The new era in arrhythmia ablation
Maximum effectiveness and safety with the use of 3D imaging
The most common arrhythmia is atrial fibrillation, which affects 3-4% of the population. Atrial fibrillation is characterized by a chaotic, completely irregular heartbeat and is now easily detected through modern smart technologies (smart watches).
In practice, it is not a simple arrhythmia but a disease with an increased risk of stroke and heart failure. Lifestyle changes, anticoagulant therapy and its invasive treatment (ablation) effectively aim to change its natural history and the subsequent well-being and longevity.
However, the appearance of rhythmic supraventricular reentrant tachycardias is also common, which are also arrhythmias since they replace the normal sinus rhythm.
What are the clinical characteristics of these rhythmic tachycardias?
The main element that characterizes reentrant tachycardias is their sudden onset and, respectively, their sudden cessation as if pressing a button. Suddenly, the heart rate rises to very high beats (from 150 to more than 200), the heartbeat is not chaotic as in fibrillation but stable and even dizziness or fainting can occur. Often these arrhythmias – tachycardias are not recorded since they have stopped until access to a doctor and their diagnosis is based on these clinical characteristics.
Who does this tachycardia concern?
Supraventricular reentrant tachycardias often appear from adolescence, often during exercise and in women more than in men. Their frequency and duration worsen with age, especially after menopause. It is noteworthy that while the substrate for reentrant tachycardia is present at birth, it can appear for the first time even after 65 years of age.
What are the treatment options?
Supraventricular reentrant tachycardias affect the quality of life of patients, but not their prognosis. We advise patients to avoid swimming in deep water, to stop driving during an episode, and we train them to terminate the episodes themselves with Valsalva maneuvers (squeezing while exhaling or even while sitting down). When the episodes are highly symptomatic and affect the person’s daily life (avoiding travel, exercise, frequent visits to emergency departments) we recommend immediate interventional treatment with ablation.
What are the developments in the ablation of supraventricular arrhythmias?
At the Electrophysiology and Pacing Laboratory of the Standard Heart and Vascular Center of the Athens Medical Center, we perform these ablation procedures with the most modern electroanatomical mapping systems that visualize the area of interest in three-dimensional form with millimeter accuracy. With these innovative technologies, we have reached success rates close to absolute (99%), while at the same time we definitively avoid the only possible complication related to pacemaker implantation (1 in 1000 compared to 1% with the conventional method).The use of radiation is limited to a minimum, while it is possible to perform ablation with complete avoidance of radiation, a fact necessary for pregnant women and young people.
What is the recovery period?
The ablation procedure is painless, the patient is mobilized the same day and returns to work the next day. It is impressive that professional athletes have competed within 72 hours after ablation, while the improvement in their performance after the definitive cure of reentrant tachycardia is also a given.
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