Ablation (Invasive)
Why
is the doctor performing this procedure?
To treat
an abnormal heart rhythm by ablating or destroying an area of the heart
that is responsible either for initiating an abnormal impulse, or
conducting the impulse, within the heart.
What
is the procedure?
Catheter
ablation is a procedure that allows for the delivery of energy, through a
catheter, to a portion of the heart. A catheter is a 3-4mm wide tube
which may be either hollow or wire-filled. In the case of hollow tubes,
pressures within the heart and vascular system can be measured, or liquid
substances delivered. Such substances may include contrast media, or
dyes, to allow for visualization of either veins,
arteries, or chambers within the heart, or in the case of alcohol
ablation, the delivery of alcohol through the catheter to a particular
area within the heart to allow for the intentional destruction of some of
the cardiac tissue. In the case of wire-filled catheters, the catheter
tip may have anywhere from two to ten electrode pairs that allow for the
measurement of electrical force, as well as the delivery of radio
frequency energy. In a typical diagnostic electrophysiology study, one to
four catheters are introduced into the venous system of the circulation,
and advanced under x-ray monitoring to various locations within the
heart. Electric impulses are measured with the patient in the native, or
natural, heart rhythm. By introducing electrical impulses at various
locations within the heart, different cardiac rhythm abnormalities may be
induced. A large variety of these rhythm problems utilize an abnormal
electrical pathway. This abnormal pathway may frequently be abolished by
applying radio frequency energy to the specific area of the heart where
the pathway lies.
The
arrhythmias that are currently treated with catheter ablation include A-V
Nodal Reentrant Tachycardia, A-V Reciprocating Tachycardia, tachycardias related to Wolff-Parkinson-White
Syndrome (WPW), focal atrial tachycardias, and some ventricular tachycardias. One of the newest indications for radio
frequency ablation is the treatment of Paroxysmal Atrial
Fibrillation.
Where
is the procedure performed?
In the
Cardiac Electrophysiology Laboratory (EP Lab).
How
long does this procedure take?
Catheter
ablation may take anywhere from one to three hours.
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