Our Summary

This research paper is about a study carried out on 49 patients with cardiac electronic implantable devices (CIEDs) who underwent a certain type of heart procedure called catheter ablation. This procedure is often used to treat a type of irregular heart rhythm. The study was conducted to see if it’s possible and safe to perform this procedure without using a common imaging technique called fluoroscopy.

The patients were divided into two groups: one group had the procedure without fluoroscopy (15 patients), and the other group had the procedure with fluoroscopy (34 patients). The study found that the time taken for the procedure, the success rates, and the rate of complications were similar for both groups. Additionally, no patient had any problems with their implanted cardiac device after the procedure.

In conclusion, the study showed that it’s feasible and safe to carry out this heart procedure without using fluoroscopy in patients with implanted cardiac devices, as long as the catheter (a thin tube used during the procedure) is carefully handled. This is the first study of its kind and could have implications for the way these procedures are performed in the future.

FAQs

  1. What is the purpose of the study on catheter ablation in patients with CIEDs?
  2. Can catheter ablation be safely performed without using fluoroscopy according to the study?
  3. Were there any complications or issues with the implanted cardiac devices post-procedure in both groups of patients?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cardiac ablation is to discuss the possibility of undergoing the procedure without the use of fluoroscopy. This study suggests that it is safe and effective to perform the procedure without fluoroscopy in patients with implanted cardiac devices, as long as the catheter is carefully handled. Patients should talk to their doctor about the benefits and risks of this approach and see if it is a suitable option for them.

Suitable For

Patients who are typically recommended cardiac ablation include those with certain types of irregular heart rhythms, such as atrial fibrillation or ventricular tachycardia, that have not responded to other treatments such as medication. Additionally, patients who experience symptoms such as palpitations, dizziness, fainting, or shortness of breath due to their irregular heart rhythm may also be candidates for cardiac ablation. Patients with structural heart disease or a history of heart attacks may also benefit from this procedure.

In the context of the study mentioned above, patients with implanted cardiac electronic devices who require catheter ablation for their irregular heart rhythm may be recommended for the procedure. These patients may have specific considerations due to the presence of the implanted device, and the decision to perform the procedure without fluoroscopy would depend on individual patient factors and the expertise of the medical team.

Timeline

Before the cardiac ablation procedure:

  • The patient is diagnosed with an irregular heart rhythm (arrhythmia) that is not responding to medication.
  • The patient undergoes various tests, such as an electrocardiogram (ECG) and echocardiogram, to determine the exact type and location of the arrhythmia.
  • The patient discusses the risks and benefits of the procedure with their cardiologist and decides to proceed with cardiac ablation.
  • The patient may need to stop certain medications, such as blood thinners, before the procedure.

During the cardiac ablation procedure:

  • The patient is brought into the electrophysiology lab and prepared for the procedure, which is usually done under local anesthesia.
  • A catheter is inserted into a blood vessel, usually in the groin, and guided to the heart where the arrhythmia is located.
  • The cardiologist uses a combination of mapping techniques and energy sources, such as radiofrequency or cryoablation, to destroy the abnormal heart tissue causing the arrhythmia.
  • The entire procedure typically takes a few hours to complete and the patient may need to stay overnight in the hospital for monitoring.

After the cardiac ablation procedure:

  • The patient is monitored closely for any complications, such as bleeding or infection at the catheter insertion site.
  • The patient may experience some discomfort or chest pain in the days following the procedure, which can usually be managed with pain medication.
  • The patient will need to follow up with their cardiologist for regular check-ups and monitoring to ensure the success of the procedure.
  • In most cases, the patient will experience a significant improvement in their symptoms and quality of life after successful cardiac ablation.

What to Ask Your Doctor

  1. Is cardiac ablation the best treatment option for my irregular heart rhythm?
  2. How experienced are you in performing cardiac ablation procedures?
  3. What are the potential risks and complications associated with cardiac ablation?
  4. How long will the procedure take, and what is the recovery time?
  5. Will I need to stop taking any medications before or after the procedure?
  6. Will I need to undergo any tests or evaluations before the procedure?
  7. Will I need to stay in the hospital overnight after the procedure?
  8. How will the procedure affect my implanted cardiac device?
  9. Are there any alternative treatment options to consider?
  10. How successful is cardiac ablation in treating my specific condition?

Reference

Authors: Shimamoto K, Yamagata K, Wakamiya A, Ueda N, Kamakura T, Wada M, Inoue-Yamada Y, Miyamoto K, Nagase S, Kusano KF. Journal: J Cardiovasc Electrophysiol. 2022 Mar;33(3):423-429. doi: 10.1111/jce.15332. Epub 2021 Dec 28. PMID: 34921701