Cardiac Ablation

What is Cardiac Ablation?

Cardiac ablation is a treatment performed by a specialized type of cardiologist, called an electrophysiologist, that targets abnormal heart tissue contributing to irregular heartbeats, known as arrhythmias.

Cardiac ablation aims to restore your heart to a normal rhythm.

The normal flow of electrical signals within the heart is disrupted by abnormal heart tissue, leading to irregular heartbeats that require treatment. Irregular heartbeats can prevent a steady blood flow, leading to more severe heart issues.

Cardiac ablation may offer relief:

• If you have been experiencing persistent AFib lasting longer than seven days.
• Long-standing AFib lasting more than 12 months.
• Other treatments have yet to be successful.

Catheter ablation is not the only treatment for a fast heartbeat. Doctors can use other treatments for a fast heartbeat. These can include medicines, different procedures, or surgery.

How Cardiac Ablation is Performed

Usually, ablations are performed by inserting a catheter into a blood vessel in the neck or upper thigh.

Catheter ablation is considered an interventional procedure. Interventional procedures use catheters or needles to diagnose or treat conditions without major incisions or open surgery.

After inserting the catheter through blood vessels to reach the heart, energy is delivered to modify small areas of heart tissue that cause abnormal heart rhythms.

This method is less invasive compared to traditional open-heart surgery, which requires opening the chest to access the heart.

Identify and Target Abnormal Tissue:

The specific heart areas causing the arrhythmia are identified through diagnostic procedures. These areas consist of abnormal tissue that generates or conducts faulty electrical signals.

The ablation procedure then involves either modifying the function of this tissue or destroying it. This is done to prevent the abnormal tissue from creating faulty electrical signals in the heart that lead to arrhythmias.

Understanding the 3 Types of Catheter Ablations

There are three main techniques to treat arrhythmias with catheter ablation:

• Radiofrequency Ablation
• Cryoablation
• Pulsed Field Ablation

Radiofrequency Ablation

Radiofrequency ablation uses microwave energy to create heat and remove a small area of heart tissue.

After locating the problematic tissue, the tip of the catheter delivers a controlled amount of radiofrequency energy to the area. This energy heats and destroys the tissue, creating a small scar (lesion) that cannot conduct electricity. This interruption of abnormal electrical pathways restores normal heart rhythm.

Radiofrequency cardiac catheter ablation is considered a safe and effective treatment for many people with certain types of heart rhythm disorders.

However, as with any medical procedure, risks are involved, including bleeding at the catheter insertion site, damage to the heart or blood vessels, and the possibility of additional procedures if the first ablation does not completely correct the arrhythmia.

Cryoablation

Cryoablation is similar to radiofrequency ablation. However, it uses extreme cold instead of heat to target and treat arrhythmias.

Once the area that needs to be treated is identified, the tip of the cryoablation catheter is cooled to a very low temperature, often around -112°F to -130°F.

This cold temperature creates a lesion or scar tissue by freezing the targeted cells, disrupting their ability to conduct electrical signals and contributing to the arrhythmia.

The freezing process can cause less discomfort and lower the risk of blood clot formation during the procedure.

Like radiofrequency ablation, cryoablation isn't suitable for everyone or every type of arrhythmia. It offers an alternative when medications are ineffective or cause significant side effects.

Every patient's situation is unique, and decisions about cryoablation are tailored to them, ensuring the treatment aligns with your overall health and specific heart condition.

Pulsed Field Ablation

Pulsed Field Ablation is a new technology approved by the Food and Drug Administration. It is used in cardiac electrophysiology procedures to treat cardiac arrhythmias, particularly atrial fibrillation.

It's an alternative to traditional catheter ablation techniques. AFib is the primary condition treated with Pulsed Field Ablation.

Instead of using heat or cold to destroy problematic heart tissue, PFA uses electric fields to create pores in the cell membranes of the targeted tissue, leading to cell death without significant heating or cooling.

Key advantages of Pulsed Field Ablation include:

• Tissue Selectivity: Pulsed Field Ablation is more selective for cardiac muscle cells, reducing the risk of damage to surrounding tissues such as the esophagus, phrenic nerve, and pulmonary veins, which can be a concern with thermal ablation methods.
• Reduced Risk of Complications: Due to its non-thermal nature, PFA minimizes the risk of collateral damage to adjacent structures, potentially leading to fewer complications and a safer procedure overall.
• Efficiency: Early studies suggest that PFA can create effective lesions for blocking abnormal electrical pathways more quickly than traditional ablation techniques, possibly leading to shorter procedure times.
• Rapid Recovery of Tissue: The targeted ablation of cells with PFA allows for quicker recovery of the heart tissue, possibly less scarring.

The Convenience of Catheter Ablation

Catheter ablation's minimally invasive nature means that, in most cases, patients can expect to leave the hospital and be driven home by a loved one either on the day of the procedure or shortly after that. This convenience significantly advances more invasive heart procedures, offering less discomfort and a quicker return to daily activities.

Preventing Further Heart Disease and Blood Clots

By correcting abnormal heart rhythms, catheter ablation is critical in preventing heart disease progression and blood clot formation. These benefits underscore the procedure's importance not only in symptom management but also in reducing the risk of more serious conditions like stroke.

Addressing the Challenge of Abnormal Heart Rhythms

Abnormal heart rhythms, or arrhythmias, pose a significant health risk, leading to a variety of complications if left untreated. Catheter ablation offers a targeted approach to modify or destroy the tissue causing these rhythms, aiming to restore normal heart function and prevent further complications.