Ablation therapy of heart rhythm disorders

What is ablation therapy?

Ablative forms of anti-arrhythmic therapy are minimally-invasive treatments with decades of history. In the treatment of cardiac arrhythmias, these procedures specifically inactivate tissue which emits uncoordinated electrical impulses and thereby disturb the normal heart rhythm.
Objective of the treatment
In the ablation procedures used in the treatment of cardiac arrhythmias, scars are deliberately created in the heart muscle, thereby permanently inactivating the tissue triggering the heart rhythm disorder.
After identification and localisation of the pathways triggering the heart palpitations, these are electrically disrupted and so shut down.

When is this treatment necessary?

In the case of tachycardial arrhythmias (palpitations), the heart rate is over 100 beats per minute. The arrhythmia may originate from the atria or ventricles of the heart: sometimes additional pathways trigger uncontrolled stimulation of the heart, which is perceived by the patient as seizure-like palpitations.
Due to the rapid heart rate, which sets in suddenly in many cases, the chambers or the heart have less and less time to be refilled, or the heart muscle contractions become weak and uncoordinated. As a result, less and less blood is pumped into the circulatory system. The heart is now no longer able to work economically and this quickly results in deficient supply of the whole organism with oxygen and nutrients.

Many different conditions can trigger tachycardial arrhythmia, from a myocardial infarction to coronary heart disease, cardiac insufficiency or a heart defect, high blood pressure or non-cardiac factors such as hyperthyroidism, an electrolyte imbalance or an overdose of anti-arrhythmic agents or the interaction of other medications.

Course of the treatment

In ablation therapy, and depending on the ablation procedure used, heat (high-frequency current ablation, lasers, ultrasound) is either supplied or withdrawn from the heart tissue using special ablation catheter, which is introduced to the heart in the course of an electrophysiological examination via a vein in the groin, arm, chest or (in rare cases) the neck.
The heat or cold destroys the cardiac tissue in the area previously identified as morbid, and creates a lesion. To successfully complete a treatment it may be necessary to carry out several such lesions. After the first ablation, the attending cardiologist waits 30 minutes, and tests by stimulation whether the heart rhythm disorder can still be triggered. If this is the case, a further ablation (and if necessary several) is performed.

Duration of the treatment

The duration of treatment depends on the type of heart rhythm disorder and the selected ablation procedure, and the number of lesions to be performed.
Usually a treatment lasts less than 2 hours, although in some cases it is possible that the treatment period extends to several hours.

Risks

Ablation therapy has a long history and is as a result a treatment in which complications rarely occur. As with any medical intervention however, ablation therapy also poses risks, which depend primarily on the type of arrhythmia being treated.

Note

The patient must have an empty stomach for the examination. To be prepared for all eventualities, allowance should also be made for a prolonged course of the examination and possible in-patient treatment.
Following the out-patient treatment, the patient should not operate machinery or a motor vehicle on that day. You should therefore arrange to be picked up by family members or friends (we can also of course call a taxi for you if required).