Ablation

 

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.

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An animation of a Catheter Ablation procedure.

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.