Cardiology: Radiofrequency Ablation (RFA) to Treat Atrial Fibrillation (FlutTER)
Atrial flutter is frequent (up to 400 per minute) rhythmic contractions of the atria. According to statistics, the problem is detected in approximately 1% of cardiac patients. The reason for this condition is appearance of a pathological wave of pulses circulating through the myocardium repeatedly. Pathology treatment depends on its type. For the chronic form of flutter, the physician may recommend radiofrequency ablation (RFA).
The method implies destruction (ablation) of a pathological focus of excitation with a high frequency current. The procedure is performed through a catheter, which is applied to the desired location under the X-ray monitoring. Therefore, the ablation is called "catheter ablation". The normal heart rhythm after RFA is restored in 80% cases.
The following conditions may become an obstacle to surgery:
- blood clots in the atria,
- uncorrected cardiac pathology,
- severe extracardiac diseases,
- electrolyte disorders.
On the eve of RFA, all patients are prescribed:
- 12-lead ECG,
- 24h (Halter) ECG monitoring,
- transesophageal echocardiography (to rule out the atrial thrombosis)
- ultrasound of large vessels (upon suspicion for the presence of blood clots)
- a set of laboratory tests (coagulation, blood tests for HIV, hepatitis and so on).
At the planning stage, the heart surgeon holds a discussion with the patient.
The intervention is performed without incisions. Through a vein in the thigh, the physician brings the catheter with electrodes to the right atrium. After identification of arrhythmogenic areas, they are exposed to RF energy. Manipulation precision is monitored by X-rays. During surgery, the patient remains in the waking state and follows the surgeon’s instructions.
After the procedure, the catheter is removed, and a pressure bandage is applied on the puncture site. The patient is transported to the ward. He is prescribed bed rest for a few hours. When the patient feels good, s/he is discharged from the hospital in 1 or 2 days.
After the Procedure
In order to prevent complications, the patient is recommended to take anticoagulants for 3 months. To determine the RFA effectiveness, the ECG monitoring is carried out. During the first year, the follow-up examinations are repeated every 3 months, and during the next 2 years, every 6 months. Upon successful outcome of the procedure, the patient does not need drug therapy.Hide