial fibrillation, though a permanent pacemaker will need to be implanted, and the need for coumadin would still be present. These are pretty sophisticated options and an expert opinion from a large medical center might be a good idea.

I hope this has been useful. I wish you the best of luck. Feel free to write back.

Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.