Cardiac Ablation

Cardiac ablation is a procedure performed for the correction of arrhythmias or heart rhythm problems. Cardiac ablation helps in the elimination or scarring of the heart tissue that is causing an arrhythmia. It helps in stopping the unusual electrical signals moving through the heart and causing an uneven heartbeat.

Types:
The different types of cardiac ablation are:
1. Catheter ablation:
Long, thin tubes, known as catheters, are inserted into the blood vessels to destroy the disruptive cells in the heart.
This can be done by radiofrequency ablation (using radiofrequency energy similar to the heat from the microwave) or cryoablation (by freezing the tissues).

2. Surgical ablation:
This procedure is normally performed while a patient is having surgery for other heart problems.
It can be performed in the following different ways:

  • Maze procedure: This procedure involves making small cuts in the upper part of the heart, and then stitching them together to form scar tissue.
  • Mini maze: Many small cuts are made between the ribs and a camera is used to perform catheter ablation.

3. Hybrid surgical-catheter ablation:
This procedure combines catheter ablation and a mini maze procedure.

Know More About Surgery

Cardiac ablation is done in the following cases:

  • Supraventricular tachycardia (the heart beats much faster than its normal heart rate, starting above the two lower heart chambers)

  • Atrial flutter (when the upper chambers of the heart beat too rapidly)

  • Atrial fibrillation (a rapid, irregular heart rate causing a poor flow of blood)

  • Heart attack caused due to arrhythmia

  1. Physical examination: The heartbeat of the patient is checked using a stethoscope. The patient’s symptoms, medical history, and family history are taken down.

  2. Blood tests and urine tests: These tests help in checking for any underlying diseases or infections.

  3. Chest x-ray, cardiac MRI, and cardiac CT angiography: These are imaging tests done to obtain clear images of the heart and the blood vessels in and around the heart.

  4. Electrocardiogram (ECG): It helps in recording the electrical activity of the heart and checking if there are any heart problems.

  5. Echocardiogram: Sound waves for creating images of the heart in motion.

  6. Transesophageal echocardiogram: An ultrasound probe is placed down the throat to make sure that there are no blood clots present before cardiac ablation is performed.

 

The procedure for the different types of cardiac ablations are as follows:
1. Catheter ablation:

  • Certain medications are injected into the veins (given intravenously) of the patient.
  • The patient will feel drowsy during the procedure due to the medicines injected.
  • The surgeon inserts a thin tube, known as a catheter, through the groin area, and the catheter is then guided to the heart using imaging tests.
  • Once the catheter reaches its desired position, the pulses of energy (either cold or heat) are provided to kill the abnormal cells in that area.
  • This procedure takes approximately 2 to 4 hours to complete.

2. Surgical ablation:

  • This procedure is done under general anesthesia (the patient is completely asleep during the procedure).
  • The surgeon makes a cut or incision on the inside of the heart to create scar tissue.
  • This scar tissue restores the balance to the electrical system of the heart.
  • In some cases, a heart-lung bypass machine is required to take over the function of the heart and lungs.
  • However, all surgeries will not require a bypass machine.

3. Hybrid surgical-catheter ablation:

  • Two procedures will be performed in this type of treatment.
  • Small cuts are made by the doctor on the side of the chest, and a catheter ablation procedure is then performed.
  • Both the procedures can be done during a single stay in the hospital, or can be spaced out.

The different complications, depending on the type of procedure performed, may include:

1. Catheter ablation: 

  • Damage to the blood vessels
  • Damage to the heart
  • Damage to the nearby organs and tissues of the body
  • Electrical system of the heart gets destabilized

2. Surgical ablation: 

  • Infection
  • Bleeding
  • Allergic reactions to an anesthetic agent
  • Blood clot formation
  • Stroke (the blood supply to the brain is stopped)
  • Heart attack
  • Death

3. Hybrid surgical-catheter ablation: 

  • Damage to the nearby heart, blood vessels, and tissues
  • Destabilization of the electrical system of the heart

 

The post-procedure recovery and healing depend on the type of procedure performed. The post-procedure steps for each type of procedure are as follows:

1. Catheter ablation:

  • The procedure is done on an outpatient basis, that is, the patient goes home on the same day of the procedure.
  • The patient needs to keep the legs straight for six to eight hours after the procedure, and only then get out of bed.
  • The patient can resume his/her daily activities on the next day of the procedure.
  • Avoid heavy lifting and strenuous activities for at least three days after the procedure.
  • Avoid driving for at least one day after the procedure.
  • Avoid the consumption of alcohol at least one day after the procedure.

2. Surgical ablation:

  • The patient usually stays in the hospital five to seven days after the surgical ablation.
  • Avoid heavy lifting and strenuous activities during the recovery period.
  • Complete recovery may take about a month.
  • All the post-surgery instructions about diet, medications, and lifestyle that are given by your doctor should be followed.
  • It may take approximately three months before the results of the procedure become visible.

3. Hybrid surgical-catheter ablation:

  • The patient needs to stay in the hospital for two to five days after this procedure.
  • Complete recovery may take about fifteen days.

Cardiac Ablation Cost in Bengaluru

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Cardiac Ablation

Cardiac ablation is a procedure performed for the correction of arrhythmias or heart rhythm problems. Cardiac ablation helps in the elimination or scarring of the heart tissue that is causing an arrhythmia. It helps in stopping the unusual electrical signals moving through the heart and causing an uneven heartbeat.

Types:
The different types of cardiac ablation are:
1. Catheter ablation:
Long, thin tubes, known as catheters, are inserted into the blood vessels to destroy the disruptive cells in the heart.
This can be done by radiofrequency ablation (using radiofrequency energy similar to the heat from the microwave) or cryoablation (by freezing the tissues).

2. Surgical ablation:
This procedure is normally performed while a patient is having surgery for other heart problems.
It can be performed in the following different ways:

  • Maze procedure: This procedure involves making small cuts in the upper part of the heart, and then stitching them together to form scar tissue.
  • Mini maze: Many small cuts are made between the ribs and a camera is used to perform catheter ablation.

3. Hybrid surgical-catheter ablation:
This procedure combines catheter ablation and a mini maze procedure.

Symptoms

Cardiac ablation is done in the following cases:

  • Supraventricular tachycardia (the heart beats much faster than its normal heart rate, starting above the two lower heart chambers)

  • Atrial flutter (when the upper chambers of the heart beat too rapidly)

  • Atrial fibrillation (a rapid, irregular heart rate causing a poor flow of blood)

  • Heart attack caused due to arrhythmia

Diagnosis

  1. Physical examination: The heartbeat of the patient is checked using a stethoscope. The patient’s symptoms, medical history, and family history are taken down.

  2. Blood tests and urine tests: These tests help in checking for any underlying diseases or infections.

  3. Chest x-ray, cardiac MRI, and cardiac CT angiography: These are imaging tests done to obtain clear images of the heart and the blood vessels in and around the heart.

  4. Electrocardiogram (ECG): It helps in recording the electrical activity of the heart and checking if there are any heart problems.

  5. Echocardiogram: Sound waves for creating images of the heart in motion.

  6. Transesophageal echocardiogram: An ultrasound probe is placed down the throat to make sure that there are no blood clots present before cardiac ablation is performed.

 

Treatment

The procedure for the different types of cardiac ablations are as follows:
1. Catheter ablation:

  • Certain medications are injected into the veins (given intravenously) of the patient.
  • The patient will feel drowsy during the procedure due to the medicines injected.
  • The surgeon inserts a thin tube, known as a catheter, through the groin area, and the catheter is then guided to the heart using imaging tests.
  • Once the catheter reaches its desired position, the pulses of energy (either cold or heat) are provided to kill the abnormal cells in that area.
  • This procedure takes approximately 2 to 4 hours to complete.

2. Surgical ablation:

  • This procedure is done under general anesthesia (the patient is completely asleep during the procedure).
  • The surgeon makes a cut or incision on the inside of the heart to create scar tissue.
  • This scar tissue restores the balance to the electrical system of the heart.
  • In some cases, a heart-lung bypass machine is required to take over the function of the heart and lungs.
  • However, all surgeries will not require a bypass machine.

3. Hybrid surgical-catheter ablation:

  • Two procedures will be performed in this type of treatment.
  • Small cuts are made by the doctor on the side of the chest, and a catheter ablation procedure is then performed.
  • Both the procedures can be done during a single stay in the hospital, or can be spaced out.

Risks

The different complications, depending on the type of procedure performed, may include:

1. Catheter ablation: 

  • Damage to the blood vessels
  • Damage to the heart
  • Damage to the nearby organs and tissues of the body
  • Electrical system of the heart gets destabilized

2. Surgical ablation: 

  • Infection
  • Bleeding
  • Allergic reactions to an anesthetic agent
  • Blood clot formation
  • Stroke (the blood supply to the brain is stopped)
  • Heart attack
  • Death

3. Hybrid surgical-catheter ablation: 

  • Damage to the nearby heart, blood vessels, and tissues
  • Destabilization of the electrical system of the heart

 

After Procedure

The post-procedure recovery and healing depend on the type of procedure performed. The post-procedure steps for each type of procedure are as follows:

1. Catheter ablation:

  • The procedure is done on an outpatient basis, that is, the patient goes home on the same day of the procedure.
  • The patient needs to keep the legs straight for six to eight hours after the procedure, and only then get out of bed.
  • The patient can resume his/her daily activities on the next day of the procedure.
  • Avoid heavy lifting and strenuous activities for at least three days after the procedure.
  • Avoid driving for at least one day after the procedure.
  • Avoid the consumption of alcohol at least one day after the procedure.

2. Surgical ablation:

  • The patient usually stays in the hospital five to seven days after the surgical ablation.
  • Avoid heavy lifting and strenuous activities during the recovery period.
  • Complete recovery may take about a month.
  • All the post-surgery instructions about diet, medications, and lifestyle that are given by your doctor should be followed.
  • It may take approximately three months before the results of the procedure become visible.

3. Hybrid surgical-catheter ablation:

  • The patient needs to stay in the hospital for two to five days after this procedure.
  • Complete recovery may take about fifteen days.

FAQ Section

1) What is catheter ablation?

Catheter ablation is a minimally invasive procedure used in the treatment of arrhythmia or irregular heartbeat caused due to atrial fibrillation. A catheter ablation works by sending radio waves to a specific part of the heart. These waves work by raising the temperature of the part of your heart that is causing the problem.

2) How do you know if this treatment is right for you?

Catheter ablation is recommended as a last resort Atrial Fibration (AFib), only when conservative treatment methods have failed to reduce symptoms and the condition is interfering with your daily life.

Catheter ablation may also be recommended if drugs used to treat the underlying condition cause side effects severe enough for the drugs to be stopped. 

3) What is the process of having this procedure?

First of all, you will need to visit the clinic or hospital where a nurse will provide you information about the procedure and the preparatory measures you will have to take – including what precautions you have to take before the procedure and what drugs and medications to take or avoid before the process.

On the day of the procedure, you will be taken into a prep area where you will have to sign a consent form and the accompanying nurse will answer any further doubts you may have regarding the procedure. 

4) How long does a catheter ablation take?

The procedure can take anywhere from 3-4 hours, depending on the patient’s condition and if any complications occur during the process. This time includes the time required to prepare the patient for the procedure. However, it excludes recovery time.

5) Will you be awake during the procedure? 

The procedure generally doesn’t make use of general anaesthesia, so you might be awake during most of the procedure. However, you will be in a phase called “twilight sleep” and may not remember anything from the procedure.

 

6) Will you feel pain during or after the procedure?

There might be some pain during the procedure, however severe pain will not be felt due to your dampened consciousness.

After the procedure, some residual pain may be felt, however it is usually controlled with narcotic or non-narcotic painkillers. Any remaining pain will subside over days to weeks following the procedure.

7) How long will you have to be at the hospital after the procedure?

At the very least, you will need to stay in the hospital overnight after the procedure. You might be discharged the day after, if your doctor feels you are out of danger. However, if post-surgical complications develop, a prolonged hospital stay may be necessary to treat the complications. 

8) How long will it take for the patient to feel better?

Often, post-surgical atrial fibrillation persists in patients who have undergone catheter ablation. This is mostly because scar tissue takes about three to four months to develop and only after this period will the procedure be fully effective.

You will not be able to lift or pull anything or drive up to three days after the procedure. Pain and bruising at the site of the incision is common and may take a few days to heal.

 

9) How will you know if the procedure worked? 

Assessment of the patient’s condition is only done three months after the procedure as the effects are fully seen only after this period. In a follow-up appointment after three months, the doctor will be able to tell you how effective the procedure was.

 

10) Do you need to have more than one catheter ablation?

In a small number of cases, the atrial fibrillation may be persistent, requiring a number of repeat procedures to treat the cause and reduce risk of complications.

However, in most cases, if the patient is in an overall healthy state, a single procedure is enough to treat the problem.

 

11) What is the cost of Cardiac ablation in India? 

The cost of Cardiac Ablation in India varies across different cities and hospitals.

Cost of Cardiac ablation in India
CITY COST
Cost of Cardiac Ablation in Mumbai                 INR 200000- INR 250000        
Cost of Cardiac Ablation in Bangalore INR 190000- INR 240000
Cost of Cardiac Ablation in Delhi INR 190000- INR 240000
Cost of Cardiac Ablation in Chennai     INR 180000- INR 230000

 

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