Assignment: Atrial Fibrillation Assessment for Preoperative
Assignment: Atrial Fibrillation Assessment for Preoperative
Catheter ablation of atrial fibrillation (AF) is one of the most commonly performed electrophysiology procedures in the management of AF. Catheter ablation is indicated in patients with atrial fibrillation with lifestyle-impairing symptoms and inefficacy or intolerance of at least one antiarrhythmic agent (Björkenheim et al., 2022). Both left atrial ablation for restoration of sinus rhythm and AV junction ablation for rate control are class I indications, depending on the circumstance.
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Imaging tests performed before catheter ablation include a review of electrocardiograms (ECGs) (12-lead, if available), which are obtained during the tachycardia and in sinus rhythm. An echocardiogram is obtained to exclude structural heart disease. Other tests that are indicated in specific situations include exercise testing with or without cardiac imaging, especially for exercise-induced tachyarrhythmias, cardiac computed tomography (CT) scanning, cardiac magnetic resonance imaging (MRI), and coronary angiography (Rottner et al., 2020). A series of imaging tests are performed in the preoperative phase to show how a patient’s heart is functioning. Thus, imaging tests like chest X-ray, ambulatory ECG monitor, an echocardiogram, CT angiogram, and MRI are appropriate for a patient before undergoing the Catheter ablation procedure.
Pre-procedural lab work usually includes a complete blood cell count and an assessment of renal function and electrolyte levels. A Complete blood count, renal function, and liver functions should be performed, especially in patients who are on antiarrhythmic drugs (Björkenheim et al., 2022). A coagulation profile is obtained for patients on anticoagulation.
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References
Björkenheim, A., Fengsrud, E., & Blomström-Lundqvist, C. (2022). Catheter ablation of symptomatic atrial fibrillation: Sex, ethnicity, and socioeconomic disparities. Heart rhythm O2, 3(6Part B), 766–770. https://doi.org/10.1016/j.hroo.2022.07.008
Rottner, L., Bellmann, B., Lin, T., Reissmann, B., Tönnis, T., Schleberger, R., Nies, M., Jungen, C., Dinshaw, L., Klatt, N., Dickow, J., Münkler, P., Meyer, C., Metzner, A., & Rillig, A. (2020). Catheter Ablation of Atrial Fibrillation: State of the Art and Future Perspectives. Cardiology and therapy, 9(1), 45–58. https://doi.org/10.1007/s40119-019-00158-2
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