A minimally invasive procedure known as cardiac catheter ablation involves catheters--thin, flexible tubes--destroying abnormal heart tissues when reaching the heart via the patient's blood vessels, according to the Mayo Clinic. Candidates for cardiac catheter ablation include those 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 heat. Radiofrequency is applied through the catheter tips, destroying the abnormal heart tissue and therefore the arrhythmia.
Candidates
An alternative treatment option, cardiac catheter ablation is used when a medication regimen fails to control the arrhythmia. The Mayo Clinic states cardiac catheter ablation candidates must have 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 & Methods
The type of cardiac catheter ablation performed depends on the cause and severity of the patient's heart rhythm disorder, according to the Mayo Clinic. The procedures include pulmonary vein isolation ablation, AV node ablation with pacemakers and supraventricular tachycardia ablation.
Pulmonary vein isolation isolates hot spots in the pulmonary veins which trigger atrial fibrillation, a type of irregular heart rhythm, according to the Mayo Clinic. A majority of patients who undergo pulmonary vein isolation ablation are completely treated and 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 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
Cardiac catheter ablation procedures carry risks; these include 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 and puncture of the heart. Other risks, according to Mayo Clinic, include blood clots that could lead to a heart attack or stroke, narrowing of the veins that carry blood between the lungs and heart, and damage to the kidneys from dye used during the procedure.
Patients are at increased risk of these complications if they have diabetes or kidney disease.
Advantages
Patients who have a cardiac catheter ablation 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. These patients usually have fast recovery times, leaving the hospital after one or two days.
Another advantage: Cardiac catheter ablation destroys the triggers that provoked arrhythmias, so the heart beats in a regular, controlled and coordinated manner.
