Catheter Ablation for A-Fib & Arrhythmia
Catheter ablation for the treatment of Atrial Fibrillation or A-Fib and many other arrhythmias is one of the biggest advances in the treatment of irregular heart rhythms. With this technology, patients suffering from irregular heartbeat have more options than ever before and can often avoid medication that causes significant side effects. For many common arrhythmias, cure rates are upwards of 95-98% while others may need “touch-ups” within 3-6 months of the initial procedure. In many cases, catheter ablation can be considered as the initial treatment modality because of its safety and effectiveness.
Catheter ablations are performed in a cardiac cath lab or EP lab. This specially outfitted room is dedicated to the detection and treatment of arrhythmias using very specialized tools and software.
What is A Cardiac Cather and How Does It Function?
A cardiac catheter is a long, wire-like device that is inserted into a vein on the inner thigh. By using a straw-like sheath to insert the catheter, we can almost always avoid the need for surgical incisions, making recovery quicker and reducing complications.
During the procedure, the catheter is threaded through the vein and up to the heart. Guided X-ray, known as fluoroscopy is used to precisely monitor the location of the catheter in real-time. Using advanced computing power, the catheter send images of the heart and specialized software creates a 3D map of the heart including a live view of electrical impulses. We use this map to understand the origin of the arrhythmia.
If the patient is not experiencing an arrhythmia at the time of the procedure, we can induce an irregular heartbeat using the very same device.
What is Ablation and How Does It Work?
Ablation involves the destruction of abnormal tissue using heat. To achieve this, the catheter emits RF or radiofrequency waves that create heat and ablate the tissue in the area(s) causing the improper electrical impulses. Cooling liquid that circulates within the catheter allows us to precisely regulate the amount of heat needed. The destruction of tissue effectively ends the arrhythmia and the tissue is slowly absorbed into the body. Because we receive real-time images from the catheter, we can evaluate the area treated to be sure no further improper electrical impulses are being generated. If necessary we can retreat the area.
The procedure is most often performed under twilight IV sedation although some patients may need general anesthesia. A typical catheter ablation can last from one to four hours depending on the complexity of the case and the number of sites that need to be treated. Touch-ups, or follow-on procedures, are sometimes needed within a few to several months of the initial ablation to reinforce results.
Patients rarely require an overnight hospital stay and can often go home on the same day as the procedure. They should avoid driving for at least 48 hours and can be back at work and performing normal activities within a few days.
Main Advantages of Catheter Ablation
- Exceptional success rates
- Low complication rate
- An outpatient procedure with a short (few days) recovery
- Often a permanent solution to arrhythmia versus the need for indefinite use of medical/prescription drug therapy
Risks and Consideration of Catheter Ablation
- Damage at the catheter’s entry point which may cause bleeding, vascular damage and infection
- Rarely, damage to the heart during the ablation
- Stroke, blood clots and/or death – these are extremely rare
- Use of continuous X-ray may not be appropriate for younger patients
- Not all patients will be able to end their medication regimen
- A follow-on touch-up procedure may be necessary in some cases
Catheter ablation for the treatment of irregular heartbeat is indicated for a wide cross-section of patients, though it will not be appropriate for everyone. Learn more about this procedure by scheduling a consultation with one of our electrophysiologists.