Cardiac ablation

Heart rhythm disorders, medically known as arrhythmias, can significantly impact a person’s health and quality of life. Cardiac ablation is a medical procedure designed to correct these irregular heartbeats by targeting and destroying the heart tissues causing abnormal rhythms.

This guide delves into cardiac ablation in detail, including its types, causes, symptoms, and the different methods used to perform it. Understanding cardiac ablation can empower patients and caregivers to make informed healthcare decisions and seek timely treatment.

Cardiac ablation is a procedure used to correct heart rhythm problems by using energy (radiofrequency, cryotherapy, or laser) to scar or destroy tissues in the heart that are responsible for abnormal electrical signals. These damaged tissues stop sending the errant impulses, allowing the heart to beat normally.

The procedure is typically performed in a catheterisation lab and guided by sophisticated imaging technology. It is especially effective for conditions such as atrial fibrillation (AFib), supraventricular tachycardia (SVT), and Wolff-Parkinson-White syndrome.

India

Cardiac arrhythmias are increasingly recognised in India, particularly due to rising lifestyle-related conditions like hypertension, diabetes, and obesity. Although comprehensive data on cardiac ablation prevalence is limited, the Indian Heart Rhythm Society notes a growing number of patients opting for ablation procedures, especially in urban areas.

Worldwide

Globally, cardiac arrhythmias affect millions of people. According to the World Health Organization (WHO), atrial fibrillation alone affects 33.5 million individuals worldwide. Cardiac ablation is a common treatment option in developed nations and is increasingly available in emerging economies.

• Radiofrequency Ablation: Uses heat generated by high-frequency radio waves to destroy abnormal tissue.
• Cryoablation: Freezes the problematic heart tissue, particularly effective in treating atrial fibrillation.
• Laser Ablation: Uses focused laser energy for precise tissue removal.
• Surgical Ablation (Maze Procedure): Involves creating scar tissue through surgical incisions during open-heart surgery, typically done when another cardiac surgery is also planned.
   

Cardiac ablation is used to treat arrhythmias caused by:

• Electrical Misfiring: Extra or misdirected electrical pathways.
• Structural Abnormalities: Congenital or acquired heart defects.
• Heart Disease: Previous heart attacks or heart failure.
• High Blood Pressure: Causes strain on the heart muscle.
• Lifestyle Factors: Stress, caffeine, alcohol, and tobacco.
• Medications: Certain drugs can trigger arrhythmias as a side effect.

Common signs that may indicate the need for cardiac ablation include:

• Palpitations or fluttering sensation in the chest
• Chest discomfort
• Shortness of breath
• Fatigue or weakness
• Dizziness or light-headedness
• Fainting (syncope)
• Irregular or rapid heartbeat

• Electrocardiogram (ECG): Primary test to identify arrhythmias.
• Holter Monitor: A portable ECG device worn for 24–48 hours.
• Event Recorder: Similar to a Holter monitor but worn longer.
• Echocardiogram: Uses ultrasound to view the heart’s structure.
• Electrophysiological Study (EPS): Invasive test to map electrical activity inside the heart.

The goal of cardiac ablation is to stop the arrhythmia by removing its source. It can be done in combination with medications or as a standalone solution when drugs fail.

Medications

Medications may still be used before or after ablation to manage arrhythmia:

• Antiarrhythmics: Like amiodarone or flecainide to stabilise heartbeat. (Duron 200mg Tablet)
• Beta-blockers: Such as metoprolol to reduce heart rate. (Metored 25mg Tablet)
• Calcium Channel Blockers: Help relax heart muscles.
• Anticoagulants: Like warfarin or apixaban to prevent blood clots, especially in AFib.(Warf 5mg Tablet)

Procedure

1. Preparation: Patients are advised to stop eating and drinking several hours before the procedure.
2. Anaesthesia: Local or general anaesthesia is given.
3. Catheter Insertion: Thin tubes are inserted via a vein in the groin or neck.
4. Mapping: Electrical signals in the heart are recorded to locate the problematic area.
5. Ablation: The targeted tissue is treated with heat, cold, or laser.
6. Monitoring: Heart rhythm is observed post-procedure to assess success.

The entire process may take 2–4 hours and usually involves an overnight hospital stay
 

Though cardiac ablation is effective, some patients may also explore complementary treatments:

• Lifestyle Changes: Avoiding alcohol, quitting smoking, reducing caffeine.
• Stress Management: Yoga, meditation, and breathing exercises.
• Dietary Adjustments: Reducing salt, increasing potassium and magnesium.
• Herbal Remedies: Like hawthorn extract (only under medical supervision).

• Age: Older adults are more susceptible.
• Genetics: Family history of arrhythmia.
• Heart Conditions: Past surgeries or structural issues.
• Diabetes and Hypertension: Elevate risk significantly.
• Obesity and Sedentary Lifestyle: Contribute to the development of arrhythmias.
• Substance Use: Alcohol, recreational drugs, and excessive caffeine.

While generally safe, cardiac ablation may lead to:

• Bleeding or infection at catheter site
• Blood clots or stroke
• Damage to blood vessels or heart valves
• Pericarditis (inflammation of the heart lining)
• Heart block (may require a pacemaker)
• Recurrence of arrhythmia

• Track Symptoms: Keep a diary of irregular heartbeats.
• Adhere to Medications: Follow your doctor’s advice.
• Avoid Triggers: Limit stress and stimulants.
• Stay Active: Moderate physical activity is beneficial.
• Wear a Medical ID: In case of emergencies.
• Join Support Groups: Sharing experiences can provide emotional relief.

• "It’s a major surgery": Most ablations are minimally invasive.
• "Ablation is only for severe cases": It can benefit mild arrhythmias too.
• "The arrhythmia will never return": Some patients may require repeat procedures.
• "You won’t need medication after ablation": Some cases still need drugs.

Seek immediate medical attention if you experience:

• Sudden, irregular, or rapid heartbeats
• Fainting or loss of consciousness
• Shortness of breath or chest pain
• New or worsening palpitations

Early diagnosis and treatment significantly improve outcomes.

• Is cardiac ablation suitable for my condition?
• What risks are involved?
• Will I need more than one procedure?
• What’s the recovery time?
• Will I still need medication?
• What lifestyle changes are recommended?

• Be Informed: Learn about arrhythmias and cardiac ablation.
• Offer Practical Help: Drive them to appointments, help with chores.
• Emotional Support: Listen to their concerns and be patient.
• Encourage Healthy Habits: Support their lifestyle changes.
• Be Prepared: Learn CPR in case of emergencies.

Cardiac ablation is a highly effective and safe method for treating arrhythmias, offering lasting relief for many patients. Understanding the procedure, risks, and lifestyle changes required can empower individuals to manage their heart health more confidently. Early diagnosis, medical guidance, and emotional support are key elements for a successful outcome.