​                         Professor Francisco Leyva-León

Catheter ablation

Catheter ablation is a treatment for abnormalities of the heart rhythm (cardiac arrhythmias). It involves introducing a catheter (a thin tube) into the heart. The first part of the procedure involves mapping out the abnormal heart circuits in the upper (atria) and lower (ventricles) chambers of the heart. The second part involves interrupting, or disconnecting, the abnormal electrical circuits with the delivery of energy. Different rhythm abnormalitites (arrhythmias) require different types of ablation. The 'simplest' are those for supraventricular tachycardias. 

Atrial fibrillation ablation is effective if atrial fibrillation has been intermittent (paroxysmal), or recent onset (persistent). It is not effective if it is longstanding (permanent).  In experienced units, ablation for paroxysmal atrial fibrillation is successful in around 85% of patients and the procedure lasts from 1 to 3 hours, depending on complexity. A repeat procedure may be required. The success rate is lower with longer durations of AF. The complication rate from AF ablation is 2-3%.

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The procedure

Catheter ablation involves introducing catheters (small plastic tubes) and wires into the heart. These are used to find the abnormal part of the heart that is causing the arrhythmia. Once found, a small amount of energy is delivered, so as to deaden it. Ablation procedures vary in their complexity, risks and benefits. Ablation of a Woolf-Pakinson-White pathway is low-risk and has a high success rate. Ablation for AF is more complex and the success rates vary according to the type of AF and individual patient characteristics.



Are there any risks?

Catheter ablation procedure is generally very safe. However, as with any invasive procedure, there are risks. Special precautions are taken to decrease these risks. Your doctor will discuss the risks of the procedure.

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Evaluation
A thorough evaluation is needed to determine if catheter ablation is an appropriate treatment option for you. This evaluation may include:

• Medical history and examination
• Electrocardiogram (ECG)
• Echocardiogram (Echo)
• Holter monitor test
• An implantable loop recorder

• A cardiac MRI scan

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Ablation links

https://my.clevelandclinic.org/health/treatments/17401-pulmonary-vein-isolation-ablation