It is the most complex rhythm disorder. It is not organized and regular, but is instead the result of a very rapid, disordered and chaotic electrical activation of the atria. Unlike most other tachycardias, its ablation cannot be reduced to the destruction of a single target (such as an electrical source or an abnormal conduction zone) . It is an electrical anomaly affecting all of the atrial tissue that must be treated. The areas most frequently involved are most often found in the left atrium (LA), and more specifically at the junction of the LA and the pulmonary veins. Over time and with the repetition of fibrillation attacks, certain areas of the atria deteriorate and themselves become sources of fibrillation. In some cases, these areas require additional treatment to that of the pulmonary veins.
Atrial fibrillation evolves over time towards crises that are generally more and more prolonged. It can cause serious complications, which vary according to the terrain and the risk factors of each patient. These complications are dominated by the risk of cerebral vascular accident by poor emptying of the atria in fibrillation and stagnation of blood which can then clot. Fibrillation can also cause all stages of heart failure, from simple fatigue or shortness of breath on exertion to severe damage to the heart muscle with severe signs of heart failure.
Overall, fibrillation is believed to cause mortality comparable to that of myocardial infarction, diabetes, or high blood pressure. In addition to the prognostic severity of the disease, the effects of arrhythmia-related symptoms on morale and quality of life can be as great as those of a serious disease such as cancer.
Treatment varies but essentially consists of either compartmentalizing the atria with radiofrequency lines, or electively treating areas that appear to be pathological and responsible for maintaining the arrhythmia.
Ablation by radiofrequency probe: during the operation under anesthesia, a probe is introduced into the femoral vein of the lower limb, then routed to the heart. The end of the probe burns small areas of the heart responsible for the arrhythmia.
The cavities traversed by the catheter are reconstructed in 3 dimensions by a specific computer system which then makes it possible to move the probes and identify the areas to be treated with very high precision. The objective of the operation is a true electrical disconnection between the atrium and the ventricle.
After the intervention and awakening, postoperative monitoring in a continuous care unit may be necessary, but hospitalization is generally short, 2 to 3 days.