Radiofrequency ablation is a procedure that enables the treatment of many types of rapid heart beat (tachycardia). A special catheter (ablation catheter) is introduced into the heart and positioned over a small area of the heart muscle responsible for the occurrence of irregular heart beats (arrhythmia). The ablation catheters is able to deliver radiofrequency energy (frequency 300-500 kHz, energy 10-50 watts, duration varies for each separate application). Radiofrequency energy thereby causes permanent micro-damage to the tissue with heat. Thus, damaged tissue is no longer able to produce the impulses responsible for arrhythmia or significantly reduces their occurrence. This method enables the patient to be permanently cured in some types of arrhythmia.
What types of arrhythmia can be treated with catheter radiofrequency ablation?
Paroxysmal supraventricular tachycardia (PSVT), including:
- Wolf-Parkinson-White Syndrome (WPW Syndrome) or atrioventricular re-entry tachycardia (AVRT)
- Atrioventricular nodal re-entry tachycardia (AVNRT)
- Atrial tachycardia (AT)
- Atrial flutter (AFl)
Atrial Fibrillation (AF)
Ventricular tachycardia (VT) and ventricular premature beats (known as extrasystoles – VES)
Some days before the procedure, it is necessary to stop taking certain medications in agreement with the cardiologist-electrophysiologist (anti-clotting drugs, some antiarrhythmic drugs). Consult with your doctor about stopping taking some medication a few days before your scheduled procedure, unless you have been told otherwise.
RF ablation is a therapeutic procedure that usually continues after a diagnostic electrophysiology study (see Cardiac electrophysiology study). Prior RF ablation starts, the patient may receive a venous sedative and/or painkiller. The use of RF energy generally does not cause pain, but chest discomfort or burning sensation may occur, which disappears after RF energy delivery stops and/or after medication administration.
Cardiac electrophysiology study
The ablation catheter is introduced into the heart usually through the femoral vein or artery to the heart. Afterwards, the same electrode locates the origin of arrhythmia (so-called mapping) and delivers RF energy.
At the end of the procedure, the doctor tries to cause the arrhythmia again, and if the arrhythmia is not provoked, the procedure ends. However, if arrhythmia is again triggered, the use of RF energy is repeated.
The duration of the procedure varies from patient to patient, depending on the arrhythmia involved. Typically, the procedure lasts two or more hours.