Ablation
(Invasive)
Why is the doctor performing this procedure?
To treat an abnormal heart rhythm by ablating or destroying
an area of the heart that is responsible either for initiating
an abnormal impulse, or conducting the impulse, within the
heart.
What is the procedure?
Catheter ablation is a procedure that allows for the delivery
of energy, through a catheter, to a portion of the heart.
A catheter is a 3-4mm wide tube which may be either hollow
or wire-filled. In the case of hollow tubes, pressures within
the heart and vascular system can be measured, or liquid substances
delivered. Such substances may include contrast media, or
dyes, to allow for visualization of either veins, arteries,
or chambers within the heart, or in the case of alcohol ablation,
the delivery of alcohol through the catheter to a particular
area within the heart to allow for the intentional destruction
of some of the cardiac tissue. In the case of wire-filled
catheters, the catheter tip may have anywhere from two to
ten electrode pairs that allow for the measurement of electrical
force, as well as the delivery of radio frequency energy.
In a typical diagnostic electrophysiology study, one to four
catheters are introduced into the venous system of the circulation,
and advanced under x-ray monitoring to various locations
within the heart. Electric impulses are measured with the
patient in the native, or natural, heart rhythm. By introducing
electrical impulses at various locations within the heart,
different cardiac rhythm abnormalities may be induced. A large
variety of these rhythm problems utilize an abnormal electrical
pathway. This abnormal pathway may frequently be abolished
by applying radio frequency energy to the specific area of
the heart where the pathway lies.
The arrhythmias that are
currently treated with catheter ablation include A-V Nodal
Reentrant Tachycardia, A-V Reciprocating Tachycardia, tachycardias
related to Wolff-Parkinson-White Syndrome (WPW), focal atrial
tachycardias, and some ventricular tachycardias. One of the
newest indications for radio frequency ablation is the treatment
of Paroxysmal Atrial Fibrillation.
Where is the procedure performed?
In the Cardiac Electrophysiology Laboratory (EP Lab).
How long does this procedure take?
Catheter ablation may take anywhere from one to three hours.
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