Heart rhythm disturbance and radiofrequency ablation – a modern method of treating arrhythmia

Arrhythmia is a condition in which the heart rhythm is disturbed and can cause serious disturbances in the activity of the heart or the function of other organs.

According to statistics, conduction disturbances and heart rhythm in 10-15% of cases is the cause of death.

There are various forms of heart rhythm disturbance: tachycardia (above 90 beats / minute), bradycardia (below 60 beats / minute), or irregular arrhythmias.

Almost everyone, sooner or later, will experience some form of cardiac arrhythmia, and most often weak palpation or “skipping” of the beats.

What causes heart rhythm disturbances and arrhythmias?
-The heart is the “center” of our body and everything that happens in us and around us is reflected in its work.

The most common cause of heart rhythm disorders is due to acquired heart disease: cardiovascular disease – (angina pectoris (chest pain) or myocardial infarction), heart muscle disease – cardiomyopathy, inflammation of the heart muscle – myocarditis, heart valve disease, etc.

Cardiac dysfunction can also occur as a consequence of diseases of other organs: thyroid gland, adrenal gland, kidneys, lungs, blood diseases, alcohol poisoning, narcotics, nicotine, but also as a manifestation of side effects. of some drugs.

Bad life habits such as: intense emotions, severe physical pain, excessive mental and physical stress and exhaustion, overheating of the body, overeating, consuming too much coffee, alcohol and energy drinks, cigarettes, etc. are also the cause of arrhythmia.

What are the symptoms of a heart rhythm disorder?
-One of the main problems of arrhythmias is their early recognition, especially due to the frequent asymptomatic nature. One-third of patients with arrhythmia have so-called asymptomatic atrial fibrillation.

They are usually described as a feeling of fast work, loud beats, throbbing, premature beating, skipping a “dumpling” sensation in the throat after a stroke, sometimes accompanied by dizziness, collapse or loss of consciousness. Arrhythmias are manifested by numerous and varied symptoms, from mild to severe and disabling.

What types of arrhythmias are there?
-The human heart consists of 4 cavities, two atria and two ventricles. Depending on which part of the heart there is an irregularity, ie a disturbance in the conduction of the impulse, the arrhythmias can be atrial and ventricular.
1.Extrasystoles – are premature heartbeats. They are the most common heart rhythm disorders and almost every one of us has experienced them. Extrasystoles can also be divided into atrial and ventricular and although very common, they are generally not dangerous. Patients often complain of discomfort that forces them to cough. Only in a small percentage of cardiac patients can extrasystoles initiate more complex arrhythmias.

2.Atrial (atrial) fibrillation – is the most common form of heart failure with irregular rapid atrial fibrillation. This type of arrhythmia occurs in over 2% of the general population. Over 6-7 million people in Europe suffer from this arrhythmia and it is closely related to the frequent death outcome, stroke, heart failure. Atrial fibrillation increases the risk of stroke by 5 times. This type of arrhythmia is the cause of one in five strokes.

3.Supraventricular tachycardia – is a group of cardiac arrhythmias that cause an improperly fast pulse. This type of tachycardia can occur in children, adolescents and adults. Appears in combination with alternating periods of normal rhythm. The most common symptoms of this arrhythmia are palpitations, dizziness, headache, tremors in the extremities, shortness of breath.

4.Ventricular arrhythmias – are the most severe heart rhythm disorders. There are: ventricular tachycardia (ventricular acceleration) and ventricular fibrillation. About 80% of sudden cardiac deaths result from these ventricular arrhythmias. Arrhythmias can occur at any age, but are more common in older people. If not reacted in the shortest time, they are a life-threatening condition. The most common cause is acute myocardial infarction. When ventricular fibrillation does not expel blood from the heart, the heart does not pump blood.

5.Other types of changes in the electrical conduction in the heart are the appearance of first, second, third degree AV blocks.

How to detect and recognize cardiac arrhythmia?
The diagnosis of cardiac arrhythmias is based on the patient’s clinical examination, electrocardiogram – ECG, echocardiography, 24-hour ECG (Holter ECG) observation, stress tests, heart magnet and electrophysiological examination of the heart or known as electrophysiological study.

How are arrhythmias treated?
-Treatment will depend on what type of arrhythmia you have and how severe it is. Most often in the treatment of cardiac arrhythmias, first drugs are used that suppress the disorder or reduce the frequency and intensity of its occurrence – antiarrhythmics and beta blockers.

In the case of bradycardia arrhythmias, i.e. a heartbeat that is too slow, it may be necessary to use a pacemaker. In acute cases of ventricular fibrillation, prompt, urgent treatment with a defibrillator is necessary. Therefore, treatment should be started on time to reduce the possibility of complications.

In conditions where the arrhythmia cannot be relieved with medication, then electrical cardioversion is applied, ie a procedure where the rhythm is calmed by an electric shock or an electrophysiological study with radiofrequency ablation is also recommended.

What does electrophysiological study with radiofrequency ablation mean and why is an electrophysiological study performed?
-Electrophysiological study is a diagnostic test used to confirm the arrhythmia and its mechanism.

This technique determines the type of abnormal heart rhythm and all patients with documented arrhythmia, patients to evaluate the effectiveness of prescribed drugs in the treatment of irregular heart rhythm, patients with symptoms such as fainting, loss of consciousness for unknown reasons, need this examination. as well as patients at risk of sudden cardiac death.

There are several ways in which the study of electrophysiological study can help and decide on further treatment. Based on the results of the EP study include:

1.Pacemaker implantation: If the EP study confirms the presence of significant bradycardia, a permanent pacemaker can often be inserted during the same procedure.
2.Implantable defibrillators: If rapid forms of VT and / or ventricular fibrillation (VF) are identified during the EP study, an implantable defibrillator is usually the treatment of choice. This device can now often be inserted into the EP laboratory, immediately after the EP study.
3.Radiofrequency ablation is a burning, is a condition where by transferring some form of energy through the catheter (thermal energy, freezing energy or radiofrequency energy). This creates a blockage in the electrical pathway that caused the arrhythmia.

This type of therapy is often the treatment of choice if supraventricular tachycardia (SVT) is detected – and some forms of ventricular tachycardia (VT) and for many it is a single and definitive treatment.

In recent years, ablation procedures have become quite advanced and typically use computerized mapping systems that use both 3D imaging and electrical mapping to pinpoint the appropriate ablation site.

you procedures usually take several hours and take a day or two during hospital recovery.

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