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Epicardial/Endocardial Ablation


For patients living with permanent, persistent Atrial Fibrillation (AF) with structural heart disease, Dignity Health Heart & Vascular Institute is among a few providers to offer Epicardial/Endocardial Ablation.

This combination therapy is a planned, staged approach using the best of the surgical- and catheter-based approach. This procedure involves both Epicardial (surgical) and Endocardial (catheter) ablation. (Ablation treats irregular heartbeat by creating scar tissue in the area of the heart that is causing the problem.)

Candidates for the Epicardial/Endocardial ablation procedures include patients who have lived with AF for many years; have structural heart disease; have failed other AF treatments and have been diagnosed with persistent, permanent AF.

What is Epicardial/Endocardial Ablation?

Epicardial/Endocardial Ablation begins with the surgeon using a minimally invasive approach to perform an epicardial ablation. If that does not resolve the AF, the electrophysiologist will perform an endocardial ablation via catheter to fill in any remaining gaps and confirm that all of the abnormal electrical impulses are eliminated.

The patient will continue to be monitored by a cardiologist, who will determine if he or she still needs anticoagulant therapy. Most patients experience normal heart rhythm following this planned, staged approach and are able to stop taking some daily medications.

Benefits of Epicardial/Endocardial Ablation

Benefits to the Epicardial/Endocardial Ablation therapy include:

  • Combines best techniques of both cardiac surgeon and electrophysiologist
  • Minimally invasive surgical approach with small chest incisions
  • Minimal pain, shorter hospital stay, quicker recovery time
  • Success of procedure can be determined using intra-operative diagnostics and close follow up

Atrial Fibrillation Clinic

Epicardial/Endocardial Ablation therapy is one of several treatments available through the Atrial Fibrillation Clinic at St. Joseph's Heart & Vascular Institute. The clinic treats patients with persistent or permanent AF who are difficult to treat or continue to experience symptoms.

A multidisciplinary team of electrophysiologists, cardiologists and surgeons, and nurse coordinators work together with the patient to determine the best therapy to enhance their quality of life.

An RN Program Coordinator assists patients with assessments, procedure planning, monitoring, and long-term follow up.