What is a cardiac arrhythmia?
A cardiac arrhythmia, also called dysrhythmia, is an irregular or abnormal heart rhythm.
Electrical system of the heart
The atria and ventricles work together, alternately contracting and relaxing to pump blood through the heart. The electrical system of the heart is the power source that makes this possible.
Normally, the electrical impulse begins at the sinoatrial (SA) node, located in the right atrium. The electrical activity spreads through the walls of the atria, causing them to contract.
Next, the electrical impulse travels through the AV node, located between the atria and ventricles. The AV node acts like a gate that slows the electrical signal before it enters the ventricles. This delay gives the atria time to contract before the ventricles do. From the AV node, the electrical impulse travels through the His-Purkinje network, a pathway of specialized electricity- conducting fibers. Then the impulse travels into the muscular walls of the ventricles, causing them to contract. This sequence occurs with every heartbeat (usually 60-100 times per minute).
What is catheter ablation?
Catheter ablation is a treatment for cardiac arrhythmias. During ablation, a doctor inserts a catheter (thin, flexible tube) into the heart. A special machine delivers energy through the catheter to tiny areas of the heart muscle that cause the abnormal heart rhythm. This energy “disconnects” the pathway of the abnormal rhythm.
Ablation can also be used to disconnect the electrical pathway between the upper chambers (atria) and lower chambers (ventricles) of the heart. The type of ablation performed depends upon the type of arrhythmia.
What types of Rhythms are treated with this procedure?
Normally, the heart’s impulses travel down an electrical pathway through the heart. The atria and ventricles work together, alternately contracting and relaxing to pump blood through the heart. The electrical system of the heart is the power source that makes this possible. Each electrical impulse causes the heart to beat. Catheter ablation can be used to treat:
- AV Nodal Reentrant Tachycardia (AVNRT): An extra pathway lies in or near the AV node, which causes the impulses to move in a circle and re-enter areas it already passed through.
- Accessory Pathway: Extra pathways can exist from birth that connect the atrium and ventricles. The extra pathway causes signals to travel back to the atrium, making it beat faster.
- Atrial Fibrillation and Atrial Flutter: Extra signals originating in different parts of the atrium cause the atria to beat rapidly (atrial flutter) or quiver (atrial fibrillation).
- Ventricular Tachycardia: A rapid, potentially life-threatening rhythm originating from impulses in the ventricles. The rapid rate prevents the heart from filling with enough blood, and less blood is able to circulate through the body.
How successful is catheter ablation?
The type of catheter ablation performed and individual variables affect the success rate of the procedure. Please talk to your doctor about the success you can expect.
Are there any risks?
The catheter ablation procedure is generally very safe. However, as with any invasive procedure, there are risks. Special precautions are taken to decrease these risks. Your doctor will discuss the risks of the procedure.
A thorough evaluation is needed to determine if catheter ablation is an appropriate treatment option for you. This evaluation may include:
- A review of your medical history
- Complete physical examination
- Electrocardiogram (ECG)
- Echocardiogram (Echo)
- Holter monitor test
- Other tests as needed
After the evaluation, your doctor will talk to you about appropriate treatment options and, together, you will decide the best option for you.
How can I schedule an evaluation?
If you are currently being treated outside of Cleveland Clinic, please call the Heart & Vascular Institute resource nurse toll-free at 866.289.6911 or 216.445.9288. The nurse can offer options for evaluation at Cleveland Clinic. Or call Cardiology Appointments at 216.444.6697 or toll-free at 800.223.2273, ext. 46697.
If you are a Cleveland Clinic patient and are receiving treatment for your arrhythmia, talk to your cardiologist about whether catheter ablation is an option for you.