Mid-Atlantic Cardiothoracic Surgeons

Sentara Heart Hospital, 6th Floor • 600 Gresham Drive, Suite 8600
Norfolk, VA • 757.388.6005info@macts.com
Joseph R. Newton, M.D.
Joseph Newton, M.D.
Jonathan M. Philpott, M.D.
Jonathan Philpott, M.D.
Christopher J. Barreiro, M.D.
Christopher Barreiro, M.D.
John Sirak, M.D.
John Sirak, M.D.
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George Dimeling, M.D.
Clinton Kemp, M.D.
Clinton Kemp, M.D.


Ablation may be an option for people who cannot tolerate medications or when medications are not effective in maintaining a normal heart rhythm. Pulmonary vein ablation and AV node ablation are the two types of catheter ablation procedures used to treat AFIB. Hybrid ablation combines catheter ablation with a surgical procedure and is performed by a team of doctors working together.

Pulmonary Vein Ablation

During pulmonary vein ablation, a doctor inserts catheters (long, flexible tubes) into the blood vessels of the leg, and sometimes the neck, and guides the catheters into the atrium. Energy is delivered through the tip of the catheter to tissue that is targeted for ablation. The energy is applied around the connections of the pulmonary veins to the left atrium. Frequently, other areas involved in triggering or maintaining atrial fibrillation are also targeted.Small circular scars eventually form and prevent the abnormal signals that cause atrial fibrillation from reaching the rest of the atrium.

AV Node Ablation

This procedure involves a catheter inserted into the heart to produce a permanent electrical disconnection of the atria from the ventricles. The atria are left in permanent fibrillation, and a permanent pacemaker is needed to drive the ventricular rhythm. The atrial contribution to the heart's output is lost, and the patient must typically remain on warfarin chronically to guard against stroke.

Hybrid ablation

Also called the hybrid procedure, hybrid ablation combines a surgical procedure and catheter ablation in the same procedure in the same setting.

It is done by a team that consists of both a surgeon and an electrophysiologist in an EP suite using both EP and surgical equipment, and incorporating electrophysiological testing to confirm that the erratic electrical signals have been blocked.