Cardiology
Radiofrequency cardiac ablation
Radiofrequency cardiac ablation (RFA) is a non-pharmacologic method of arrhythmia treatment. Currently, RFA is one of the safe and effective procedures that are used in cases of life-threatening severe arrhythmias, ineffective drug therapy, and resistance to antiarrhythmic drugs.
The procedure of radiofrequency ablation of the heart can be performed in leading clinics in Israel and Germany. World-class specialists with extensive experience work with patients. Dozens of RFA manipulations per day are performed in cardiology centers. The technique is constantly being improved, new protocols and equipment are developed. World innovations in the field of RFA are immediately implemented in specialized clinics in Israel and Germany. Thus, the patient receives the most modern and safe treatment.
The essence of RFA technique
Radiofrequency ablation is a minimally invasive manipulation, the essence of which is the destruction (destruction) of the myocardial area that generates an irregular rhythm. To the arrhythmogenic focus is brought catheter-electrode, which is fed an electric current of low force and high frequency - radiofrequency pulse. As a result of the effect there is a local heating of the tissue with the destruction of cells generating abnormal heart rhythm.
Historical background
The method of radiofrequency ablation was first introduced into practice in the 80-90s of the last century. During this time, scientific and clinical work has been carried out, optimizing the technique and making RFA the safest procedure possible. Currently, radiofrequency ablation is widely used as a method of treatment of arrhythmias not only in adult patients, but also in children. Of all methods of catheter-based destruction of irregular rhythm foci, radiofrequency ablation is considered to be the safest procedure because it has the least impact on healthy myocardial tissue.
Stage of performing RFA
The procedure is performed in a specialized department of endovascular surgery in the radiology operating room. In carrying out RFA involves trained specialists: cardiac surgeons, arrhythmologists, anesthesiologists.
In most cases, RFA does not require anesthesia. Under local anesthesia in the operating room, puncture and catheterization of a large vessel is performed: femoral vein or artery, less often - radial artery. A system of catheter electrodes is guided through an intraducer (a plastic tube with a valve). The electrodes are placed in specific areas of the heart. The position is monitored using ECG monitoring and fluoroscopy.
After the specialists make sure that the electrodes are positioned correctly, an electrophysiologic study (EPI) is performed to identify the pathologically altered area of the myocardium that generates an abnormal rhythm.
To destroy this area, a high frequency current pulse is applied to the electrodes. The distal end of the electrode is equipped with thermal sensors that determine the temperature of tissues, which allows specialists to adjust the mode of operation of the electrode and the duration of exposure. At the end of the procedure, a control EFI is performed. After removing the catheter electrodes, a hemostatic dressing is applied to the puncture site. Usually the duration of the procedure is from two to six hours.
In case of successful radiofrequency ablation, the patient permanently gets rid of arrhythmia and does not need further specific antiarrhythmic therapy.
According to the statistics of foreign clinics in Germany and Israel, the success of RFA is observed in 90% of cases.
Preparation for RFA procedure
Radiofrequency ablation can be performed both in a planned and urgent procedure. For elective RFA, the patient needs to stop taking arrhythmia medications and anticoagulants a few days before the intervention. Usually hospitalization in the hospital is carried out a day before the procedure. The patient is examined by such specialists as a cardiologist-arrhythmologist, cardiac surgeon and anesthesiologist. During the conversation, the doctor will find out what medications the patient is taking, whether there is no allergy to medications, etc. It may be necessary to conduct ECG and ECHO CG (cardiac ultrasound), general clinical tests, coagulogram. The patient will be asked not to drink or eat on the day of the study.
NB! All decisions about the withdrawal of medications should be made only after agreement with the doctor!
Complications of the procedure
Complications possible during RFA include:
- Heart rhythm disturbance
- Thrombosis and embolism
- Bleeding from the puncture site
The patient's condition during the RFA manipulation will be monitored by a team of specialists. Modern monitoring equipment will not allow you to miss the slightest deviations from the norm.
About possible complications in the delayed period, the doctor will inform the patient in detail and give recommendations on how to minimize the risks.
Usually discharge from the hospital occurs the day after RFA, or (less often) on the day of manipulation.
The procedure of radiofrequency ablation of the heart can be performed in leading clinics in Israel and Germany.
World-class specialists with extensive experience work with patients. Dozens of RFA manipulations per day are performed in cardiology centers. The technique is constantly being improved, new protocols and equipment are developed. World innovations in the field of RFA are immediately implemented in specialized clinics in Israel and Germany. Thus, the patient receives the most modern and safe treatment.
