Our Summary

This research paper is about a technique used to treat certain types of heart rhythm problems, specifically those found in the ventricles (lower chambers of the heart). The technique is called radiofrequency ablation, which uses energy to destroy a small area of heart tissue that is causing the abnormal heart rhythms.

Sometimes, however, this technique doesn’t work well because it can’t effectively transfer enough energy to the targeted heart tissue. To solve this issue, the researchers suggest using two catheters (thin, flexible tubes) instead of one in the radiofrequency circuit during the procedure. This method, known as bipolar ablation, has been shown to create deeper lesions (areas of damaged tissue), which may make it more effective at getting rid of heart rhythm problems that couldn’t be fixed with the standard technique.

In the paper, the researchers provide a detailed guide on when and how to perform this bipolar ablation technique for treating irregular heart rhythms.

FAQs

  1. What is the difference between standard RF ablation and bipolar ablation for ventricular arrhythmias?
  2. How does the bipolar ablation technique contribute to deeper lesion formation in ventricular arrhythmias?
  3. When is it advisable to perform bipolar ablation of ventricular arrhythmias?

Doctor’s Tip

One helpful tip a doctor might give a patient about cardiac ablation is to make sure to follow all pre-procedure instructions provided by your healthcare team. This may include fasting before the procedure, stopping certain medications, and arranging for transportation to and from the hospital. Following these instructions can help ensure the procedure goes smoothly and reduces the risk of complications.

Suitable For

Patients who are typically recommended for cardiac ablation are those who have certain types of arrhythmias, such as atrial fibrillation, atrial flutter, supraventricular tachycardia, and ventricular tachycardia. These patients may have symptoms such as palpitations, dizziness, chest pain, or fainting episodes that are not well controlled with medication. Additionally, patients who have structural heart disease, such as coronary artery disease, cardiomyopathy, or congenital heart defects, may also be considered for cardiac ablation. It is important for patients to undergo a thorough evaluation by a cardiologist or electrophysiologist to determine if they are suitable candidates for the procedure.

Timeline

  • Patient is diagnosed with ventricular arrhythmias and is recommended to undergo cardiac ablation as a treatment option.
  • Patient undergoes pre-procedural testing, such as electrocardiogram (ECG), echocardiogram, and possibly cardiac MRI to assess the extent of the arrhythmia and plan the ablation procedure.
  • Patient is briefed on the procedure, risks, and benefits, and gives consent for the cardiac ablation.
  • On the day of the procedure, patient is admitted to the hospital and prepared for the ablation under sedation or general anesthesia.
  • Cardiac ablation procedure is performed, where catheters are inserted through veins in the groin and guided to the heart to deliver energy (radiofrequency or cryoablation) to the areas causing the arrhythmias.
  • Post-procedure, patient is monitored in the hospital for a few hours to ensure stability and absence of complications.
  • Patient is discharged with instructions on post-procedural care, including restrictions on physical activity and medications to manage any discomfort.
  • Follow-up appointments are scheduled to monitor the effectiveness of the ablation and make any necessary adjustments to the treatment plan.
  • Patient experiences a reduction or elimination of ventricular arrhythmias, leading to improved quality of life and reduced risk of complications associated with the arrhythmias.

What to Ask Your Doctor

  1. What is cardiac ablation and how does it work?
  2. Am I a candidate for cardiac ablation?
  3. What are the potential risks and complications of cardiac ablation?
  4. What is the success rate of cardiac ablation for my specific condition?
  5. How many cardiac ablation procedures have you performed and what is your success rate?
  6. What is the recovery process like after cardiac ablation?
  7. Are there any alternative treatments to cardiac ablation that I should consider?
  8. Will I need to take any medications after the procedure?
  9. How long do the effects of cardiac ablation typically last?
  10. Are there any lifestyle changes I should make after undergoing cardiac ablation?

Reference

Authors: Futyma P, Chen S, Enriquez A, Pürerfellner H, Santangeli P. Journal: J Cardiovasc Electrophysiol. 2023 Dec;34(12):2599-2606. doi: 10.1111/jce.16131. Epub 2023 Nov 15. PMID: 37968834