Your center for modern atrial fibrillation ablation in Zurich
What is an ablation?
Ablation is a minimally invasive procedure in which heart tissue that causes faulty electrical signals is selectively destroyed. This involves the use of an energy source such as cold (cryoenergy), heat (radiofrequency), or electrical impulses (pulsed field ablation, PFA). The treatment is performed with pinpoint accuracy at the location in the heart that is causing the arrhythmia.
Depending on the type of cardiac arrhythmia, this target area is located in different parts of the heart. Precise diagnosis is therefore crucial for successful ablation. This is done using an ECG, long-term ECG, transesophageal pacing (TEP), or high-resolution 3D mapping of the heart rhythm.
This diagram shows the origins of various cardiac arrhythmias that can be treated with cardiac ablation. The most important distinction is whether the arrhythmia originates in the right or left side of the heart. If the arrhythmia originates in the left atrium—as is the case with atrial fibrillation, for example—the physician must pass from the right atrium to the left atrium via a small puncture site in the atrial septum (known as a transseptal puncture). This allows the ablation to be performed precisely at the affected site—without open-heart surgery and using a completely minimally invasive technique.
Different types of ablation:
- Ablation of tachycardias, atrial flutter, PVCs, ...
- Catheter ablation of atrial fibrillation (Cryo, PFA & RF)
- Surgical ablation (Stand alone) in complex atrial fibrillation
- Hybrid ablation
Ablation team
The team consists of heart surgeon Prof. Salzberg (left) and electrophysiologist Dr. Zerm.
How to proceed
Either your family doctor will refer you, or your cardiologist will send you directly for ablation. In many cases, however, patients also contact us directly.
In order for us to get a comprehensive picture of your situation, we need the following documents:
- Cardiology report (if available)
- Electrocardiogram (ECG), long-term ECG (Holter, etc.), Apple Watch, ...
- Ultrasound findings, CT, MRI, ...
- Blood tests
With this information, we can arrange an appointment with you. For patients from abroad, we have set up a separate information page where all the important details are clearly summarized – you can find it here.
After initial contact, we will arrange an appointment for a consultation—or, if you prefer, directly for the ablation. The next steps will then be discussed with our team. We will accompany you throughout the subsequent therapy.
Succes rate and statistics
Defining success rates in medicine is challenging because many individual factors play a role. Based on current scientific literature, the following success rates can be expected:
Paroxysmal atrial fibrillation In cases of paroxysmal atrial fibrillation, a freedom from atrial fibrillation of over 90% can be expected after one year. In some cases, a second procedure is necessary to permanently eliminate atrial fibrillation. Cryo and PFA (pulsed field ablation) ablation techniques show very similar success rates in these scenarios. Both procedures are established, safe, and well-studied for pulmonary vein isolation (PVI).
Persistent atrial fibrillation In this form of atrial fibrillation, the origin lies not only in the electrical activity around the pulmonary veins, but often also in scar tissue (fibrosis) in the left atrium. Therefore, precise 3D mapping is crucial after PVI to identify additional triggers.
The success rate of cardiac ablation in this setting is approximately 70 to 90% freedom from atrial fibrillation after 12 months, depending on the individual findings and the severity of the fibrosis.
We have been working in our outpatient operating room in Zurich for 3 years. Our complication rate is documented in the Swiss Rhythmology Registry as 0%.
What to expect
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Initial consultation and diagnosis – During the initial consultation, we conduct a detailed analysis of all available documentation. If further examinations are necessary for the planned treatment, we can arrange these directly.
- Treatment – Treatment is performed on an outpatient basis in our state-of-the-art hybrid operating room. Most procedures can be performed as day treatments. This means that you will be monitored for about six hours after the procedure and can then go home. You will, of course, be given an emergency number that you can use to reach one of our doctors at any time.
- Aftercare – The day after the procedure, a clinical check-up is usually carried out at our practice. In uncomplicated cases, this can also be done by your family doctor. Further aftercare is carried out according to a clearly defined schedule by the referring doctor or your cardiologist.
Cardiac ablation – the story of continuous development
The treatment of cardiac arrhythmias has undergone impressive developments in recent decades. In the 1960s and 1970s, doctors increasingly recognized that many arrhythmias were caused by electrical malfunctions in the heart. Surgical procedures were initially developed to treat these specifically. In 1982, American heart surgeon Dr. James Cox first described the so-called Maze procedure.
This procedure required the chest to be completely opened and the heart to be connected to a heart-lung machine. The atria were incised in a labyrinthine pattern and then sutured back together – hence the name “Maze.” Although the operation was very complex, it laid the foundation for all subsequent treatments of atrial fibrillation. For many years, the therapy remained a purely surgical procedure that was continuously refined.
The 1990s and 2000s saw a decisive advance: with the development of modern 3D mapping systems, new forms of energy such as cryoablation (cold) and specialized catheters, the procedure was significantly simplified and made safer. Pulmonary vein isolation (PVI) established itself as the standard treatment for atrial fibrillation.
Since 2024, the hybrid approach, i.e., the combination of minimally invasive cardiac surgery techniques with modern electrophysiological methods, has been officially enshrined in the new European guidelines. This close collaboration between cardiac surgery and electrophysiology combines the advantages of both disciplines and offers a significantly higher success rate, especially for patients with complex or persistent atrial fibrillation.
Today, more than 40 years after the first Maze procedure, rhythmology is once again at a turning point: Pulsed Field Ablation (PFA) is a novel, non-thermal technology that selectively treats heart muscle cells while sparing surrounding tissue. It enables shorter procedure times and greater safety, marking the beginning of a new era in the treatment of atrial fibrillation.