Normal heart function is regulated by electrical flow throughout heart tissue, which maintains a regular beat and rhythm. Sometimes, disruptions in the normal flow of electricity can cause disturbances in heart beat and/or rhythm. In radiofrequency ablation (RFA), a catheter is put into a blood vessel and fed through all the way into the heart. At this point the physician can locate the damaged site of the heart that needs treatment; electrical energy is used to destroy a small amount of the tissue. This usually results in return to normal heart beat and rhythm. However, the procedure has its own risk of side effects that must be measured by the patient before undergoing treatment.
Perforation
Perforation can result from faulty advancement of the catheter and a condition known as tamponade can result. The blood leaking from the perforation in the heart can compress the heart and prevent it from beating effectively. The risk of this complication is about 1 percent, according to a report in the February 2009 edition of "Cardiology Clinics." If the perforation occurs in the rear portion of the heart, a link can develop between the heart and the esophagus (which lies right behind the heart). This can result in blood leaking into the esophagus.
Phrenic Nerve Injury
The phrenic nerve can be damaged during RFA. As a result, the diaphragm can be paralyzed, which can severely hamper the patient's breathing. In addition, it can also affect the emptying time of the stomach. Usually these symptoms resolve about 66 percent of the time, according to an article in the March 2005 edition of "Circulation."
Stroke
Strokes, also known as cerebrovascular accidents, can also occur as a result of RFA. According to an April 1999 report in the "Journal of Cardiovascular Electrophysiology," RFA of the left side of the heart has the highest risk of stroke with a range between .5 percent to 2.5 percent during the procedure depending on various coexisting medical conditions and treatments. For example, blood thinning medication has been reported to decrease the risk of stroke.
Pulmonary Vein Stenosis
This describes a condition in which the inside of the pulmonary veins is narrowed or constricted. When ablation is done within the pulmonary veins, the risk of this has been reported in 15 percent to 20 percent of patients, as reported in the February 2009 edition of "Cardiology Clinics." This can often be asymptomatic, especially with newer methods that limit both the amount of constriction and the symptoms produced by it.
References
- "Cardiology Clinics;" Catheter Ablation of Atrial Fibrillation; Callahan, T et al. Volume 27, February 2009
- "Circulation;" Worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation; Cappato, R. Volume 111, March 2005.
- "Journal of Cardiovascular Electrophysiology;" Thromboembolic complications of cardiac radiofrequency catheter ablation: a review of the reported incidence, pathogenesis and current research directions; Zhou, L et al. Volume 10, April 1999.
