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Catheter Ablation
A Guided Approach for Treating Atrial Arrhythmias
A
P A T I E N T
H A N D B O O K
This brochure will provide an
overview of atrial arrhythmias
(heart rhythm problems affecting
the upper chambers of the heart)
and catheter ablation, a guided
treatment method that can
improve the quality of your life.
1
What Is an Arrhythmia?
Typically, a healthy heart beats 60 to 80 times per minute during rest. However,
some people have an irregular heart beat or an arrhythmia which can cause the
heart to pump poorly. If you have an arrhythmia, you may feel dizzy or tired
or have other symptoms. An arrhythmia may also put you at increased risk of
stroke, heart attack, or even sudden cardiac arrest depending on the specific type
of rhythm problem.
Arrhythmias can be categorized according to whether they cause a heartbeat that
is too slow, erratic, or too fast and by the location in the heart where the irregular
heart beat starts. This brochure will focus on arrhythmias that originate in the
atria (the upper chambers of the heart).
AF is a very fast,
uncontrolled heart
rhythm. The upper
chambers of the
heart quiver and
do not pump
blood effectively.
2
Your Heart’s Electrical System
Your heart has an “electrical system” that causes it to beat and pump blood and
nutrients throughout your body.
The sinoatrial (SA) node is the electrical control center of the heart and sets the
pace or rhythm of the heart. The SA node starts the electrical stimulation of the
heart muscle. The electrical signal then spreads across the heart’s upper chambers,
causing them to pump.
The electrical signal then travels to the atrioventricular (AV) node in the middle
of the heart, where it is then sent to the lower chambers of heart. After the lower
chambers have finished pumping, the SA node begins the cycle again.
An arrhythmia may result from problems in the SA or AV nodes or in the
electrical pathways throughout the heart.
SA node
AV node
Heart showing the
SA and AV nodes
with normal rhythm.
3
Common Types of
Atrial Arrhythmias
This section will provide a brief overview of the most common types of atrial
arrhythmias treated with catheter ablation, along with the cause and symptoms of
each type.
Atrial Fibrillation
Atrial fibrillation (AF) is a very fast and disorganized heat beat that occurs in the
upper chambers of the heart. During AF, the atria beat between 350 and 600
times per minute. If you have AF, you may experience symptoms such as dizziness,
fatigue, shortness of breath, and palpitations.
During AF, blood does not empty properly from the upper chambers of the heart.
The blood can pool and sometimes clot. This can ultimately lead to a stroke.
Atrial Flutter
Atrial flutter is similar to AF, as it is a fast rhythm that originates within the upper
chambers of the heart, but it is more organized and regular. During atrial flutter,
the upper chambers of the heart can not empty properly. Symptoms of atrial
flutter include palpitations or pounding of the heart. Episodes of atrial flutter can
last for hours or days. Therefore, most people with atrial flutter require treatment.
4
AV Nodal Reentrant Tachycardia
AV nodal reentrant tachycardia (AVNRT) is the term used to describe an
arrhythmia that occurs when an extra electrical pathway is found in or near
the AV node. Many people with AVNRT have a very rapid heart rate (160 to
220 beats per minute). Symptoms include a sensation of chest pressure, i.e.,
pain or shortness of breath, and palpitations. Some people may feel light
headed or even faint.
Wolff-Parkinson-White Syndrome
In Wolff-Parkinson-White (WPW) syndrome there is an abnormal electrical
connection between the atria and ventricles that allows electrical impulses to
bypass the AV node. This accessory pathway or short circuit can cause the
heart to beat very rapidly. WPW syndrome is associated with a slightly
increased risk of sudden cardiac arrest due to dangerous arrhythmias in the
ventricles (lower chambers of the heart).
5
Treatment Goals
Recent advances provide new solutions for the millions of people suffering from
atrial arrhythmias.
The goals of treatment are to:
• Restore a normal heart rhythm
• Control your heart rate
• Reduce the risk of consequences including stroke, heart attack, and sudden
cardiac arrest, depending on the type of arrhythmia that is involved.
Catheter ablation is
performed in a cardiac
catheterization lab, also
known as a cath lab.
6
Treatment Options
Your AF treatment plan may include:
• Medications
A number of different medications may be prescribed to manage your heart’s
rate or rhythm.
• Electrical cardioversion
AF can be treated electrically with a procedure called cardioversion. During
the procedure, an electrical shock is delivered to your heart in order to restore a
normal heart rhythm. The procedure is performed using short-acting anesthesia.
• Catheter ablation
Catheter ablation is a procedure used to remove the tissue responsible for an
atrial arrhythmia. During the procedure, small wires are threaded into the heart
to map its electrical activity and help locate the problem areas. These problem
areas are then burned away (ablated).
• Implantable devices
In select cases of AF, a pacemaker may be implanted after an ablation
procedure to keep the heart rate stable.
• Surgical therapy for AF
Surgical therapy may be an option for people with persistent or permanent
arrhythmias (usually AF) that cannot be managed with drugs or other
therapies. These procedures require open heart surgery and general anesthesia.
For patients who have AF in addition to heart problems requiring surgery, it
may be possible to perform both surgeries at the same time. Surgery is rarely
performed to treat atrial arrhythmias, other than AF.
7
How Is Catheter Ablation
Performed?
Catheter ablation involves inserting several long, flexible tubes called catheters
into your heart. The procedure is performed in a specially equipped room called
an electrophysiology lab. General anesthesia is not required for the procedure.
Medications will be given to relax you and keep you comfortable during
the procedure.
Access to a vein and/or artery is obtained with needles and small tubes, and one or
more catheters are then inserted and threaded into the heart. After the diagnostic
catheters have been placed, they are used to “map” the particular areas of the heart
responsible for your arrhythmia.
In some cases, a small puncture may be made in the wall that separates the left
and right atria in order to navigate a catheter into the left atrium. This is called a
transseptal puncture.
A computer may also be used to generate three-dimensional models of your heart
and map its electrical activity. These models and maps can be used to locate areas
responsible for an arrhythmia more quickly and accurately.
After your arrhythmia has been mapped, a special ablation catheter is inserted
into the heart. Electrical energy is then delivered to precisely targeted areas to
disrupt the abnormal electrical pathways and restore a normal heart rhythm.
8
Special catheters
are used to ablate
precisely targeted
tissue responsible
for AF.
9
After a Catheter Ablation Procedure
After the catheter ablation procedure has been completed, the catheters will be
removed, and you will be monitored in the recovery area. Generally, you will be
allowed to go home either on the day of the procedure or after an overnight stay
in the hospital.
Your doctor will provide you with a follow-up plan. This could include the
continued use of medications and possibly other therapies. Therefore, it is
important to stay in touch with your doctor, keep follow-up appointments,
and take all of your medications as prescribed during the recovery period.
Benefits of Catheter Ablation
• Relief from symptoms.
• In many cases, medications can be reduced or eliminated after
catheter ablation.
• Is a minimally invasive procedure with a low risk of complications
during and after the procedure.
Catheter ablation is a good alternative for patients who still experience
symptoms from atrial arrhythmias, following ineffective drug therapy or
electrical cardioversion.
10
Patient Resources
To learn more about atrial arrhythmias, talk to your doctor. You may also wish to
check the following website:
• Heart Rhythm Society Patient and Public Information Center
The Heart Rhythm Society is a professional society for doctors specializing in
the diagnosis and treatment of heart rhythm problems. This site also includes
extensive patient information on arrhythmias and their diagnosis and treatment
including catheter ablation.
http://tinyurl.com/3a5p6n
11
Notes
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This information was brought to you by:
… in partnership with St. Jude Medical, Inc.
Visit our website: www.sjm.com
For further information, please call:
St. Jude Medical, Inc.
Global Headquarters
One Lillehei Plaza
St. Paul, MN 55117
651 483 2000
Telex: 298453
651 766 3045 Fax
GMAF81EN
©2008 St. Jude Medical.
All rights reserved.
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