Atrial fibrillation – ablation as an effective treatment procedure

Proven content

Severe heart palpitations must be diagnosed and treated. For those who cannot be dealt with by drugs, ablation is effective. – This is a procedure that changes the lives of patients – says Dr. n. med. Paweł Derejko, head of the Department of Cardiology and Internal Diseases at the Medicover Hospital.

Palpitations are a common symptom of arrhythmias, which can sometimes be fatal. Therefore, it is worth consulting such ailment with a doctor. Especially since there are already methods for successfully treating cardiac arrhythmias.

A treatment that changes your life

One of the patients of Dr. Paweł Derejko, a 35-year-old resident of Warsaw, says that a few months ago she would wake up every day with fear about what the next day would bring. All because of arrhythmia – atrial fibrillation, which was a consequence of a heart disease called hypertrophic cardiomyopathy. – It was exhausting. Not only physically but also mentally – he says. Unfortunately, her arrhythmia was immune to all medications. – I lived in constant fear. I couldn’t function normally – he says. Ablation proved to be an effective remedy. – Atrial fibrillation occurs much less frequently. I also no longer have problems with fainting and collapses – he says.

In the rhythm of the heart

Our heart is stimulated to work thanks to electrical impulses generated by the sinoatrial node, which, like a metronome, is responsible for the regularity of the beats. A healthy person’s heart beats at a frequency of 60–80 beats per minute. During sleep, it drops to 40–60 beats, and during exercise, it increases to 90–220. The heart also beats a little faster when we are afraid, nervous or excited. Meanwhile, during an arrhythmia, the heart can beat up to 300 times a minute. – Please try to clench your fist 75 times a minute. This will map the work of the heart. However, when you want to increase the frequency and do it 300 times a minute, your hand will vibrate. The heart that works in this way is unable to pump blood, which may result in cardiac arrest and, consequently, death of the patient, explains Dr. Derejko.

Disrupting arrhythmia

It is estimated that cardiac arrhythmias affect at least 2% of people. society. However, specialists believe that these figures are understated. Arrhythmias have different backgrounds. Sometimes the most dangerous are those we hardly feel at all. Most often, however, those experiencing arrhythmias complain of palpitations and weakness leading to loss of consciousness. Not all arrhythmias are diagnosed by symptoms. It happens that the patient does not feel anything and only auscultation of the heart with a stethoscope or an ECG test enables the diagnosis of arrhythmia.

Severe flickering

Atrial fibrillation is an increasingly serious problem. Currently in Poland it affects at least 400 thousand. people. It is estimated that there will be more and more sick people. This increase is mainly due to the aging of the population, as well as the increasing number of people who are overweight, with high blood pressure, diabetes and lung disease. The flicker itself is not fatal. But it is known that those suffering from this condition die twice as often. The most serious complication of flicker is stroke. One-fourth of patients with blinking die shortly after a stroke, and half within a year of its occurrence. In addition, patients with fibrillation have a worse prognosis in the event of a heart attack or heart failure.

What should worry you?

Palpitations are not always caused by heart conditions. It can also be the result of electrolyte disturbances, e.g. lack of potassium. It happens with diarrhea, vomiting, dehydration due to heat, and also after consuming more alcohol. If palpitations have only occurred once and the cause is known, such as diarrhea, we do not need to go to the cardiologist right away. However, repeated episodes require medical consultation and appropriate tests. If your doctor suspects arrhythmia but has trouble diagnosing it, he or she may perform a specialized electrophysiological (EPS) test. During EPS, electrodes are inserted into the heart through the femoral veins, which stimulate its work and allow the assessment of rhythm and conduction disturbances. The analysis of the obtained results makes it possible to locate the place of the arrhythmia.

Ablation of a selected area of ​​the heart

The ablation procedure is aimed at destroying the basis of the arrhythmia. It is performed in a hospital. If there are no complications, you can go home the next day. The patient is usually conscious during the procedure. However, he is given painkillers. The doctor introduces thin tubes into the vessels on the thigh or neck, and sometimes under the collarbone. vascular sheaths, and through them wires with a thickness of 1,5 mm to 3 mm, called electrodes. The electrode tips heat the heart tissue pointwise to a temperature of about 50-60 ° C. This makes it possible to permanently destroy the arrhythmic focus. In the case of cryoablation, these places are frozen. Sometimes it is a small fragment measuring about 5 mm by 5 mm. Then a short application of energy lasting several dozen seconds can destroy it. Sometimes an area of ​​a few centimeters has to be ablated. Then point by point, even for several dozen minutes, the diseased place is eliminated with electrical impulses. Ablation can take anywhere from 40 minutes to several hours.

Efficient destruction

The decision on how to treat arrhythmias is made by the doctor together with the patient, analyzing the possible benefits and risks. Ablation is performed in both one-year-old children and people over ninety. From year to year, indications for this procedure are getting wider, which results from the effectiveness and safety of this method. In the case of supraventricular arrhythmias, the effectiveness of the procedure exceeds 90%. In patients with atrial fibrillation and ventricular arrhythmias, it fluctuates between 50-90%, depending on the severity of the disease and the degree of structural damage to the heart. In comparison with the effectiveness of pharmacological treatment, which is estimated at 30%, this is a lot. The treatment often allows for complete recovery and allows the discontinuation of medications. It happens, however, that the arrhythmia returns and the ablation has to be repeated. The most serious complications associated with ablation are atrioventricular block requiring pacemaker implantation, stroke, and cardiac tamponade. These complications are very rare and their frequency depends on the severity of the heart disease and the extent of the procedure. Complications occur sporadically in young people without damage to the heart. Less serious complications include those occurring at the site of electrode insertion, e.g. hematoma or arteriovenous fistula at the puncture site

Treatment offered too rarely

In Poland, compared to other European countries, few ablations are performed. For example, the number of surgeries in the Czech Republic is three times greater, while in Germany as many as seven times more. Meanwhile, such a procedure brings the National Health Fund tangible savings. A patient cured in this way does not go to hospital many times, does not have to use reimbursed drugs, and can return to normal life and professional activity. Ablation is a procedure reimbursed by the National Health Fund.