Arrythmias and Ablation
Every situation that modifies the normal heart beat is called arrhythmia. Tachyarrhythmias cause the heart beat faster than normal or in a fast arrhythmic way. Patients with arrhythmias can experience palpitation, dyspnoea, fatigue, syncope. In case of drug inefficacy in controlling symptoms, most arrhythmias can be treated by catheter ablation. In many cases catheter ablation can be considered as a first choice therapy. This technique is performed by introducing one or more leads (wires) via femoral/subclavian/basilic vein in order to reach the heart chambers. Once inside the heart, specific electric stimuli are delivered in order to study the heart electrical conduction system and to reproduce the clinical arrhythmia: once the arrhythmia is induced, the physician can study the underlying electrical mechanism and focus the ablation on the target area.
Electrical pathways generating the arrhythmias can be “burned” (via radiofrequency ablation) or freezed (via cryoablation). Both techniques cause cell death, thus interrupting the electrical abnormal conduction pathways that caused the arrhythmia and may finally solve the arrhythmic disease.
In order to obtain the best results from ablation procedures, the utilization of Sterotaxis is extremely helpful. Stereotaxis is a robotic system guided by two big magnet that can gently pull and change direction of the ablation catheter. The primary advantage is that robotic control provides very precise catheter navigation, right to the spot where the operator wants to go. Moreover, once the catheter gets there, it is extremely stable. Catheter instability is one of the reasons for long-term failure of AF ablation, for instance, because during a hand-controlled procedure, the operator often is unable to keep the catheter stable long enough to create a permanent lesion. Therefore, potentially, with a more stable, robotically controlled catheter, patients will experience less recovery of abnormal conduction following the procedure and the AF recurrence rate will be reduced as well as the complication rate.
The second important advantage of Stereotaxis is that in reality the catheter is not pushed (as it is manually), but gently pulled by the magnets permitting to precisely reach the different chambers of the heart. As a direct consequence these gently movement dramatically reduce risks during the procedure. Since 2006 In Humanitas we perform > 90% of ablation procedure with Stereotaxis, trying to achieve the best and safest results. During the last 15 years 3-4000 ablation procedures have been performed, including 1200 with Stereotaxis.