Heart palpitations? Let's talk about Cardiac Ablation!

Do you sometimes feel your heart beating faster, or your heartbeat skipping, or beating in a strange way? Sometimes this can come with chest tightness and dizziness. In medical terms, this kind of heart rhythm disturbance is called 'Arrhythmia'. Even with medication, this condition can sometimes be difficult to control. But don't worry, there is a very effective, non-invasive treatment for this. That treatment, that is, Cardiac Ablation, is what we are going to talk about today.

Simply put, what is cardiac ablation?

Imagine that there is a small 'short' or faulty 'wiring' somewhere in the electrical system of your home. Then the light does not stay on but 'blinks', or it suddenly goes out, right? That's what happens in our heart. Our heart beats with a delicate system of electrical signals. If these electrical signals start in the wrong place, or if they go the wrong way, the heartbeat becomes erratic.

Cardiac Ablation (also called Catheter Ablation) is a treatment that finds a very small area of ​​tissue in the heart that is causing the abnormal electrical signals and turns it off. This is not a major operation. A cardiologist inserts a very thin, flexible tube (this is what we call a catheter ) into your heart through a large blood vessel in your groin, arm, or neck.

Then, using instruments at the end of this catheter, the area of ​​heart tissue with the problem is treated. There are several ways to do this:

• Radiofrequency Ablation: Radiofrequency waves (heat) are used to heat the tissue, creating a small scar.
• Cryoablation: Using extreme cold, the tissue is frozen, creating a scar.
• Pulsed Field Ablation: This uses very short waves of electrical energy to destroy the tissue.

Because of the small scar created in this way, the faulty electrical signal cannot travel beyond that point. It's like putting insulation tape over the short circuit in your house. Then your heart rate returns to normal. You won't feel any pain during this treatment. You may be given sedation or general anesthesia.

What types of heart conditions does this treatment treat?

Cardiac ablation is primarily used to treat fast heart arrhythmias. This is the best solution when they cannot be controlled with medication or are life-threatening.

Check out the table below to see what the main conditions this treatment is used for.

Additionally, this treatment may be recommended for people who are at high risk of sudden cardiac arrest. Sometimes, to find out exactly where the problem is coming from, doctors perform an electrophysiology study (EP study) before this ablation procedure. This involves using a catheter to measure electrical signals inside the heart.

How should I prepare before treatment?

Once your doctor has decided to perform this treatment, there are a few things you need to do. Your doctor will explain all of this to you clearly.

• Blood thinners: If you are taking blood thinners (e.g., apixaban, rivaroxaban, warfarin), your doctor will tell you how many days before treatment you should stop taking them. Never stop taking these medications without your doctor's advice.
• Food and Drink: You will be asked to refrain from eating or drinking for a few hours before treatment (usually after midnight).
• Someone to drive you home: Arrange in advance for someone to drive you home after treatment.
• Clothing and belongings: Wear comfortable clothing when you come to the hospital. It is best to leave valuables like jewelry and money at home.
• IV line: At the hospital, a small tube (IV line) is inserted into a vein in your arm. This is where you will be given the necessary medications, saline, and anesthetics.

What happens during treatment?

This is actually not as scary as you might think. The whole process goes like this:

1. Preparation: The area where the catheter will be inserted (usually the groin) is shaved, cleaned, and numbed.

2. Inserting the sheath: A small tube (sheath) is inserted through the skin into the blood vessel to create a passageway.

3. Catheter insertion: Fine catheters with electrodes are inserted through the prepared path. These are carefully guided to the heart without X-ray guidance.

4. Mapping the problem: Once inside the heart, the signals coming from the catheter are looked at to find the exact location of the faulty electrical signals (mapping).

5. Treatment (Ablation): Once the right location is found, as mentioned earlier, the tissue is treated and deactivated using heat, cold, or other energy.

6. Completion: After the treatment is complete, the catheter and sheath are carefully removed and a plug or suture is placed to stop the bleeding.

The entire process usually takes between 2 and 4 hours, but sometimes it can take longer.

What happens after treatment?

After the treatment, you will be taken to a recovery room for a few hours. A nurse will continue to monitor your condition. Depending on your condition, you may be able to go home the same day, or you may need to stay in the hospital overnight.

When you go home, you will be given some instructions to follow at home. You may be asked to take blood thinners to prevent blood clots. Depending on your medical history, you may need to take these medications for several months or longer.

What are the benefits and risks of this treatment?

Like any treatment, this has both benefits and minor risks.

Benefits

• This is not a major surgery. There is no need to bandage the chest. So you can recover quickly.
• It provides the opportunity to permanently cure heart rhythm disorders that cannot be controlled with medication.
• Some can save lives from life-threatening situations.
• You can get rid of the side effects of medications.

Risks

The risks of cardiac ablation are very low. Complications are rare, especially in an experienced hospital that performs this treatment frequently. But it's good to be aware.

• Blood clots
• Damage to the blood vessel where the catheter was inserted
• Damage to heart tissue or valves
• Infection or bleeding
• Stroke
• Need for a permanent pacemaker (very rare)

When should I start working normally again?

Your recovery may vary from person to person.

• Going back to work: If you do a non-physical job, such as lifting weights, you can go back to work in about a week.
• Heavy lifting: Avoid lifting anything heavier than 10 pounds (about 4.5 kg) for at least a week.
• Exercise and driving: Ask your doctor about the best time to resume exercise and driving.

What symptoms should I see a doctor for?

If you experience any of the symptoms below when you go home after treatment, you should call your doctor immediately . Some cases may require immediate treatment at the hospital's Emergency Department (ETU).

Finally, it is normal to feel a little nervous or anxious about having surgery or treatment for your heart. However, Cardiac Ablation is a safe, low-risk procedure that has been used successfully to treat many people with heart rhythm problems. If you have any questions about this, please ask your doctor. Once you understand the procedure, your fears will be alleviated.

Cardiac Ablation, Heartbeat, Heart Disease, Arrhythmia, Atrial Fibrillation, Heart Treatment, Catheter Ablation