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Radiofrequency ablation
Last reviewed: 23.04.2024
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If the development of tachyarrhythmia occurs due to the presence of a specific pathway or ectopic source of rhythm, this zone can be ablated with a low-voltage high-frequency (300-750 MHz) electric pulse supplied by an electrode catheter. Such energy damages and necroticizes the zone <1 cm in diameter and approximately 1 cm in depth. Before the moment of exposure to an electric discharge, the corresponding zones should be identified by electrophysiological examination.
The frequency of achieving the effect is> 90% with tachycardia re-entry (at the level of the AV-connection or additional pathways), focal atrial tachycardia and flutter, as well as focal idiopathic VT (reentry VT in the area of the outgoing tract of the prostate, left part of the MZV or the legs of the bundle His). Because atrial fibrillation often occurs or is maintained at the level of the arrhythmogenic zone in the pulmonary veins, this zone can be subjected to direct ablation or (more rarely) electrical isolation by ablation of the site of pulmonary veins into the left atrium or at the left atrial level. As an alternative to patients with AF and a high incidence of ventricular contractions, ablation of the AV node can be performed with the implantation of a constant pacemaker. Radiofrequency ablation is sometimes effective for VT refractory to drugs, and IHD.
Radiofrequency ablation is safe. Mortality is less than 1: 2000. Complications include valve damage, embolism, cardiac perforation, tamponade (1%), and abnormal ablation of the AV node.
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