Ablations
Catheter ablation of arrhythmia is a method of endovascular (through punctures in blood vessels) diagnosis and treatment of cardiac arrhythmias.
Catheter ablation of arrhythmia is a method of endovascular (through punctures in blood vessels) diagnosis and treatment of cardiac arrhythmias.
The procedure is performed with special catheters (long electrodes), which are inserted into the heart cavity through punctures in the blood vessels, and with the help of a special computer station (electrophysiology unit), the doctor finds the arrhythmia and eliminates it. Arrhythmia elimination occurs by applying a burn or high-frequency radio waves, or by freezing (cryoablation) the arrhythmogenic zone.
Who needs ablation?
Catheter radiofrequency ablation (RFA) is indicated for patients with various heart rhythm disorders. These include: atrial flutter, atrial fibrillation (atrial fibrillation), WPW syndrome (Wolf-Parkinson-White syndrome), A-B nodal reciprocal tachycardia (AVVT, AVVT), atrial tachycardia, ventricular tachycardia, frequent ventricular extrasystoles.
The purpose of these operations:
improve the quality of life (allow the patient to get rid of arrhythmia)
improve patient prognosis and prevent sudden cardiac death in some types of potentially life-threatening arrhythmias.
What is the preparation for the procedure?
Before the ablation, the patient must not eat for at least 6 hours before the intervention. It is necessary to consult a doctor about taking medications a few days before the operation and on the day of the intervention.
The course of the procedure:
Catheter ablation is performed in the X-ray operating room. Before the start of the operation, the patient is placed on an X-ray non-contrast table, undressed and connected to an ECG monitor to monitor a number of vital parameters. The right and left pubic (groin) areas are shaved and treated with an antiseptic. Through punctures in blood vessels (most often, these are femoral veins and/or arteries), with the help of special delivery systems – introducers (tubes with built-in valves), diagnostic and ablation catheters are inserted into the heart under video X-ray control.
With the help of stimulation of the heart in different modes and administration of medications, arrhythmia is provoked in order to confirm its type and localization. After that, radio frequency waves are applied to the tip of the catheter, which cause a burn and form a scar in the area (areas) of the heart where the arrhythmia begins. This scar subsequently blocks excessive electrical activity and prevents the occurrence of arrhythmia.
After the ablation, the patient remains on the operating table for another 30 minutes, after which another attempt is made to induce an arrhythmia using programmed electrical stimulation of the heart. Ablation is considered successful in the absence of arrhythmia initiation.
After that, the introducers are removed from the blood vessels, and a pressure bandage is applied to the puncture site.
What does the patient feel during the ablation?
During ablation, patients are conscious most of the time, and the operation is performed under local anesthesia. Patients may feel discomfort at the site of puncture (puncture) of blood vessels, as well as interruptions in the work of the heart and even the occurrence of a typical arrhythmia, in the process of finding the source of rhythm disturbances. During the application of the burn, short-term sensations of chest pain, usually of moderate intensity, are possible.
What are the possible complications?
In the majority of patients, the ablation passes without complications, their risks are less than 1%. Possible complications include:
vascular wall damage, hematoma at the site of vascular puncture (rare)
damage to heart tissue or valves by catheters, perforation of the heart wall (extremely rare)
heart attack or stroke (extremely rare)
formation of blood clots and thromboembolism (extremely rare)
allergic reactions (extremely rare)
How long is the patient in the hospital?
Since ablation is a low-traumatic procedure, mostly patients are discharged on the 2nd day after its performance. One month after the ablation, the patient re-records the Holter ECG; if there are no signs of recurrence of arrhythmia, the patient can return to his usual lifestyle.
The material was prepared by O.I. Semenyuk, O.A. Myshakivskyi
Часті питання
- You can wear whatever you want when going to the hospital. During the procedure, you
- will be dressed in a hospital gown.
- Leave your valuables at home.
- One day before the arranged date, your doctor or nurse will tell you what you can and сan eat or drink before the procedure.
- Ask your doctor what medications you should take on the day of the procedure.
- Tell your doctor and/or nurses if you are allergic to anything.
- injected during the procedure.
- The procedure is performed in the X-ray operating room. This room is cool and dimly lit.
- You will lie on a special table above which you will see a large camera and several
- monitors.
- When the contrast medium is injected, you may feel heat or notice redness for a few
- seconds. This is normal – these sensations will quickly disappear.
- Catheters and an introducer are removed from the blood vessel. The doctor will press
- the puncture site with a finger and apply a compression bandage.
- The nurse will check your bandage regularly to prevent bleeding.
- After a puncture in the leg, you need to lie in bed for several hours.
- The puncture site may be sensitive.
- You will need to drink plenty of fluid to clear the contrast material from your body.
