Our Summary

This research paper reviews the risk of coronary artery injury during a common heart procedure called catheter ablation, which is used to treat irregular heart rhythms. While this procedure is generally safe, there is a small chance it can cause damage to the coronary arteries, which are the main blood vessels supplying the heart. The paper looks at how often this happens, what causes it, factors that might increase the risk, and how doctors can diagnose and prevent this complication. The review covers different types of catheter ablation, including radiofrequency (which uses heat), cryoablation (which uses cold), and pulsed-field ablation.

FAQs

  1. What is catheter ablation and what types of cardiac tachyarrhythmias can it treat?
  2. What are the potential complications of catheter ablation, including coronary artery injury?
  3. What are the diagnostic strategies and preventive measures related to coronary artery injury in patients undergoing catheter ablation?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cardiac ablation is to make sure to follow all pre-procedure instructions, such as fasting before the procedure and stopping certain medications as directed. This can help reduce the risk of complications during the ablation procedure, including potential coronary artery injury. Additionally, it is important to discuss any concerns or questions with your healthcare provider before the procedure to ensure you are well-informed and prepared.

Suitable For

Patients with certain types of cardiac arrhythmias are typically recommended for cardiac ablation, including:

  • Atrial fibrillation: This is the most common arrhythmia treated with cardiac ablation. Ablation is recommended for patients who have symptomatic atrial fibrillation that does not respond to medication or other treatments.

  • Atrial flutter: Ablation may be recommended for patients with atrial flutter, especially if it is recurrent or causes symptoms.

  • Supraventricular tachycardia: Ablation is often recommended for patients with supraventricular tachycardia that is difficult to control with medication.

  • Ventricular tachycardia: Ablation may be recommended for patients with ventricular tachycardia, especially if it is causing symptoms or is associated with other heart conditions.

  • Wolff-Parkinson-White syndrome: Ablation is often recommended for patients with Wolff-Parkinson-White syndrome to eliminate the extra electrical pathway in the heart.

It is important for patients to undergo a thorough evaluation by a cardiologist to determine if they are suitable candidates for cardiac ablation. The decision to undergo ablation is typically based on the type and severity of the arrhythmia, the patient’s overall health, and their individual risk factors.

Timeline

Before cardiac ablation:

  • Patient is diagnosed with a cardiac tachyarrhythmia
  • Patient undergoes various diagnostic tests such as electrocardiogram (ECG), echocardiogram, and possibly a cardiac MRI
  • Treatment options are discussed with the patient, including medication management or catheter ablation
  • Patient may undergo a pre-procedural evaluation to assess their overall health and suitability for the procedure

During cardiac ablation:

  • Patient is admitted to the hospital or outpatient surgical center
  • An intravenous (IV) line is inserted to administer medication and fluids during the procedure
  • Patient is sedated or under general anesthesia
  • A catheter is inserted into a blood vessel, usually in the groin, and guided to the heart
  • Ablation energy (such as radiofrequency or cryoablation) is delivered to the area of the heart causing the abnormal rhythm
  • The procedure typically takes several hours to complete

After cardiac ablation:

  • Patient is monitored in a recovery area for a few hours
  • Patient may experience some discomfort or soreness at the catheter insertion site
  • Patient is discharged home with instructions for post-procedure care, including limitations on physical activity and medications to take
  • Follow-up appointments are scheduled to monitor the patient’s progress and assess the success of the procedure
  • Patient may need to continue taking medications or undergo further ablation procedures if the arrhythmia persists.

What to Ask Your Doctor

  1. What is the success rate of cardiac ablation for my specific arrhythmia?
  2. What are the potential risks and complications associated with cardiac ablation, including coronary artery injury?
  3. How will you ensure the safety of my coronary arteries during the procedure?
  4. What are the symptoms of a potential coronary artery injury after cardiac ablation?
  5. How will you monitor and follow up on my condition after the procedure to prevent or detect any complications?
  6. Are there any specific factors or conditions that may increase my risk of coronary artery injury during cardiac ablation?
  7. What diagnostic tests or imaging studies will be used to assess the health of my coronary arteries before and after the procedure?
  8. What preventive measures can be taken to reduce the risk of coronary artery injury during cardiac ablation?
  9. How experienced are you and your team in performing cardiac ablation procedures, particularly in minimizing the risk of complications such as coronary artery injury?
  10. Are there any alternative treatment options for my condition that may have a lower risk of coronary artery injury?

Reference

Authors: Hasegawa K, Tada H. Journal: Circ J. 2025 May 23;89(6):751-756. doi: 10.1253/circj.CJ-24-0859. Epub 2025 Jan 9. PMID: 39779223