In a minimally invasive procedure known as cardiac catheter ablation, catheters--thin, flexible tubes--destroy abnormal heart tissue via the patient's blood vessels, according to the Mayo Clinic. Candidates for cardiac catheter ablation procedures include individuals suffering from cardiac arrhythmias, such as atrial fibrillation, atrial flutter and supraventricular tachycardias.
Mechanism
Threaded through a patient's blood vessels, the catheters eventually reach the patient's heart, where abnormal heart tissue resides. The tips of the catheters have lasers, which contains radiofrequency energy, or put more simply, heat. The radiofrequency energy is then applied through the catheter tips, destroying the abnormal heart tissue and therefore destroying the arrhythmia.
Candidates
Medication, the first line of treatment, does not always control a patient's arrhythmia. When medications fail, cardiac catheter ablation procedures provide an alternative. The Mayo Clinic states cardiac catheter ablation procedure candidates must have either tried medications to treat an arrhythmia without success, had serious side effects from arrhythmia medication, or have a high risk of serious complications from their arrhythmia, such as sudden cardiac death.
Types
The type of cardiac catheter ablation procedure performed depends on the cause and severity of the patient's heart rhythm disorder, according to the Mayo Clinic. The types of cardiac catheter ablation procedures include pulmonary vein isolation ablation, or PVI for short; AV node ablation with pacemakers; and supraventricular tachycardia ablation.
PVI isolates "hot spots" in the pulmonary veins that trigger atrial fibrillation, a type of irregular heart rhythm, according to the Mayo Clinic. A majority of patients who undergo PVI no longer experience episodes of atrial fibrillation.
AV node ablation with pacemakers involves the placement of catheters near the AV node of the heart, which electrically connects the atria to the ventricles. Radiofrequency energy, applied via the tips of the catheters, destroys the AV node and causes the patient's heart rhythm to stop completely. A permanent pacemaker is then installed to establish a regular rhythm. Patients must receive anticoagulation medication after this procedure to reduce their chances of developing blood clots.
Uncontrolled supraventricular tachycardias, a type of very fast heart rate, often require treatment via cardiac catheter ablation. Applied through the tips of the catheters, radiofrequency destroys the small area of the heart causing the fast heart rate. The patient's heart rate then slows.
Risks
The Mayo Clinic states cardiac catheter ablation procedures do carry risks, such as bleeding at the site where the catheter was inserted; damage to the blood vessels where the catheter may have scraped as it traveled to the heart; blood clots, which could lead to a heart attack or stroke; narrowing of the veins that carry blood from the lungs to the heart; and damage to the kidneys from the dye used during the procedure. Patients are at increased risk of having these complications if they have diabetes or kidney disease, according to the Mayo Clinic.
Advantages
Patients are at a reduced risk of surgical mishaps because the procedure is minimally invasive. Patients also typically have little or no pain during and after procedure, according the Mayo Clinic. The Mayo Clinic states that these patients usually have fast recovery times, leaving the hospital after one or two days. Another advantage includes permanently destroying the triggers that provoked arrhythmias to occur and therefore letting the heart beat in a regular, controlled and coordinated manner.
