Our Summary

This study looks at how well a certain treatment method (catheter ablation) works for different types of heart rhythm problems, using data from Swedish health records. Catheter ablation is a procedure that is often used to treat heart rhythm problems. It involves inserting a thin tube (catheter) into a blood vessel, guiding it to the heart, and then using heat or cold energy to “burn” or “freeze” tiny areas of the heart that are causing the problem.

The study collected data from over 26,000 patients who underwent this procedure in Sweden from 2006 to 2015. It found that the types of heart rhythm problems being treated have changed over time, with an increase in more complex cases. Also, the use of X-ray imaging (fluoroscopy) during the procedure has decreased significantly.

The success rate of the procedure varied depending on the type of heart rhythm problem. For example, patients with a condition called atrial fibrillation (an irregular, often rapid heart rate) had the highest rate of needing a repeat procedure (41% within 3 years). Overall, the rate of complications or side effects from the procedure was low, and death soon after the procedure was very rare.

Overall, the study suggests that catheter ablation has become more effective for treating atrial fibrillation over time, and that it is a safe procedure.

FAQs

  1. What is catheter ablation and how does it work?
  2. How has the use of catheter ablation evolved over time according to the Swedish health records study?
  3. According to the study, how successful is catheter ablation in treating different types of heart rhythm problems, specifically atrial fibrillation?

Doctor’s Tip

A doctor might tell a patient considering cardiac ablation that it has been shown to be an effective and safe procedure for treating certain types of heart rhythm problems, such as atrial fibrillation. They may also explain that the success rate of the procedure can vary depending on the specific condition being treated and that the risk of complications or side effects is low. It is important for patients to discuss their individual case with their healthcare provider to determine if cardiac ablation is the right treatment option for them.

Suitable For

Patients who are typically recommended for cardiac ablation include those with:

  1. Atrial fibrillation (AFib): This is the most common type of heart rhythm problem treated with catheter ablation. AFib can cause symptoms such as palpitations, shortness of breath, and fatigue.

  2. Supraventricular tachycardia (SVT): SVT is another common type of heart rhythm problem that can be treated with catheter ablation. It causes episodes of rapid heart rate that can be uncomfortable or concerning.

  3. Ventricular tachycardia: This is a more serious type of heart rhythm problem that originates in the lower chambers of the heart (ventricles). Catheter ablation may be recommended for patients with recurrent or sustained ventricular tachycardia.

  4. Atrial flutter: Atrial flutter is a type of abnormal heart rhythm similar to AFib but with distinct characteristics. It can also be treated with catheter ablation.

  5. Wolff-Parkinson-White syndrome: This is a congenital condition where there is an extra electrical pathway in the heart that can cause rapid heart rates. Catheter ablation is often recommended to correct this issue.

  6. Other arrhythmias: There are many other types of heart rhythm problems that may benefit from catheter ablation, including atrial tachycardia, atrial tachycardia, and others.

Overall, the decision to recommend cardiac ablation will depend on the specific type of heart rhythm problem, the severity of symptoms, and the individual patient’s overall health and medical history. It is important to consult with a cardiologist or electrophysiologist to determine if catheter ablation is the right treatment option for a particular patient.

Timeline

Before cardiac ablation:

  1. Patient experiences symptoms of heart rhythm problems such as palpitations, dizziness, chest pain, or shortness of breath.
  2. Patient undergoes diagnostic tests such as an electrocardiogram (ECG) or a Holter monitor to confirm the heart rhythm problem.
  3. Patient may try medications to manage the symptoms, but if they are ineffective, they may be recommended for cardiac ablation.

After cardiac ablation:

  1. Patient undergoes pre-procedure testing such as blood tests, imaging scans, and an evaluation by the cardiologist.
  2. Patient is prepared for the procedure which involves inserting a catheter into the heart through a blood vessel in the groin or arm.
  3. During the procedure, the cardiologist uses heat or cold energy to ablate (destroy) the problematic areas of the heart causing the rhythm problem.
  4. Patient is monitored closely post-procedure for any complications and may stay in the hospital overnight for observation.
  5. Patient is discharged with instructions for recovery, including restrictions on physical activity and follow-up appointments with the cardiologist.
  6. Patient experiences a recovery period with some discomfort or fatigue, but symptoms of the heart rhythm problem should improve over time.
  7. Patient follows up with the cardiologist for ongoing monitoring and may require additional procedures or adjustments to medications based on the success of the ablation.

What to Ask Your Doctor

  1. What specific type of heart rhythm problem do I have, and how does catheter ablation help to treat it?
  2. What are the potential risks and complications associated with catheter ablation?
  3. What is the success rate of catheter ablation for my specific condition?
  4. How many catheter ablation procedures have you performed for this particular heart rhythm problem?
  5. Are there any alternative treatment options available for my condition?
  6. What is the recovery process like after undergoing catheter ablation?
  7. How long will I need to stay in the hospital after the procedure?
  8. Will I need to take any medication or make any lifestyle changes following the procedure?
  9. How often will I need to follow up with you after the procedure?
  10. Are there any long-term effects or considerations I should be aware of after undergoing catheter ablation for my heart rhythm problem?

Reference

Authors: Holmqvist F, Kesek M, Englund A, Blomström-Lundqvist C, Karlsson LO, Kennebäck G, Poçi D, Samo-Ayou R, Sigurjónsdóttir R, Ringborn M, Herczku C, Carlson J, Fengsrud E, Tabrizi F, Höglund N, Lönnerholm S, Kongstad O, Jönsson A, Insulander P. Journal: Eur Heart J. 2019 Mar 7;40(10):820-830. doi: 10.1093/eurheartj/ehy709. PMID: 30452631