Catheter ablation for supraventricular tachycardia
Catheter ablation for supraventricular tachycardia Catheter ablation for supraventricular tachycardia (SVT) is a minimally invasive procedure that offers hope to many patients suffering from abnormal heart rhythms. SVT refers to a rapid heartbeat originating above the ventricles, often causing palpitations, dizziness, or even fainting. For years, medication was the primary treatment option, but advances in electrophysiology have made catheter ablation an increasingly preferred approach due to its high success rates and low complication risks.
The process begins with a detailed assessment, including an electrocardiogram (ECG) and sometimes a Holter monitor or event recorder, to accurately identify the type of SVT and its triggers. Once confirmed, the patient is scheduled for the ablation procedure, usually performed in a specialized electrophysiology (EP) lab. The goal of catheter ablation is to locate and destroy the small area of heart tissue responsible for abnormal electrical signals causing the tachycardia.
During the procedure, a thin, flexible catheter is inserted into a blood vessel—often in the groin or neck—and guided under fluoroscopy (live X-ray) to the heart. Multiple catheters may be used to map the electrical activity within the heart chambers. This mapping process helps pinpoint the specific pathway responsible for the SVT, which could involve accessory pathways, AV nodal reentry circuits, or other abnormal conduction routes. Once identified, targeted energy—most commonly radiofrequency (RF)—is delivered through the catheter to ablate, or scar, the problematic tissue. In some cases, cryoablation, which uses extreme cold, is employed as an alternative energy source, especially when the ablation site is near critical structures like the AV node.
The entire procedure generally lasts between one to several hours. Patients are usually awake but under local anesthesia, with sedation to ensure comfort. Post-procedure, patients are monitored closely for several hours or overnight for any immediate complications, such as bleeding, infection, or rare instances of heart block. Most individuals can return to normal activities within a few days, with many resuming work within a week.
Catheter ablation boasts high success rates, often exceeding 90% for common types of SVT, and offers a potential cure, reducing or eliminating the need for ongoing medication. Complications are uncommon but can include vascular injury, cardiac tamponade, or damage to the normal conduction system leading to heart block. The decision to undergo ablation depends on factors like symptom severity, frequency of episodes, response to medication, and overall health.
Advancements in technology continue to improve the safety and efficacy of catheter ablation. Today, it is regarded as a first-line treatment for many patients with SVT, especially those who experience frequent or debilitating episodes. As with any medical procedure, a thorough discussion with a cardiologist or electrophysiologist is essential to weigh the benefits and risks and determine the most appropriate treatment plan.
