Atrial ciliary arrhythmia

The most common causes of atrial ciliary arrhythmia (atrial fibrillation) are the emergence of irregular circular excitation and the new, chaotic ways of these potentials. Atrial ciliary arrhythmia not only reduces the efficiency of the heart in 10-20% and gives the unpleasant sensation of sudden palpitation, but is also a major cause of thrombus formation in the atrium.

Blood clots in the left atrium are most dangerous because they can get from blood into the left ventricle and from there to the vessels of the brain or other organs. Cerebral crisis with almost irreversible consequences is in case of brain embolism.

Thrombus embolization of other vital organs such as liver, kidneys or intestinal tract is clinically less visible but no less dangerous. Limb embolism may cause acute ischemia and even lead to the loss of limbs in the late intervention. Antiarrhythmics do not work or contraindicated for many patients.

Radiofrequency catheter ablation (Pulmonary vein isolation) for heart rhythm disturbances

Today, leading Cardiology clinics of Germany demonstrate the enormous opportunities of radical treatment of arrhythmia patients by use of radiofrequency catheter ablation.

Catheter ablation (lat. Ablatio “delete”) is a low-invasive method to remove the causes of heart rhythm disturbances by the catheter without open heart surgery. The following catheters are used thereby:

• Electrical impulse

• Cold (Cryotherapy)

• Chemical Substance

• Laser

The catheter working with the help of an electric impulse is used primarily in Germany.

Indications for radiofrequency catheter ablation are the presence of idiopathic (unreasonable) ciliary arrhythmia in the absence of organic pathology as well as paroxysmal arrhythmia and persistent (permanent) arrhythmia of the duration up to 3 months, tachycardia with atrium fibrillation, WPW-Syndrome, AV-node tachycardia, and ventricular tachycardia.

The decision about indications for catheter ablation can be taken after a series of examination to determine the electrophysiological mechanisms of various heart rhythm disturbances:

• Electrocardiogram at rest

• Electrocardiogram throughout the day (Holter)

• Electrocardiogram on load

• Echocardiography

• MRT on the heart

• X-ray examination of the chest

• A blood test to determine the amount of electrolytes (such as sodium, potassium and magnesium), functional indicators of the kidney, liver and thyroid

• The exact location of the source of disturbances is determined by irritation of the heart muscle through electrical pulse as well as by use of electro-physiological examination.

The electro-physiological examination and the whole procedure of the catheter ablation are carried out under the orderly X-ray control that provides a vision of the whole procedure in 3D space on a computer monitor.

Такой контроль позволяет избегать различного рода повреждений сосудов, проколов сердечной стенки и т.д. 

This control allows avoiding various types of vascular injury, heart wall puncture, etc. This method is based on the point exploration on problem areas of the cardiac conductive structures. The target of catheter ablation is a “division” of certain cardiac muscle fibers, which provoke a rhythm disturbance or, in other words, the removal of their conducting capacity.

The medicament for the prevention of thrombosis is inserted before catheter ablation.

Then the electrode (introducer) is introduced through a catheter installed in the femoral vein. Moving the electrode achieves the previously diagnosed focus of disturbance. The tip of the electrode heats to 70°C in case of high-frequency ablation. The micro-cicatrix is formed by point cauterization of problem areas. This micro-cicatrix becomes an obstacle to passage of a pathological impulse provoking the emergence of rhythm disturbances

A control test is carried out at the conclusion (namely, irritation of the muscle fiber by means of medicaments or electrical pulse). The doctor determines the result of the ablation. The ablation is successful if the symptoms of the disease are not observed while the provoking control of a pathological impulse.

As any intervention in the organism, the catheter ablation may lead to several complications:

• The emergence of heart rhythm disturbances while the ablation

• Bursting of cardiac muscle with the possible subsequent formation of the heart trampage

• AV node dysfunction

• Thrombosis

• Embolism

• Infectious diseases

• Damage of vessels, skin and soft body tissues

• Increased sensitivity of the organism (a reaction to medicaments used)

According to the doctor's opinion and results of medical examinations, the degree of risk is discussed in each case in order to avoid complications.

Successful treatment of heart rhythm disturbances by use of radiofrequency catheter ablation expands indications for medicated radical correction of the rhythm. Due to the great experience German specialists achieve excellent results in catheter ablation!

For example, radiofrequency catheter ablation provides 75-85% cases of complete elimination of arrhythmia in case of supraventricular tachycardia.