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 practiceAcademic & researchGMC registrationHospital profile
Is catheter ablation the right next step?
If atrial fibrillation is affecting your quality of life, you may be wondering whether catheter ablation is the right next step. There is no single answer that applies to everyone. The decision depends on the type of AF, its effect on you, previous treatment, other heart and medical conditions, and what you would like treatment to achieve.
When might AF ablation be considered?
Catheter ablation is designed to reduce or prevent episodes of AF. It may be worth discussing if:
- AF continues to cause troublesome symptoms;
- episodes are becoming more frequent or prolonged;
- AF has returned after cardioversion;
- medication has not controlled symptoms or causes side effects;
- AF is affecting heart function;
- you would prefer to consider ablation rather than long-term rhythm medication;
- AF has returned after a previous ablation; or
- you have been offered treatment but remain uncertain about the options.
You do not necessarily need to wait until AF is severe or several medications have failed before discussing ablation. Equally, having AF does not automatically mean that you need a procedure. If your immediate question is AF despite medication or AF returning after cardioversion, those pages address the next-step choices in more detail.
What does ablation aim to achieve?
The usual purpose of AF ablation is to improve symptoms and reduce the burden of atrial fibrillation. Some people have substantially fewer episodes or remain in normal rhythm for long periods; others need further treatment or a repeat procedure.
Ablation does not guarantee that AF will never recur, and it does not usually remove the need for anticoagulation where this is indicated. Decisions about blood-thinning medication are based on individual stroke risk rather than simply whether an ablation has been performed.
Do I have to try medication first?
Not always. Medication remains an appropriate option for many people, but the decision between medication and ablation is individual. Whether ablation should be considered earlier depends on your circumstances, safety considerations and preferences. The main AF ablation page explains the procedure and its planning in more detail.
What if my cardiologist has not suggested ablation?
There may be good reasons why ablation has not been recommended, and many people with AF do not require it. If AF remains troublesome, however, it is reasonable to ask whether a specialist electrophysiology opinion might add anything to your treatment plan.
A consultation does not commit you to a procedure or require you to leave the care of your existing GP or cardiologist.
Getting an electrophysiology opinion
The consultation can review your diagnosis, ECGs and previous treatment, and consider the pattern of AF, possible drivers of symptoms, further investigation, medication and non-procedural options, ablation approaches, and the likely benefits and risks in your circumstances.