The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on cryoablation for atrial fibrillation in association with other cardiac surgery.

Description

Atrial fibrillation is the irregular and rapid beating of the upper two chambers of the heart (the atria). It may be classified as paroxysmal, persistent or permanent. Patients with atrial fibrillation may be asymptomatic or they may have symptoms including palpitations, dizziness and breathlessness. They also have an increased risk of stroke as a result of blood clots forming in the left atrium and then embolising to the brain. Although atrial fibrillation may occur in the absence of other heart disease, it is particularly common in patients with mitral valve disease.

Cryoablation of the atria can be performed via a catheter introduced through a femoral vein but surgical cryoablation for atrial fibrillation is typically carried out in patients undergoing concomitant open-heart surgery, including mitral valve replacement or repair. A cryoprobe is used to freeze tissue along a pattern of lines rather than the incisions created in the traditional Cox maze surgery.

Coding and clinical classification codes for this guidance