How to Choose the Best Heart Specialist for Atrial Fibrillation Ablation and Long-Term Rhythm Control

Atrial fibrillation (AF) is one of the most common heart rhythm disorders worldwide. It can cause symptoms such as palpitations, breathlessness, fatigue, dizziness, and an increased risk of stroke. Over the last two decades, Atrial Fibrillation ablation has transformed the way AF is treated, offering many patients a long-term solution beyond medications.

AF ablation was first introduced in 1998. In its early years, it was considered experimental and reserved only for patients with severe AF who did not respond to medicines. With advances in technology and improved procedural strategies, outcomes have significantly improved. Today, AF ablation is a mainstream and guideline-supported treatment and is considered a standard of care for many patients.

Choosing the right heart specialist for this procedure plays a major role in long-term rhythm control and overall success.

Understanding Atrial Fibrillation Ablation

Most episodes of AF are triggered by abnormal electrical signals that originate from the pulmonary veins, which carry blood from the lungs to the left atrium of the heart. These signals can cause chaotic electrical activity, leading to an irregular heartbeat. Over time, an enlarged left atrium can help sustain AF, making it more difficult to control.

Pulmonary vein isolation (PVI) is the cornerstone of Atrial Fibrillation ablation. The aim of PVI is to electrically isolate the pulmonary veins from the rest of the heart by creating controlled scars around their openings. This blocks the abnormal signals responsible for triggering AF.

In patients with more advanced or long-standing AF, PVI alone may not be enough. Additional ablation lines may be created inside the left atrium to make it less capable of maintaining AF. Deciding on the correct strategy requires deep expertise and experience, which is why selecting the right electrophysiologist is critical.

How the Procedure Is Performed

During an AF ablation procedure, thin flexible catheters are guided through a vein in the leg to the heart. Using specialised tools, the heart specialist accesses the left atrium and delivers energy to targeted areas.

There are several energy sources used in modern ablation:

Radiofrequency ablation, which heats the tissue

Cryoablation, which freezes the tissue

Pulsed field ablation, which uses controlled electrical energy

Each method creates scars that block abnormal electrical pathways. The procedure usually takes 2–3 hours, although complex cases may take longer. Most patients stay in the hospital overnight and return home the next day. Normal activities can usually be resumed within a few days, with temporary restrictions on heavy lifting or strenuous exercise.

Why Experience Matters When Choosing a Heart Specialist

Atrial Fibrillation ablation is a complex procedure that requires specialised training. Studies consistently show that success rates are higher and complication rates lower when the procedure is performed by experienced operators at dedicated heart rhythm centres.

When choosing a heart specialist in the UAE, patients should look for:

Formal training in cardiac electrophysiology

Extensive experience in AF ablation procedures

Access to advanced ablation technologies

A structured follow-up and rhythm monitoring program

Reputed centres such as The Heart.ae focus on comprehensive AF management, combining procedural expertise with long-term rhythm care and patient education.

Success Rates and Factors That Influence Outcomes

Pulmonary vein isolation is a safe and effective treatment with success rates reaching 80–85% in selected patients, compared to around 40% with medications alone. However, results vary based on several factors:

Type of AF: Patients with paroxysmal (intermittent) AF tend to have better outcomes than those with persistent AF.

Duration of AF: The longer a patient has been in AF, the lower the success rate.

Age and overall health: Younger patients with fewer medical conditions usually have better results.

Left atrial size: A smaller left atrium is associated with higher success rates.

Operator expertise: Highly experienced heart specialists achieve better and safer outcomes.

Post-procedure care: Following medications, lifestyle advice, and follow-up schedules is essential.

Repeat Ablation and Long-Term Rhythm Control

One challenge of AF ablation is the heart’s natural ability to heal. Over weeks or months, small areas of the ablation scar may recover, allowing abnormal signals to pass through again. If AF recurs, a repeat procedure may be required to target these healed areas.

An experienced electrophysiologist can identify and treat these gaps effectively, improving long-term rhythm control.

Risks and Safety

Like any medical procedure, Atrial Fibrillation ablation carries risks such as bleeding, stroke, or damage to surrounding structures. However, in experienced hands, serious complications are rare and usually occur in less than 1% of cases. Careful patient selection and advanced imaging further improve safety.

Final Thoughts

In summary, Atrial Fibrillation ablation has become an essential part of AF management, especially for younger patients and those who cannot tolerate or do not wish to take long-term medications. Choosing the right heart specialist is just as important as choosing the procedure itself.

Patients in the UAE should seek care at specialised centres like The Heart.ae, where expert heart specialists focus on both procedural success and long-term rhythm control. A detailed discussion with your electrophysiologist about individual risks, benefits, and expectations is the first step toward a healthier, more stable heart rhythm.