Cardiac ablation is a surgical procedure used to treat heart arrhythmias (abnormal heart rhythms). Radio waves directed at the heart create heat and destroy certain areas of heart tissue that are responsible for the aberrant signalling that causes the abnormal heart rhythm.
Conditions of abnormal heart rhythm include:
Arrhythmias prevent sufficient oxygen from circulating around the body so an affected individual may feel faint or breathless and find it difficult or impossible to exert themselves or they might be able to feel their heart beat pounding. In severe cases, a heart arrhythmia can result in a cardiac arrest. Cardiac ablation is offered when the patient has failed to respond to medication.
Long catheters are inserted through a vein or artery in the groin and threaded up to the heart. A video screen ensures that the surgeon locates the correct area. A small electrical current is used to trigger the arrhythmia and locate the problem areas of the heart. Radio waves are then directed at these areas to destroy the malfunctioning tissue. Duration of surgery is around two to four hours for each affected area. The procedure is usually carried out with a local anaesthetic and sedation so that the patient feels comfortable and relaxed. Sometimes it is done via open heart surgery but the catheter method is preferable since the recovery time is much faster and the procedure involves less discomfort for the patient. After surgery the patient will be required to keep their leg straight and lie flat for several hours. They will be monitored carefully by medical staff.
Cryoablation is another type of ablation surgery that uses extreme cold to kill tissues instead of using radio frequency. This may be preferred by the patient as it causes less pain during the procedure. Damage caused by cold is also capable of healing so the surgeon can restore normal electrical function and rewarm frozen tissue without causing permanent burns. The chance of puncture to the atrial wall is also reduced since the integrity of the tissue is preserved. No scar tissue also means less chance of crusty deposits in the blood vessels.
Cardiac ablation is usually uncomplicated in most cases. Bleeding and bruising at the sites where the catheters were inserted can occur and there is a chance of infection. There is also a small chance of damage to the blood vessels caused by the catheter, damage to the heart valves, blood clots in the lungs or legs, pulmonary vein stenosis (a narrowing of veins that transport blood to and from the heart and lungs), puncture of the heart or a worsening of the arrhythmia that requires correction with a pacemaker. A surgeon will discuss all the risks and benefits prior to the procedure.
After the patient is discharged, they should rest and avoid driving for 24 hours and refrain from strenuous activities for three days or until their physician tells them it is safe to do so. More than half of all patients will be alleviated of their symptoms and after recovery, will be able to enjoy their normal activities again, free of any discomfort.
To arrange a heart check or consultation to discuss heart arrhythmias and cardiac ablation, call the London Cardiology Group for a private appointment with one of London’s top cardiologists.
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