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Treating Arrhythmias with Catheter Ablation



Abnormal heart rhythms are caused by a problem with the heart’s electrical system.  They are usually treated by specially trained cardiologists called Electrophysiologists (EP doctors). 

What is an Ablation?
Catheter ablation is a procedure often used to treat (and sometimes cure) an abnormally fast heart rhythm.  In an ablation, energy either destroys the areas in the heart that trigger abnormal electrical signals or creates a “wall” that keeps the signals from traveling through the heart. There are different ablation procedures that can be done to treat different arrhythmias.  Your doctor will recommend the one that’s right for you.  At Central Baptist Hospital, ablation is performed in the cardiac EP lab.


How is an Ablation Performed?
First, catheters (long, thin flexible tubes) are inserted through small punctures in your groin and neck and threaded through your veins into your heart.  Your doctor uses these catheters to record your heart’s rhythm and build an electrical map of your heart.  This map helps the doctor to pinpoint the areas of the heart that the abnormal rhythm is coming from.  Next, energy waves are sent through the catheters to destroy a superficial area of heart tissue in those areas.  Because the area is superficial (does not go all the way through the heart muscle) it does not affect the strength of the heart.  Then the catheters are removed. Afterward, you will spend the night in the post interventional unit.

Some of the most common abnormal heart rhythms treated with a catheter ablation are:

 

 Ablation for A-Fib: Pulmonary Vein Ablation (PVA)
Research has shown that the electrical signals that cause A-Fib almost always come from the four veins that carry blood back and forth between the lungs and heart, called the pulmonary veins.  During a PVA, catheters (long, thin tubes) are inserted into the veins in the groin and neck and guided to the inside of the left atrium (the top left chamber of the heart).  The catheters are used to find the heart tissue around the pulmonary veins that the abnormal electrical signals are coming from. Once the tissue is found, the catheters are used to deliver energy to ablate (or destroy) this tissue.  

Over a period of about 3 months, scars form where the energy was delivered.  The scars build a wall that the abnormal electrical signals can’t get across to cause A-Fib.  Until the scars form, many people still experience the A-Fib symptoms they had before the procedure.  This is expected, and because of this, you will continue to take your anti-arrhythmic and blood thinning medicines until after your doctor determines it is safe for you stop them.  A PVA can cure A-Fib in some patients.  It is usually done for patients who have severe symptoms with their A-Fib, or for patients in whom medications do not work. Sometimes, a second PVA may be needed if the A-Fib comes back.  There are risks with a PVA procedure.  Your health care provider will discuss these risks with you and whether or not it is the best option for you.