ablation

  I am age 59, recieved aortic (bovine pericardial) valve and mitral annuloplasty band in April 97 at Cleveland Clinic (a Cosgrove patient).  All well until December 98 and onset of atrial flutter.  Local electrocardiologist recommends ablation and regular cardiologist concurs.  Am scheduled for March 9th.  What is all this about mapping pathways first?  Nobody has mentioned that to me.  Is this a safe procedure for someone with my history?  Flutter causing shortness of breath but no pain or other old familiar symptoms.  I would appreciate whatever advice can be given.  Understand ablation is vein catheter vice arterial and requires 4??  Ouch.  Procedure offered at local hospital (Anne Arundel Medical Center) and Washington Hospital Center, a more fully dedicated Heart center.  I'm told either is acceptable.  Should I go to Washington to be safer?  Thanks, I'll look for response.

[CCF Cardio MD - MTR]

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Dear Bob, thank you for your question.  Atrial flutter responds well to ablation procedures which can often be curative and can obviate the need for medications in the future to control this rhythm disturbance.  During an ablation procedure, catheters are inserted into the femoral veins in the leg and are used to "map" the electrical pathway involved in sustaining atrial flutter.  During the mapping phase of the procedure, the catheters are used to record electrical signals and to induce the atrial flutter to occur.  Once the pathway is mapped, special catheters are used to apply radio wave energy to the flutter pathway to destroy a small amount of tissue in the pathway.  When this happens, flutter cannot be sustained and the electrical pathway is permanently interrupted.  Generally, the mapping and ablation procedures are very safe. I can't recommend one or the other hospital to you - you'll have to decide which one is better suited for you.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.  Good luck!
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