Cardiac ablation

Cardiac ablation is a minimally invasive surgical procedure that uses radiofrequency energy source to kill or destroy small regions of heart tissue that cause abnormal heart rhythms. Cardiac ablation is effective in treating several kinds of heartbeat abnormalities such as:

• Atrial flutter: An ailment where the heart beats exceedingly fast but at an even rate

• AFib: Atrial Fibrillation among the most common forms of abnormal heart rhythm resulting in rapid beats without pattern.

• Ventricular Tachycardia (VT:) A serious abnormal heart rhythm that may cause fast and irregular heartbeats at sudden point then leads to cardiac arrest.

• Symptomatic arrhythmias: These are disturbances characterized by symptoms like: palpitations, dizziness, breathlessness among others.

• Arrhythmias not responding to drugs: When medicines fail to control arrhythmia, some cases require ablation procedures.

• Life-threatening arrhythmias: Procedures of ablation may save life in situations with VT or other potentially deadly abnormal heartbeats.

Procedure:

For this operation, doctors insert a thin, flexible tube called a catheter into a vein in the patient’s thigh or groin and steer it towards the heart. Here, through the catheter they apply radiofrequency energy to abnormal tissues within the heart hence causing little damage blocking electrical impulses that cause arrhythmia completely. As a result, it gets back to its normal beating rate which it continues for future episodes prevention. The protocol can be divided into different phases as follows:

Cardiac ablation is usually done at a hospital under general anesthesia or sedation. It could last for some hours with these steps below.

Catheter insertion: A catheter which is thin and flexible is inserted into a vein in the patient's leg or groin so that it can go all way up to the heart under x-ray guidance.

Mapping: The electrophysiologist uses the catheter to map cardiac electrical activities with irregular heartbeats felt in your chest by using catheters.

Ablation: This is when radio-frequency energy is sent through the catheter into your heart to create some small scars that would block these unusual electrical waves from happening

Monitoring: After ablation, the patient must be under observation for a few hours to make sure that arrhythmia is eliminated and there are no complications.

Contraindications for Cardiac Ablation:

Although cardiac ablation is safe, it is not suitable for everyone. Some contraindications include:

In the presence of an active infection, the procedure should be postponed until any infection has subsided.

Ablation may not be effective in patients with severe valve disease.

The procedure can trigger complications for patients with bleeding disorders.

Types of Cardiac Ablation

Cardiac ablation corrects heart rhythm problems (arrhythmias) without the need for traditional surgery. Catheter ablation includes two types and surgical ablation includes three types.

Catheter Ablation: It is a non-surgical procedure also known as radiofrequency or pulmonary vein ablation. During this procedure, the surgeon inserts a long, thin, flexible catheter tube into a blood vessel at the leg or neck region and guides it to reach the heart. When the catheter reaches the area causing the arrhythmia, it destroys the abnormal cells. This process enables restoration of regular heartbeat.

Radiofrequency Ablation:

In this technique the doctor uses catheters to deliver radiofrequency energy, like microwave heat.

This energy creates circular scars around the problematic veins or groups of veins, disrupting the abnormal signals causing arrhythmia.

Cryoablation:

• A single catheter with a balloon tip is used.
• The balloon is filled with a material that freezes the tissue, forming a scar that prevents abnormal electrical signals.

Surgical Ablation: This type of ablation is performed using.

Maze Procedure:

• Typically performed during open-heart surgery for other issues, such as a bypass or valve replacement.
• Typically, small cuts are made at the upper part of the heart and stitches them together, forming scar tissue that blocks abnormal signals.

Mini Maze:

• This procedure is less invasive and an ideal option for patients who do not need open-heart surgery.
• Several small cuts are made between the ribs, and a camera is used to guide catheter ablation.
• Some hospitals use robotic-assisted technology for even smaller incisions and greater precision.
• These procedures help to manage and correct arrhythmias, aiming to maintain a regular and healthy heartbeat.

Convergent Procedure:

• This procedure combines catheter ablation with a mini maze procedure.
• The doctor performs radiofrequency ablation inside the pulmonary vein.
• Additionally, a surgeon makes a small cut under the breastbone to apply radiofrequency energy to the outside of the heart, enhancing the effectiveness of the treatment.

Benefits of Cardiac Ablation:

Cardiac ablation offers several benefits over other treatment options for arrhythmias, including:

Ablation is very effective at doing away with or notably bringing down the frequency of arrhythmias. This procedure is slightly invasive; hence recovery time is also shorter than in open-heart surgery. Ablation can substantially increase the patient's life quality through symptom reduction, lessening of their disease effects, (thereby allowing them to lead an active life).

• High success rate: Ablation is very effective at doing away with or notably bringing down the frequency of arrhythmias.
• Minimally invasive: This procedure is slightly invasive; hence recovery time is also shorter than in open-heart surgery.
• Durable results: In many cases, the results of ablation are long-lasting, providing sustained relief from arrhythmias.
• Improved quality of life: Ablation can substantially increase the patient's life quality through symptom reduction, lessening of their disease effects, (thereby allowing them to lead an active life).

Risks and Complications:

As with any medical procedure, cardiac ablation comes with some risks and complications, although they are relatively rare. These may include:

• There is a small risk of bleeding at the insertion site.
• Infection is a rare but possible complication.
• Damage to surrounding tissues: In rare cases, the catheter may damage surrounding tissues, such as blood vessels or nerves.
• The risk of stroke is very low but can occur if a blood clot forms during the procedure.
• In some cases, the arrhythmia may return after ablation, requiring additional treatment.

Recovery and Follow-up:

Most patients recover quickly from cardiac ablation and can go home the same day or the following day. They may experience some soreness at the insertion site, which typically resolves within a few days. It is important to follow the doctor's instructions for recovery, including avoiding strenuous activity and taking any prescribed medications. Regular follow-up appointments are necessary to monitor the heart's rhythm and ensure the long-term success of the procedure.

Key Factors Determining Cardiac Ablation Success Rates

Patient Characteristics: The success rate of cardiac ablation includes various factors such as age, underlying heart conditions, severity of arrhythmia and history of previous ablation procedures.

Procedure-Related Factors: In some cases, success also depends on experience and expertise in who performs ablation procedure, technology used during the procedure and length of the procedure.

Other Factors: This includes patient compliance with follow-up care and lifestyle factors.