Specialist electrophysiology care

Dr Rohan WijesurendraConsultant Cardiologist & Electrophysiologist

1,500+ ablationsPersonally performed catheter ablation procedures

Oxford-based carePrivate care at Nuffield Health The Manor Hospital

NHS practice Academic & research GMC registration Hospital profile

Introduction

Atrial fibrillation ablation is a specialist catheter procedure that usually aims to isolate electrical triggers around the pulmonary veins. It can be considered when AF symptoms remain troublesome, and in some circumstances it may be an option earlier in the treatment pathway. If you are at the stage of weighing this up, Should I have an AF ablation? gives a more detailed guide to that decision.

When should AF ablation be considered?

The decision considers your symptoms, AF pattern, response to medication, heart structure, other health conditions and personal preferences. The aim is usually to improve rhythm control and quality of life; it does not automatically remove the need for stroke-risk assessment or blood-thinning medication.

Ablation may be worth discussing when symptoms remain troublesome despite treatment, when medication is not preferred or has caused side effects, when AF returns after cardioversion, or when an early rhythm-control strategy is being considered. It is not the right approach for everyone, and the alternatives may include medication, cardioversion, risk-factor management or observation. There is more specific information if you have AF despite medication or AF returning after cardioversion.

Experience and Outcomes

I have personally performed over 1500 catheter ablation procedures as of August 2026, including thermal energy and pulsed field ablation.

The likely benefit of AF ablation is considered in the context of your own AF pattern, symptoms, heart health and treatment goals. Published averages can be useful background, but they do not predict an individual outcome; the expected benefit, chance of recurrence and alternatives should be discussed for your situation.

Do I have to try medication first?

Not always. Medication is an important option for many people, but whether it should be tried before ablation depends on the AF pattern, symptoms, safety considerations and your priorities. A consultation is an opportunity to understand the advantages and limitations of each approach for you. AF despite medication: what are the options? explores this comparison in more detail.

What if my cardiologist has not suggested ablation?

There may be good reasons to continue the current plan, but it is reasonable to ask whether an electrophysiology opinion would add anything. An AF ablation second opinion can help clarify whether ablation is a realistic alternative without assuming that a procedure is necessary.

AF pattern and previous treatment

Paroxysmal AF stops by itself, while persistent AF lasts longer or needs treatment to restore normal rhythm. This distinction can influence the likely treatment pathway, but it is only one part of the decision.

The discussion is also different for a first procedure and for recurrent AF after an earlier ablation. In either situation, the plan is based on the rhythm history, previous response to treatment and what matters most to you. If AF has returned after a procedure, see AF after ablation: do I need another procedure?.

Pulsed field ablation

Pulsed field ablation is one of several ways to deliver AF ablation. It uses electrical pulses rather than heat or freezing energy. It may be suitable for some people, including many suitable first-time procedures, but the technology alone does not determine whether ablation is appropriate or what result to expect.

What to send before a consultation

ECGs, rhythm-monitor reports, echo or cardiac imaging reports, clinic letters, medication lists and details of any cardioversion or previous ablation are helpful. They allow the consultation to focus on the decision that matters to you.

Cost of private AF ablation

For a clear breakdown of the hospital, consultant and anaesthetist elements, see the private AF ablation cost guide. Every patient receives an individual written quotation once the clinical plan is clear.

Key points

Suitability depends on AF pattern, symptoms, heart health and personal priorities.
The procedure is not always effective and AF can recur.
Stroke prevention and other treatments are considered separately from rhythm symptoms.

Patient note

“The decision is not simply whether AF is present. It is whether an ablation is likely to offer worthwhile improvement for you.”

Questions before choosing AF ablation

What improvement is realistic? What are the risks? How does ablation compare with medication or cardioversion in my case? Is a second opinion helpful before I decide?

FAQ

Can AF return after ablation?

Yes. Recurrence is possible, and some people need further treatment. This should be part of the discussion before proceeding.