Surgical Procedures for Heart Irregularities: Varieties, Potential Complications, Preparation and Further Details
Cardiac ablation is a medical procedure used to correct arrhythmia, a problem with the rhythm of a person's heartbeat. This article provides an overview of the main types of cardiac ablation procedures, their benefits, and potential risks.
Radiofrequency Catheter Ablation (RFA)
RFA is the most common type of ablation, particularly for atrial fibrillation (A-fib). It uses radio waves to deliver heat that destroys heart tissue causing misfiring electrical signals. Long-term success rates for A-fib range from about 50% to 80%, influenced by patient factors like age, atrial size, and AF duration. RFA is often performed minimally invasively with a catheter inserted through a vein.
Cryoablation
Cryoablation uses extreme cold to destroy heart tissue. It is applied often in A-fib and can offer a “one-shot” approach due to the circular shape of the cryocatheter, which can simplify pulmonary vein isolation. Success rates are comparable to RFA, though detailed rates depend on patient specifics.
Pulsed-Field Ablation (PFA)
PFA is a novel, non-thermal technique using rapid high-voltage electrical pulses to create pores in cell membranes, leading to cell death. It significantly lowers the risk of damage to adjacent structures like the esophagus or phrenic nerve compared to RFA or cryoablation. PFA has become an emerging preferred technique, improving both safety and procedure time.
Maze Procedure (Surgical)
The maze procedure, usually done alongside other open-heart surgeries, creates scar tissue in the atria to block erratic electrical signals causing A-fib. It is more invasive, used for severe or refractory cases or combined with other heart surgeries.
Success Rates for Ablation Depending on Arrhythmia Type
| Arrhythmia Type | Typical Success Rate after Ablation | Notes | |----------------------|-------------------------------------------------------|-----------------------------------------------| | Atrial Fibrillation | 50% - 80% (varies with ablation type and patient) | Lower than others due to complex arrhythmia | | Atrial Flutter | >90% | Generally easier to ablate, high success | | Supraventricular Tachycardia (SVT) | >90% | High success and low recurrence |
Procedure Details
Catheter ablation involves inserting long, thin tubes called catheters into blood vessels to destroy disruptive cells in the heart. It usually lasts between 2 and 4 hours and takes place in a hospital or designated lab, with the person remaining conscious but receiving intravenous medication to cause drowsiness. For catheter ablation, people can resume most of their regular activities the day after they return from the hospital, but they should not drive or drink alcohol for 24 hours and avoid strenuous physical activity for around 3 days.
Surgical ablation, also known as the Cox-maze procedure, aims to eliminate atrial fibrillation (A-fib) and is often performed during surgery for additional heart problems. It requires general anesthesia and may involve spreading the person's ribs and putting their heart on a heart-lung bypass machine. For surgical ablation, people need 5-7 days of hospitalization and a 4-week recovery period.
Hybrid surgical-catheter ablation combines catheter ablation with the mini-maze procedure. It does not require a cardiopulmonary bypass, reducing the risks associated with other kinds of surgery. People stay in the hospital for 2-5 days, and recovery takes about 2 weeks.
It is advisable for a person preparing for cardiac ablation surgery to refrain from smoking for 2 weeks before the surgery, not eat or drink the night before the procedure, not wear scented products on the day of the surgery, and gather relevant identification and insurance documents, a complete list of medications and supplements, and cases to store eyeglasses or dentures. Tests before the procedure may include a blood test, a urine test, an electrocardiogram, and an X-ray.
Cardiac ablation is generally a low-risk procedure, but the risks vary with each type of treatment. It carries a chance of damage to the heart, blood vessels, and nearby body parts, as well as destabilization of the heart's electrical system. Surgical ablation, being a form of open-heart surgery, involves the risks associated with surgeries of this kind, including bleeding, stroke, infection, reaction to anesthetics, and potentially fatal damage to the heart.
The outlook for people who have cardiac ablation surgery is generally positive, with a study finding a 68.6% success rate 1 year after individuals with A-fib had one procedure, a 61.1% success rate at 3 years, and a 62.3% success rate at 5 years.
[1] Cardiac Ablation: What to Expect [2] Radiofrequency Catheter Ablation [3] Cryoablation [4] Pulsed-Field Ablation [5] Cox-Maze Procedure
- The maze procedure, a surgical heart procedure, is often performed alongside other open-heart surgeries for severe or refractory cases of atrial fibrillation (A-fib).
- In science, cardiac ablation is a medical-health and wellness solution used to correct arrhythmia, a problem with the rhythm of a person's heartbeat, particularly for atrial fibrillation (A-fib).
- Radiofrequency catheter ablation (RFA), the most common type of ablation for atrial fibrillation (A-fib), uses radio waves to deliver heat that destroys heart tissue causing misfiring electrical signals.
- Other heart procedures, such as cryoablation and pulsed-field ablation (PFA), are non-thermal alternatives to RFA, offering lower risks of damage to adjacent structures and improving safety, but their success rates may vary depending on patient specifics.
- Cancer treatment and various medical-conditions, including other heart diseases like atrial flutter and supraventricular tachycardia (SVT), may benefit from heart procedures like cardiac ablations, as they demonstrate high success rates and low recurrence rates in treating arrhythmia.
