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Arrhythmias and Ablation

Every situation that modifies the normal heart beat is called arrhythmia. Tachyarrhythmia cause the heart beat faster than normal or in a fast arrhythmic way. Patients with arrhythmias can experience palpitation, dysponea, fatigue and syncope. The type of arrhythmia and the presence of other heart disease generally determines whether ablation can be performed surgically or non surgically.

 

The different types of ablation include the following:

 

Non-surgical ablation: A procedure that involves the placement of a catheter into a specific area of the heart. A special machine then directs energy through the catheter to small areas of the heart muscle that cause abnormal heart rhythm. The energy in turn disrupts the pathway of abnormal activity.

 

Surgical ablation: Surgical procedures that involve treating atrial fibrillation. They can be minimally invasive or traditional open surgery. Surgical ablation procedures include:

 

  • The Maze procedure: An open heart surgical procedure that involves disrupting the conduction of abnormal activity and directing normal sinus impulses to travel to the atrioventricular node as they normally should.  

 

  • Minimally invasive surgical ablation: A surgical procedure that involves making smaller incisions into the heart and the insertion of endoscopes (small instruments that contain a camera).  

 

  • The modified Maze procedure: A surgical procedure that involves the use of a special catheter to carry energy that creates controlled lesions on the heart and  scar tissue. This scar tissue blocks the abnormal electrical impulses from being transported through the heart and directs the normal conduction of impulses through the proper pathway. One of four energy sources may be used to create the scars: radiofrequency, microwave, laser, or cryothermy.

 

A few recommended instructions on how to prepare for ablation include:

 

  • Consulting with a doctor about medication restrictions before the procedure
  • Avoiding eating or drinking anything after midnight the night before the procedure
  • Arranging for transportation to and from the hospital
  • Arranging for home care during recovery after surgery

 

 

Ablation therapy is also used in individuals with rapid arrhythmias to control the heart rate and reduce the risk of blood clots and strokes. In order to obtain the best results from ablation procedures, the utilization of Stereotaxis is extremely helpful.

 

Stereotaxis is a robotic system guided by two big magnets that can pull and change the direction of the ablation catheter. The primary advantage to this system is that the robotic control provides precise catheter navigation, right to the exact location where the operator wants to go. Moreover, once the catheter is inserted, it is extremely stable.

Catheter instability is one of the reasons for long term failure of AF ablation. During a hand controlled procedure, the operator often is unable to keep the catheter stable long enough to create a permanent lesion. Therefore, with the use of Stereotaxis, the rate of AF recurrence and complications occurring during the procedure are reduced.

 

 

 

 

 

Like with any surgical procedure, possible risks that can arise include:

 

  • Bleeding where the catheter was inserted
  • Bruising
  • Small collection of blood under the skin (hematoma)
  • Damage to the heart’s normal electrical pathways

 

After the procedure, lying flat on the back and resting for a few hours is essential. For a few days, an individual may feel tired; however, returning back to normal should occur within a few days.

 

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