Catheter ablation

Catheter ablation is an invasive treatment of arrhythmias (heart rhythm disturbances). In this procedure, special catheters are used to produce a small scar in the heart which acts as a road block to prevent the abnormal electrical signal from spreading and generating the arrhythmia.

Indications

Catheter ablation is also called EP (electrophysiology) ablation. It can be used to treat a wide range of tachycardias which can be dangerous or difficult to treat with medication. The arrhythmias commonly treated with EP ablation are eg atrial flutter, AVNRT (atrioventricular node reentry tachycardia), ablate accessory pathways in AVRT (atrioventricular reentry tachycardia, Wolff Parkinson White - WPW syndrome), atrial fibrillation (pulmonary vein isolation or as a part of pace and ablate strategy with implantation of permanent pacemaker and ablation of AV node) and some types of ventricular tachycardias. Catheter ablation has very high success rate in most arrhythmias and acts as a curative procedure, but in atrial fibrillation further medication including anticoagulation with warfarin and repeat ablations are often necessary and in ventricular arrhythmias medication and sometimes implantations of devices (ICD - implantable cardioverter defibrillator) may be recommended.

Procedure

Catheter ablations are carried out by electrophysiologists, cardiologists specializing in this area. During the catheter ablation, thin flexible tubes (catheters) are passed from the vein in the groin to the heart. Catheters are then used to measure electrical signals within heart and locate the precise area for ablation. Energy is sent through the catheters to the selected area to destroy it. The energy could be in the form of heat (radiofrequency ablation) or cold (cryoablation). Catheter ablation is usually carried out under local anesthesia and sedation as a day case procedure (without the need for overnight admission to hospital).

Complications

Catheter ablation is safe but there are potential complications including triggering short lived arrhythmias (fast and irregular beats), infection and pain at the site of catheter insertion, failure to terminate the arrhythmia and need for redo procedure.