2. What is Catheter Abalation?
• Cardiac ablation is a procedure to treat heart
rhythm problems referred to as cardiac
arrhythmias.
• It involves the use of heat or cold energy to
destroy small areas of heart tissue, blocking
the abnormal electrical signals that move
through the heart and cause rhythmic
disruptions.
3. Contd…
• Cardiac ablation is most often done using thin,
flexible tubes called catheters inserted through
the veins or arteries. Less commonly, ablation is
performed during cardiac surgery.
• When the root of the problem is discovered, the
tissue causing the problem is ablated or
destroyed.
4. Why it's done?
• When the heart beats, the electrical signals that
cause the heart to squeeze (contract) must
follow a specific pathway through the heart. Any
disruption in the signaling pathway can trigger
an irregular heartbeat (arrhythmia).
• Depending on the type of heart rhythm
problem, cardiac ablation may be one of the first
treatments. Other times, it's done when other
medicines or treatments don't work.
5. What are the types of catheter ablation
procedures?
• Catheter ablation uses either hot or cold energy to destroy heart
tissue.
• Physician will choose the method they are most comfortable
with and that is most appropriate for your condition.
• The patient will receive sedation or possibly general anesthesia
during the procedure and won’t feel any extremes of hot or
cold.
• The types of catheter ablation include:
– Radiofrequency ablation: This method utilizes catheters to convey
radiofrequency energy (similar to microwave heat) to destroy the
problematic heart tissue.
– Cryoablation: Cryoablation uses cold energy to freeze and scar heart
tissue. This method utilizes a single catheter to deliver a balloon
tipped with a freezing material to cause a scar in the problematic
heart tissue.
7. Historical Development
• Catheters were first used for intracardiac recording and
stimulation in the late 1960s, but surgical treatment for
refractory tachyarrhythmias until it was superseded by
catheter ablation.
• The initial energy source used was direct current (DC)
from a standard external defibrillator.
• A shock was delivered between the distal catheter
electrode and a cutaneous surface electrode; however,
this high-voltage discharge was difficult to control and
could cause extensive tissue damage.
8. Contd…
• RF energy, a low-voltage, high-frequency form of
electrical energy familiar to physicians from its use in
surgery (eg, electrocautery), quickly supplanted DC
ablation.
• RF energy produces small, uniform, necrotic lesions by
heating tissue. Lesion size is influenced, in part, by the
length of the distal ablation electrode and the type of
catheter (standard vs saline-cooled).
• With typical power settings and good catheter contact
pressure with cardiac tissue, lesions are minimally about
5-7 mm in diameter and 3-5 mm in depth.
9.
10.
11. Contd…
• Catheter-based cryoablation was developed after RFCA,
and it utilizes tissue cooling to cause tissue necrosis.
• Low-intensity cooling (cryomapping, -10°C) allows
assessment of lesion efficacy and safety, prior to
delivering the deeper cooling (-70°C) that causes
irreversible tissue necrosis.
• Though not as versatile or widely used compared to
RFCA, cryoablation is safer for ablation near the
compact atrioventricular (AV) node.
12. PROCEDURE
• In general, cardiac ablation involves the following steps:
– The patient will be administered a sedative drug just before the
procedure to keep him relaxed.
– A small incision is made in the area where the catheter (a small,
flexible tube) is to be inserted.
– Next, a catheter is inserted through the incision into one of the blood
vessels in the area.
– The physician may inject a contrast medium (dye) through the
catheter so that the blood vessels are clearly visible on X-ray images.
– Under live X-ray guidance, the physician carefully passes the catheter
through the vessel up into your heart. Often, more than one catheter
is required.
– Electrodes at the tip of the catheter are utilized to convey electrical
signals and document your heart's electrical activity.
– The physician utilizes this information to determine where to apply
the ablation.
– Once the source of the problem has been identified, the physician will
use electrical (or sometimes cold) energy to destroy the problem area
in the heart, eliminating the heart rhythm problem.
13. Risks and Complications Involved
• Cardiac ablation is a relatively safe procedure;
however, as with any procedure some risks and
complications may occur such as:
– Bleeding
– Infection
– Damage to heart valves
– Damage to blood vessels
– Blood clots or deep vein thrombosis (DVT)
– Slow heart rate
– Stroke
– Heart attack
– Death, in rare instances
