Certain types of rapid heart beats, also known as tachycardias, are caused by abnormal electrical pathways in the heart that disrupt the cardiac electrical signal. ( Read here about the normal cardiac electrical system.) In these cases, if the abnormal pathways can be treated and eliminated, the tachycardia often goes away permanently. How is this done? By something called an ablation procedure.
How Ablation is Performed
Ablation procedures can be performed in the operating room during open-heart surgery, but by far the most common form of ablation is done during a specialized form of cardiac catheterization, performed by a type of doctor known as a cardiac electrophysiologiss (heart rhythm specialists). These procedures are sometimes called "trans-catheter ablations."
During trans-catheter ablation procedures, specialized electrode catheters are positioned inside the heart, and the cardiac electrical system is mapped, showing the abnormal electrical pathways that are often responsible for producing the rapid heart rate. If these abnormal pathways are identified, the tip of the catheter (a tube) is placed on the abnormal pathway and the pathway is ablated (eliminated). The ablation itself is accomplished by transmitting some form of energy through the catheter (heat energy, freezing energy, or microwave energy), in order to damage the tissue at the tip of the catheter.
Pros and Cons of Ablation Surgery
The major advantage of the ablation procedure is that, if successful, the rapid heart beat is completely cured, and should never return. The disadvantage is that it is an invasive cardiac catheterization procedure, so the patient is exposed to all the potential complications of a catheterization.
Ablation procedures can be particularly effective in treating certain types of supraventricular tachycardia (SVT), including the SVTs known as "AV nodal reentrant tachycardia," SVT caused by bypass tracts, and atrial flutter. There are also a few rare forms of ventricular tachycardia that can be treated by ablation techniques.
Treating Atrial Fibrillation With Ablation
Atrial fibrillation presents a special challenge. Ablation procedures aimed at eliminating atrial fibrillation are being developed, and while a few medical centers are reporting reasonable results, these techniques are not fully mature and significant complications remain quite troublesome. On the other hand, ablation procedures aimed not at curing atrial fibrillation but instead at controlling the heart rate, while a fairly drastic step, can be quite effective.
