Written by Dimitrios Vrachatis, Specialist Cardiologist, PhD, National and Kapodistrian University of Athens.
Cardiac arrhythmias are usually caused by disturbances of the heart’s electrical system. Arrhythmia ablation is a safe, modern treatment for most arrhythmias, leading to their definitive elimination.
Which arrhythmias can be treated with ablation?
Advances in biomedical technology have significantly expanded the possibilities of interventional electrophysiology. Today, a wide range of both supraventricular arrhythmias — including atrial tachycardia, atrioventricular nodal re-entry tachycardia (AVNRT), atrial flutter and atrial fibrillation — and ventricular arrhythmias can be treated effectively.
Where is arrhythmia ablation performed?
These procedures take place in an electrophysiology laboratory using specialised equipment that monitors and records electrical signals from inside the heart. When needed, electroanatomical mapping creates a virtual three-dimensional map of the heart in real time.
Special magnetic fields are used to identify the movement of dedicated catheters within the heart. Advanced systems can combine these data with earlier cardiac images, such as MRI scans.
What is the first step in arrhythmia ablation?
Guided by surface ECG recordings and the patient’s history, the interventional electrophysiologist first attempts to confirm or diagnose the precise arrhythmia and locate the relevant areas of the myocardium through an electrophysiological study.
How is the arrhythmia ablated?
After the diagnostic stage, the interventional electrophysiologist uses dedicated ablation catheters and appropriate techniques to treat selected areas of the myocardium and destroy the circuit or focus responsible for the arrhythmia. Localised energy — such as radiofrequency energy or cryotherapy — is delivered through the ablation catheter to destroy the small areas of heart muscle causing the arrhythmia.
What are the success rates and risks?
Success rates and the degree of risk vary according to the arrhythmia being treated. Your physician will explain these before the procedure and again after the diagnostic stage has been completed, before the final treatment decisions are made.
How do the catheters reach the heart?
The procedure involves puncturing the femoral vein and/or artery to introduce the catheters into the body and advance them into the heart.
After the procedure — when will I be discharged?
After an ablation procedure, the patient is usually monitored for 24–48 hours and then returns to their activities.