{{Short description|A medical procedure used to treat certain types of arrhythmias}}
'''Catheter ablation''' is a procedure used to remove or terminate a faulty electrical pathway from sections of the [[heart]]s of those who are prone to developing [[cardiac arrhythmia]]s such as [[atrial fibrillation]], [[atrial flutter]], [[supraventricular tachycardia]]s (SVT) and [[Wolff-Parkinson-White syndrome]] (WPW syndrome). If not controlled, such arrhythmias increase the risk of [[ventricular fibrillation]] and sudden [[cardiac arrest]]. The ablation procedure can be classified by energy source: [[radiofrequency ablation]] and [[cryoablation]].
[[File:Herzkatheterlabor.jpg|thumb|right|A catheter ablation procedure being performed in a cardiac catheterization laboratory.]]
==Medical uses==
'''Catheter ablation''' is a medical procedure used to treat certain types of [[cardiac arrhythmias]]. It involves the use of a catheter to deliver energy to specific areas of the heart tissue, with the aim of modifying or destroying the tissue that is causing the abnormal heart rhythm.
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==Procedure==
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Catheter ablation is typically performed in a [[cardiac catheterization laboratory]]. The procedure begins with the insertion of a catheter, usually through a vein in the groin, which is then guided to the heart. Once the catheter is in place, the physician uses it to deliver energy, such as radiofrequency or cryotherapy, to the targeted heart tissue.
Catheter ablation may be recommended for a recurrent or persistent [[Heart arrhythmia|arrhythmia]] resulting in symptoms or other dysfunction. Typically, catheter ablation is used only when pharmacologic treatment has been ineffective.
===Types of Energy Used===
* '''Radiofrequency ablation''': This method uses high-frequency electrical energy to generate heat and destroy the abnormal tissue.
* '''Cryoablation''': This technique involves freezing the tissue to achieve the desired effect.
===Effectiveness===
==Indications==
Catheter ablation of most arrhythmias has a high success rate. Success rates for WPW syndrome have been as high as 95% <ref name="pmid8087753">{{cite journal | vauthors = Thakur RK, Klein GJ, Yee R | title = Radiofrequency catheter ablation in patients with Wolff-Parkinson-White syndrome | journal = CMAJ | volume = 151 | issue = 6 | pages = 771–6 | date = September 1994 | pmid = 8087753 | pmc = 1337132 }}</ref> For SVT, single procedure success is 91% to 96% (95% CI) and multiple procedure success is 92% to 97% (95% CI).<ref name=":0">{{cite journal | vauthors = Spector P, Reynolds MR, Calkins H, Sondhi M, Xu Y, Martin A, Williams CJ, Sledge I | title = Meta-analysis of ablation of atrial flutter and supraventricular tachycardia | journal = Am. J. Cardiol. | volume = 104 | issue = 5 | pages = 671–7 | date = September 2009 | pmid = 19699343 | doi = 10.1016/j.amjcard.2009.04.040 }}</ref> For atrial flutter, single procedure success is 88% to 95% (95% CI) and multiple procedure success is 95% to 99% (95% CI).<ref name=":0" /> For automatic atrial tachycardias, the success rates are 70–90%.{{Citation needed|date=March 2009}} The potential complications include bleeding, blood clots, pericardial tamponade, and heart block, but these risks are very low, ranging from 2.6–3.2%.
Catheter ablation is indicated for patients with various types of arrhythmias, including:
* [[Atrial fibrillation]]
* [[Atrial flutter]]
* [[Supraventricular tachycardia]]
* [[Ventricular tachycardia]]
For [[atrial fibrillation]], several experienced teams of electrophysiologists in US heart centers claim they can achieve up to a 75% success rate. However one recent study claims that the success rates are in fact much lower – at 28% for single procedures. Often, several procedures are needed to raise the success rate to the 70–80% range.<ref name="pmid17019636">{{cite journal | vauthors = Cheema A, Vasamreddy CR, Dalal D, Marine JE, Dong J, Henrikson CA, Spragg D, Cheng A, Nazarian S, Sinha S, Halperin H, Berger R, Calkins H | title = Long-term single procedure efficacy of catheter ablation of atrial fibrillation | journal = J Interv Card Electrophysiol | volume = 15 | issue = 3 | pages = 145–55 | date = April 2006 | pmid = 17019636 | doi = 10.1007/s10840-006-9005-9 }}</ref> One reason for this may be that once the heart has undergone atrial remodeling as in the case of chronic atrial fibrillation sufferers, largely 50 and older, it is much more difficult to correct the 'bad' electrical pathways. Young people with AF with paroxysmal, or intermittent, AF therefore have an increased chance of success with an ablation since their heart has not undergone atrial remodeling yet.
==Risks and Complications==
While catheter ablation is generally safe, it carries some risks, including:
* Bleeding or infection at the catheter insertion site
* Damage to blood vessels
* Heart perforation
* Arrhythmias
== Risks ==
==Recovery==
Risks of catheter ablation for atrial fibrillation include, but are not limited to: [[stroke]], esophageal injury, [[pulmonary vein stenosis]], and death.
After the procedure, patients are usually monitored for a few hours in the hospital. Most patients can return to normal activities within a few days, although strenuous activities should be avoided for a period as advised by the physician.
==Technique==
==Related pages==
Catheter ablation involves advancing several flexible [[catheters]] into the patient's [[blood vessel]]s, usually either in the [[femoral vein]], internal jugular vein, or [[subclavian vein]]. The catheters are then advanced towards the heart. Electrical impulses are then used to induce the arrhythmia and local heating or freezing is used to [[ablation#Medicine|ablate]] (destroy) the abnormal tissue that is causing it. Originally, a DC impulse was used to create lesions in the intra-cardiac conduction system.<ref name="pmid7148651">{{cite journal | vauthors = Beazell JW, Adomian GE, Furmanski M, Tan KS | title = Experimental production of complete heart block by electrocoagulation in the closed chest dog | journal = Am. Heart J. | volume = 104 | issue = 6 | pages = 1328–34 | date = December 1982 | pmid = 7148651 | doi=10.1016/0002-8703(82)90163-6}}</ref> However, due to a high incidence of complications, widespread use was never achieved. Newer procedures allow for the terminating of diseased or dying tissue to reduce the chance of arrhythmia.
* [[Cardiac electrophysiology]]
* [[Electrocardiogram]]
* [[Pacemaker]]
Catheter ablation is usually performed by an [[electrophysiologist]] (a specially trained [[cardiologist]]) in a [[cath lab]] or a specialized EP lab.
==Recovery or rehabilitation==
After catheter ablation the patients are moved to a cardiac recovery unit, intensive care unit, or [[Coronary care unit|cardiovascular intensive care unit]] where they are not allowed to move for 4–6 hours. Minimizing movement helps prevent bleeding from the site of catheter insertion. Some people have to stay overnight for observation, some need to stay much longer and others are able to go home on the same day. This all depends on the problem, the length of the operation and whether or not [[general anaesthetic]] was used.
==References==
{{reflist}}
==External links==
* [http://www.heartrhythmcharity.org.uk/ The Arrhythmia Alliance UK]
* [http://hrsonline.org/ The Heart Rhythm Society]
{{Cardiac surgery}}
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[[Category:Cardiac procedures]]
[[Category:Cardiac procedures]]
[[Category:Medical treatments]]
Revision as of 11:16, 15 February 2025
A medical procedure used to treat certain types of arrhythmias
A catheter ablation procedure being performed in a cardiac catheterization laboratory.
Catheter ablation is a medical procedure used to treat certain types of cardiac arrhythmias. It involves the use of a catheter to deliver energy to specific areas of the heart tissue, with the aim of modifying or destroying the tissue that is causing the abnormal heart rhythm.
Catheter ablation is typically performed in a cardiac catheterization laboratory. The procedure begins with the insertion of a catheter, usually through a vein in the groin, which is then guided to the heart. Once the catheter is in place, the physician uses it to deliver energy, such as radiofrequency or cryotherapy, to the targeted heart tissue.
Types of Energy Used
Radiofrequency ablation: This method uses high-frequency electrical energy to generate heat and destroy the abnormal tissue.
Cryoablation: This technique involves freezing the tissue to achieve the desired effect.
Indications
Catheter ablation is indicated for patients with various types of arrhythmias, including:
While catheter ablation is generally safe, it carries some risks, including:
Bleeding or infection at the catheter insertion site
Damage to blood vessels
Heart perforation
Arrhythmias
Recovery
After the procedure, patients are usually monitored for a few hours in the hospital. Most patients can return to normal activities within a few days, although strenuous activities should be avoided for a period as advised by the physician.
