Hybrid ablation for atrial fibrillation


Hybrid ablation for atrial fibrillation (A-fib) combines minimally invasive treatment inside and outside the heart to interrupt the cause of A-fib and restore a normal heart rhythm.

The procedure is called hybrid because of the combination. During treatment, specialists at the Norton Heart & Vascular Institute use precise tools to deliver a little heat (ablation) to the heart muscle, creating scar tissue that interrupts the stray electrical signals that cause A-fib and can minimize the symptoms that feel you. A-fib can also have long-term effects on the health of your heart.

Specialists at the Norton Heart & Vascular Institute, serving Louisville and southern Indiana, have been performing hybrid ablations since 2017, longer than any other provider in the region. Norton Heart & Vascular Institute is among the 10 most experienced programs in the country for successful hybrid ablation procedures.

By making the procedure accessible to many more patients, the Food and Drug Administration (FDA) recently approved hybrid ablation as the only minimally invasive ablation treatment for patients who have been on continuous A-fib for over a year.

The American College of Cardiology recognized Norton Audubon Hospital, Norton Brownsboro Hospital, and Norton Hospital for their expertise and commitment to cardiac catheterization procedures like hybrid ablation. The accreditation recognizes consistent best practice in patient care and the ability to provide the highest standard of cardiac catheterization procedures.

The experienced hybrid ablation specialists at Norton Heart & Vascular Institute regularly train other physicians on how to perform the procedure safely. Norton Healthcare contributed to the FDA decision process to approve the procedure by providing data on the procedure and success rates.

Norton Heart & Vascular Institute Atrial Fibrillation Clinic

Norton Heart & Vascular Institute’s Atrial Fibrillation Clinic is designed to assess and treat anyone with this common arrhythmia. The team of providers and a pivot nurse create a personalized treatment plan for each patient that considers options ranging from medication to evaluating advanced treatment options like hybrid ablation.

What is the hybrid ablation procedure?

Cardiac ablation in general is the precise use of heat or cold to create tiny pieces of scar tissue in or on the heart at the source of A-fib to stabilize the heartbeat. Some patients may undergo catheter ablation, which attacks only inside the heart, before the hybrid procedure is considered as a minimally invasive way of treating the outside of the heart.

You will be treated by highly experienced electrophysiologists and cardiothoracic surgeons who work together to achieve the best possible result.

The first step is to approach the outside of the heart through an inch-long incision under the rib cage. The surgeon inserts an instrument that delivers radiofrequency heat to the exact spot outside your heart to interrupt A-fib.

After several weeks, a second procedure is performed that targets A-fib signals inside the heart. A small catheter is inserted through the groin and into the heart. The tip of the catheter delivers heat to the exact spot inside your heart to interrupt the signals that cause A-fib.

By removing the inside and outside of the heart, our specialists increase the chances of restoring a normal sinus rhythm (normal heart rhythm).

A-fib educational workshop on demand

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Benefits of hybrid ablation

  • Higher success rates for reducing your A-fib symptoms
  • Minimally invasive approach with incisions no longer than one inch
  • Short hospital stays and recovery times for most patients

Who is a good candidate for hybrid ablation?

You may be a good candidate for the procedure if:

  • You have persistent A-fib.
  • You have long-standing persistent A-fib (over a year).
  • Your A-fib has not responded, or should not respond, to treatments such as medications or catheter-only ablation.
  • Symptoms related to A-fib persist.
  • Other health problems worsen because of A-fib.

Patients who have had open chest surgery are not eligible for hybrid ablation. See your doctor to explore your treatment options.

What to expect after hybrid ablation

  • Mild chest discomfort due to the inflammation caused by the first procedure is not uncommon. The side effects of general anesthesia are the cause of most discomfort and should go away after three to four hours.
  • After the first procedure, you will need to stay in the hospital for monitoring while your medication is adjusted. It usually takes two to three days.
  • After the second procedure, patients usually only spend one night in the hospital.
  • Most patients who feel well and do not have heavy labor can return to work within a few days. Those with physically demanding jobs may have to wait around two weeks.
  • It may take several months after the second procedure for your heart to adjust to the ablation and for your heart rate to improve.
  • You will have follow-up appointments with the surgery and electrophysiology team to assess your progress. Norton Telehealth may be an option for some of your follow-up appointments.


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