Catheter Ablation for Arrhythmias

Overview: Ablations for arrhythmias involve sending a catheter into the heart, and scarring heart tissue to block the electrical signals causing the arrhythmia. 

 

Background

When treatment with drugs does not control arrhythmias it is sometimes possible to treat the arrhythmias with an ablation. This is particularly common for atrial fibrillation and atrial flutter. Electrical signals that cause the arrhythmias start in particular regions of the heart or the pulmonary veins that bring oxygen-rich blood to the heart. In an arrhythmia ablation the doctor accesses the heart using a catheter, and destroys tissue in certain locations. This creates scar tissue that can block the arrhythmia-causing electrical signals. 

There are two main techniques: radiofrequency ablation (RFA) causes scarring by using low voltage, high frequency electricity. Cryoablation uses extreme cold to cause scarring.

One point can be confusing: ablations for arrhythmias are not at all related to alcohol septal ablations for obstruction. Both are widely used and have similar success rates and complications. An ablation for an arrhythmia won't treat obstruction, and an alcohol septal ablation won't treat your arrhythmia.

Liu, L., Zuo, L., Sun, C., Li, J., Zhang, J., Zhou, M., Guo, R., Xu, B., Hu, R., & Xiong, L. (2018, June 9). Abstract 19301: Treatment of Obstructive Hypertrophic Cardiomyopathy by Ultrasound-guided Percutaneous Radiofrequency Ablation of Interventricular Septum. American Heart Association Journals, 1(suppl_1). https://www.ahajournals.org/doi/10.1161/circ.136.suppl_1.19301

 

Yang, H., Yang, Y., Xue, Y., & Luo, S. (2020, February 7). Efficacy and safety of radiofrequency ablation for hypertrophic obstructive cardiomyopathy: A systematic review and meta‐analysis. Wiley Online Library, 43(5). https://doi.org/10.1002/clc.23341

 

HCMA 6/2021