Rhythmologie

Treatment involving ablation

Ablationen können harmlose bis lebensgefährliche Herzrhythmusstörungen beheben, insbesondere da, wo Medikamente nicht mehr hilfreich sind und eine herzchirurgische Operation vermieden werden kann.

[Translate to Englisch:] Ablation im EPU-Labor, Herzzentrum Leipzig

Ablation can put a stop to cardiac arrhythmia, whether harmless or life-threatening, especially when medication is no longer alleviating the condition and it is possible to avoid heart surgery in this way.

Cardiac ablation is one of the most frequently used and effective interventions performed at the Heart Center Leipzig to alleviate and correct cardiac arrhythmia. Every year, our team performs some 2,400 catheter ablations and electrophysiological examinations.

Ablation is especially effective in cases where drugs are not working (any longer). It is performed most commonly to treat atrial fibrillation, but there are other areas of application too for its use here at the Heart Center.

Ablation on the heart is typically performed using catheters. These reach the heart through a blood vessel, either in the groin or in an arm. Electromagnetically generated heat or cold is then applied through the tip of the catheter, depending on the method used. The lesions created on the tissue when the heat or cold is applied by the catheter prevent the abnormal cardiac pulses from continuing to be transmitted.

Below is a brief description of the use of ablation to treat various conditions; these procedures are all performed frequently at our clinic.

  • AV nodal reentry tachycardia, or AVNRT, is a benign type of cardiac arrhythmia in which the heart suddenly begins to beat faster, albeit regularly, before returning to normal again.
  • Heating the catheter and proceeding with the almost imperceptible ablation of the pathways responsible produces a very satisfactory outcome in the large majority of cases.
  • Once treatment is complete, a pressure dressing will be applied and you will be on bedrest for a few hours.
  • You will normally be able to leave the clinic on the same day, but should avoid any exertion for another week.
  • In ca. 95% of cases, there is no recurrence of the symptoms.

Persons affected by WPW (Wolff-Parkinson-White) syndrome are born with an additional electrical pathway between the atria and ventricles of the heart. Possible symptoms include a racing heart, even at a young age. If this occurs frequently and drugs are unable to help, ablation may prove a useful solution.

First, an electrophysical examination is carried out to measure the excitation and conduction of the cardiac arrhythmia. Ablation is then performed on the respective fiber and intense heat generated electrically, causing the fiber bundle to lose its conductivity.

Ectopic atrial tachycardia, or EAT, is a relatively rare form of cardiac arrhythmia. This is triggered by 'misfiring spark plugs' in the atrium, which can give rise to severe symptoms.

To treat the condition, the interior wall of the atrium must be scanned and 3D mapping performed. Once it is found, the focus of the arrhythmia can be localized and ablated in a targeted manner.

Ablation is used for ventricular extrasystoles (VES), i.e. extra beats that interrupt the regular rhythm of the heart. If drugs are no longer helping to control the symptoms, which are generally benign, then ablation may present an alternative solution.

When deciding which form of treatment is appropriate, it is important to establish where precisely in the heart the extrasystoles are originating, and how often they are being registered during 24-hour ECG monitoring.

Actual treatment in the EP laboratory involves passing an electrode catheter from the groin to the heart and using high-frequency current to ablate the focus of the arrhythmia.

Ablation for ventricular tachycardia (VT) can assist with a potentially fatal form of cardiac arrhythmia. This sinister, recurrent malfunction originates in the ventricle and can cause sudden cardiac arrest.

One of the treatment options is defibrillator implantation (ICD), and another - if the circumstances are appropriate - is ablation for ventricular tachycardia.

Our specialists use 3D mapping to establish the cause of the arrhythmia. If it is identified as ventricular tachycardia, which always originates from the same focus, then ablation may be used to treat the condition. The procedure used is similar to that described for other ablation interventions.

WHAT HAPPENS DURING ABLATION?

What all types of ablation have in common is their basic procedure: they use heat or cold to create lesions (scars) in specific locations. Muscle excitation, which is responsible for the presence of cardiac arrhythmia, is blocked by targeting the respective cells of the myocardium. The result we are aiming for is to see the heart beating normally once again. And the great advantage? Unlike many forms of drug therapy, ablation addresses the causes and not just the symptoms of the condition.

Ablation for atrial fibrillation

As ablation is most commonly used in patients suffering from atrial fibrillation, we have compiled detailed information about this form of treatment.

Terminvergabe zur stationären Aufnahme – Rhythmologie

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EP Laboratory
EP Laboratory

Ablation is performed in our laboratory for electrophysiological examinations: the EP laboratory. The Heart Center has one of the largest such laboratories in the world.

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