Cardiac Arrhythmia Ablation
Catheter ablation selectively destroys areas of the heart that are causing a heart rhythm problem. In cardiac ablation, thin, flexible wires are inserted into the femoral or carotid arteries and are threaded to the heart under X-ray guidance. The wires allow the electrophysiologists to record the heart's electrical activity to diagnose a heart rhythm problem. Radio waves can be sent through the wires to ablate the area that is causing the rhythm problem.
Ablation is recommended for the following types of arrhythmias:
Paroxysmal Supraventricular Tachycardia
Catheter ablation is a first-line theraphy for patients with moderately frequent or persistent episodes of paroxysmal supraventricular tachycardia for which an emergency room visit is required. Cryoablation of slow atrioventricular (AV) nodal pathway for atrioventricular nodal reentry tachycardia (AVNRT) carries an exceptionally low risk of AV block requiring pacemaker with greater than 95% long-term success rates making it an attractive alternative to chronic beta-blocker theraphy.
WPW
Radio frequency ablation is generally indicated as first-line therapy for symptomatic Wolff-Parkinson-White syndrome (WPW) given a small potential risk of life-threatening arrhythmia associated with atrial fibrillation and rapidly conducting accessory pathway. Long-term success rates are 95% with a very low risk of complications.
Atrial Flutter
Atrial Flutter is generally more difficult to control and to suppress with antiarrhythmic drugs than is atrial fibrillation. Ablation of the isthmus between the tricuspid annulus and the inferior vena cava is extremely effective in preventing recurrent atrial flutter (85% long-term success rate). Ablation is a reasonable first-line theraphy for patients where atrial flutter is the primary arrhythmia (little atrial fib) or patients with atrial fibrillation suppressed on type I C antiarrhythmic drugs who develop recurrent atrial flutter.
Outflow Tract Ventricular Tachycardia
Premature ventricular complexes (PVCs) are characterized by left bundle branch block and inferior QRS axis configuration on the ECG. Ablations approprate for suppression of ectopy and for high density ventricular ectopy (>30,000 PVCs/24 hours) that may depress left ventricular function. Success rates are greater than 80% with small risk of complications. | 