Many arrhythmias (abnormal heart rhythms) are caused by abnormal electrical pathways or abnormal cardiac (heart) cells that stimulate the heart. Radiofrequency ablation is a procedure which is used to identify the site of the abnormal rhythm and deliver radiofrequency energy to the site of the arrhythmia and potentially cure the arrhythmia.
The most common type of RFA (radiofrequency ablation) is used to treat supraventricular arrhythmias (SVT’s) such as WPW (Wolff Parkinson White) syndrome which is an abnormal electrical connection between the top and bottom chambers which some are born with which suddenly causes the heart to race or AVNRT (a v node reentrant tachycardia) which is an abnormal electrical connection which can develop with age. Other arrhythmias from the top of the heart such as atrial tachycardia, atrial flutter, and atrial fibrillation are also potentially amenable to ablation. Some types of Ventricular Tachycardia (VT), especially those arising from the right side of the heart are also able to be treated with ablation.
The procedure involves identifying the site of the arrhythmia during an EP (electrophysiology) study and threading a small catheter usually from the vein in the groin to the site of the abnormal rhythm. A radiofrequency generator then heats the tip of the catheter, or a cryocatheter freezes the tip of the catheter to terminate the ability of the area to conduct the electrical impulse and cause the arrhythmia.
The procedure is done similarly to the EP study, in the EP lab, under local anesthesia, with conscious sedation and generally takes about two hours. Atrial Fibrillation ablation procedures are done under general anesthesia and generally take four to six hours. Success rates of most ablations such as SVT can run over 95%, with procedures done as outpatients. Given the very high success rates and low complication rates it is often recommended as the first line of therapy of many arrhythmias.
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