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Ablation is a method of treating cardiac arrhythmias. Electric ablation deliberately damages the heart in a place that causes an arrhythmia, which is an abnormal heart rhythm. What are the indications for ablation? What exactly is the procedure? What is its effectiveness? What are the complications after ablation?

Ablationis one of the methods of treating various types of arrhythmias that uses radio frequency current (hence the name RF ablation - radio frequency).

A he althy heart beats calmly, steadily. This normal rhythm is maintained by the sinus node, a "powerhouse" of sorts, where electrical impulses are produced that stimulate the heart muscle to contract. Arrhythmia occurs when an additional conduction pathway for electrical impulses is created in the heart, or a focal point that generates an abnormal rhythm. The goal of ablation is to destroy the extra conduction pathway or focal point in the heart that is contributing to its uneven beating.

Ablation: indications

Ablation is performed when:

  • tachycardia in the atrioventricular node
  • ectopic (solitary foci) atrial tachycardia
  • idiopathic and post-infarct ventricular tachycardia
  • supraventricular arrhythmia (atrial flutter and fibrillation)

Contraindications to ablation are pregnancy and blood clots in the heart. The procedure cannot be performed even when the doctor cannot insert the electrode through the peripheral vessels.

Ablation: how to prepare for the procedure?

The patient should come to the hospital on an empty stomach and have the necessary medical documentation with him.

Ablation: what is it? How is it going?

The patient is given sedatives and sometimes a narcotic pain reliever (opioids) and local anesthesia. Just in case, a cannula is inserted, which will allow you to administer painkillers during the procedure (if necessary).

Then, in the inguinal area, a catheter with an electrode is inserted into the femoral artery or vein, which is directed through the vessels to the heart. Then an electrophysiological test is performed, during which an arrhythmia may be triggered. The next stage of the procedure is "burning" of the part of the heart muscle in whichthe focus of the arrhythmia was located. This is done with the help of the radio frequency current generated by the electrode. Everything is under the control of the X-ray image (the patient's vessels are observed on the monitor).

During the procedure, the patient may feel pain that he should report. Then, painkillers are administered through the cannula introduced earlier and the procedure is continued. The entire procedure takes up to several hours.

It is worth knowing that apart from radio frequency current, other types of energy can also be used (e.g. ultrasounds or cold application - cryoablation).

Ablation: recommendations after the procedure

After ablation, the patient should lie in bed for several hours and not bend the limbs.

Ablation: effectiveness

In most cases of arrhythmia, ablation is very effective (90-100%). It is least effective in atrial fibrillation (the effectiveness of the procedure is estimated at 60%).

Ablation: complications

Ablation is an extremely safe procedure. Intra- and periprocedural mortality is less than 0.2%. The risk of complications after ablation is also low. In rare cases, the following may arise:

  • hematomas at the injection site,
  • pseudoaneurysm,
  • arteriovenous fistula,
  • deep vein thrombosis.

Complications after ablation also include:

  • stroke,
  • pulmonary embolism (or other thromboembolic complications).

Ablation can also damage the heart valves, puncture the heart wall, spasm or close the coronary artery.

  • Tachycardia - Symptoms and Treatment
  • Should you visit a cardiologist?

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