Catheter ablation
Encyclopedia
Catheter ablation is an invasive procedure used to remove a faulty electrical pathway from the heart
s of those who are prone to developing cardiac arrhythmias such as atrial fibrillation
, atrial flutter
, supraventricular tachycardia
s (SVT) and Wolff-Parkinson-White syndrome
.
It involves advancing several flexible catheters into the patient's blood vessel
s, usually either in the femoral vein
, internal jugular vein, or subclavian vein
. The catheters are then advanced towards the heart and high-frequency electrical impulses are used to induce the arrhythmia, and then ablate (destroy) the abnormal tissue that is causing it.
Catheter ablation is usually performed by an electrophysiologist (a specially trained cardiologist) in a cath lab or a specialized EP lab.
Catheter ablation of most arrhythmias has an extremely high success rate. Success rates for WPW syndrome have been as high as 95% For SVT and atrial flutter, the success rates are 95-98%. For automatic atrial tachycardias, the success rates are 70-90%. The potential complications include bleeding, blood clots, pericardial tamponade, and heart block, but these risks are very low, ranging from 0.5-3%.
For atrial fibrillation
, several experienced teams of electrophysiologists in US heart centers claim they can achieve up to a 75% success rate. However one recent study claims that the success rates are in fact much lower. Single procedure success rates have been published in this study at 28%. Often, several procedures are needed to raise the success rate to the 70-80% range. One reason for this may be that once the heart has undergone atrial remodeling as in the case of chronic atrial fibrillation sufferers, largely 50 and older it is much more difficult to correct the 'bad' electrical pathways. Young AF sufferers with paroxysmal, or intermittent AF, therefore have an increased chance of success with an ablation since their heart has not undergone atrial remodeling yet.
Risks of catheter ablation for atrial fibrillation
include, but are not limited to: stroke, esophageal injury and death.
Former Prime Minister of the United Kingdom
, Tony Blair
, has undergone a successful catheter ablation.
The Heart Rhythm Society
Heart
The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...
s of those who are prone to developing cardiac arrhythmias such as atrial fibrillation
Atrial fibrillation
Atrial fibrillation is the most common cardiac arrhythmia . It is a common cause of irregular heart beat, identified clinically by taking a pulse. Chaotic electrical activity in the two upper chambers of the heart result in the muscle fibrillating , instead of achieving coordinated contraction...
, atrial flutter
Atrial flutter
Atrial flutter is an abnormal heart rhythm that occurs in the atria of the heart. When it first occurs, it is usually associated with a fast heart rate or tachycardia , and falls into the category of supra-ventricular tachycardias. While this rhythm occurs most often in individuals with...
, supraventricular tachycardia
Supraventricular tachycardia
Supraventricular tachycardia is a general term that refers to any rapid heart rhythm originating above the ventricular tissue. Supraventricular tachycardias can be contrasted to the potentially more dangerous ventricular tachycardias - rapid rhythms that originate within the ventricular...
s (SVT) and Wolff-Parkinson-White syndrome
Wolff-Parkinson-White syndrome
Wolff–Parkinson–White syndrome is a disorder of the heart in which the ventricles of the heart contract prematurely due to an accessory pathway known as the bundle of Kent. This accessory pathway is an abnormal electrical communication from the atria to the ventricles...
.
It involves advancing several flexible catheters into the patient's blood vessel
Blood vessel
The blood vessels are the part of the circulatory system that transports blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and...
s, usually either in the femoral vein
Femoral vein
In the human body, the femoral vein is a blood vessel that accompanies the femoral artery in the femoral sheath. It begins at the adductor canal and is a continuation of the popliteal vein...
, internal jugular vein, or subclavian vein
Subclavian vein
The subclavian veins are two large veins, one on either side of the body. Their diameter is approximately that of the smallest finger.-Path:Each subclavian vein is a continuation of the axillary vein and runs from the outer border of the first rib to the medial border of anterior scalene muscle...
. The catheters are then advanced towards the heart and high-frequency electrical impulses are used to induce the arrhythmia, and then ablate (destroy) the abnormal tissue that is causing it.
Catheter ablation is usually performed by an electrophysiologist (a specially trained cardiologist) in a cath lab or a specialized EP lab.
Catheter ablation of most arrhythmias has an extremely high success rate. Success rates for WPW syndrome have been as high as 95% For SVT and atrial flutter, the success rates are 95-98%. For automatic atrial tachycardias, the success rates are 70-90%. The potential complications include bleeding, blood clots, pericardial tamponade, and heart block, but these risks are very low, ranging from 0.5-3%.
For atrial fibrillation
Atrial fibrillation
Atrial fibrillation is the most common cardiac arrhythmia . It is a common cause of irregular heart beat, identified clinically by taking a pulse. Chaotic electrical activity in the two upper chambers of the heart result in the muscle fibrillating , instead of achieving coordinated contraction...
, several experienced teams of electrophysiologists in US heart centers claim they can achieve up to a 75% success rate. However one recent study claims that the success rates are in fact much lower. Single procedure success rates have been published in this study at 28%. Often, several procedures are needed to raise the success rate to the 70-80% range. One reason for this may be that once the heart has undergone atrial remodeling as in the case of chronic atrial fibrillation sufferers, largely 50 and older it is much more difficult to correct the 'bad' electrical pathways. Young AF sufferers with paroxysmal, or intermittent AF, therefore have an increased chance of success with an ablation since their heart has not undergone atrial remodeling yet.
Risks of catheter ablation for atrial fibrillation
Ablation of atrial fibrillation
The ablation of atrial fibrillation is an invasive technique that is used in the treatment of Atrial fibrillation , one of the most common cardiac arrhythmias. Ablation is the removal or melting away of an unwanted structure or tissue...
include, but are not limited to: stroke, esophageal injury and death.
Former Prime Minister of the United Kingdom
Prime Minister of the United Kingdom
The Prime Minister of the United Kingdom of Great Britain and Northern Ireland is the Head of Her Majesty's Government in the United Kingdom. The Prime Minister and Cabinet are collectively accountable for their policies and actions to the Sovereign, to Parliament, to their political party and...
, Tony Blair
Tony Blair
Anthony Charles Lynton Blair is a former British Labour Party politician who served as the Prime Minister of the United Kingdom from 2 May 1997 to 27 June 2007. He was the Member of Parliament for Sedgefield from 1983 to 2007 and Leader of the Labour Party from 1994 to 2007...
, has undergone a successful catheter ablation.
External links
The Arrhythmia Alliance UKThe Heart Rhythm Society