Any problem associated with the rate or rhythm of the heartbeat, causing the heart to beat too fast or too slow, is called arrhythmia. Individuals with arrhythmias can experience symptoms such as tiredness, fainting, heart palpitations and difficulty breathing. Often, catheter ablation is used to stop constant or recurrent fast heart rates from occurring and relieve symptoms associated with arrhythmias.
Catheter ablation is an invasive procedure used to treat a variety of abnormal heart rhythms, including:
- Atrial flutter
- AV nodal re-entry
- Ventricular and atrial tachycardia
- Atrial fibrillation
The choice to have catheter ablation typically depends on certain factors such as how severe the individual’s symptoms are and whether the individual has any problems with the structure of the heart. Before undergoing catheter ablation surgery, a doctor may recommend the following instructions:
- Avoiding taking certain medications that can increase the risk of bleeding during surgery
- Avoiding smoking
- Avoiding eating or drinking anything after midnight the night before surgery
- Informing the doctor of a cold, flu, fever or other illness
- Arranging for transportation to and from the hospital
- Arranging for home care during recovery after surgery
Ablation can help patients to normalize or control heart rhythm problems and prevent blood clots or a stroke by disconnecting or blocking the pathway of the abnormal rhythm. Catheter ablation procedures are done in a hospital supported by trained medical professionals. The procedure involves advancing several flexible catheters into the patient’s blood vessels, usually either in the femoral vein, internal jugular vein or subclavian vein. The catheters are then advanced towards the heart. Further, electrical impulses are used to induce the arrhythmias and local heating or freezing is used to ablate (destroy) the abnormal tissue that is causing it.
Several risks, though uncommon, associated with catheter ablation include the following:
- Accidental hole in the heart
- Nerve damage
- Bleeding
- Stroke
- Heart attack
- Death (very rare)
After surgery, the patient is hospitalized for 1-2 days before being allowed to go home. Antiarrhythmic medications are typically prescribed for a few months in order to stabilize the heart and keep it pumping at a normal rhythm. Certain symptoms, such as palpitations, might occur while the heart is healing. If palpitations do not go away within a few months, a second ablation procedure might be required.
Follow up visits are recommended in order to monitor the heart rhythm and review any irregular changes that might occur.
IN HUMANITAS:
The ablative therapy for the treatment of atrial fibrillation is based on the modification of the substrate arrhythmic electrical insulation in particular areas within the left atrium, where triggers of atrial fibrillation reside. The ablation is performed by the use of a catheter scalar, capable of delivering RF energy. The purpose of the ablative treatment is to perform the lines of lesion at the level of the four joints between the pulmonary vein and atrium, so as to electrically isolate the arrhytmogenic areas. The left atrial ablation procedure is performed under heavy sedation, via right femoral venous access approach with claim via trans-septal puncture with needle Brockenbrough. The use of new technologies allow for choosing which ablative technique is best suited in accordance with the patient’s anatomy and to the anatomical features of the left atrium. In most cases, the use of the sophisticated robotic system called Stereotaxis and navigation system called CARTO MERGE is recommended, while in other cases, the cryo-ablation catheter with balloon or multi electrode circular radiofrequency is recommended.
