Cardiac Ablation for Arrhythmia treatment – radiofrequency ablation, balloon cryoablation
Cardiac ablation has been used by Israeli cardiac surgeons for over 25 years. This is an effective and relatively safe treatment for heart arrhythmia. Currently, radiofriquency ablation RFA is performed using radio waves, rather than direct current, as in the past. The next step in the development of ablation is the freezing method or cryoablation, using a laser, ultrasound, microwaves and much more.
We collaborate with leading Israeli cardiac surgeons, electrophysiologists or arrhythmia specialists, heads of departments and research institutes in Israel, and experienced doctors in the treatment of all types of arrhythmias.
Our doctors perform all types of heart ablation in the leading Israeli hospital Assuta.
When can an Israeli doctor prescribe cardiac ablation?
Atrial fibrillation is a common heart disease that is caused by the rapid and uncontrolled pulsation of the upper (atrial) parts of the heart. Atrial fibrillation is most often treated with the medication, although medications are not always effective, and in such cases, a catheter ablation procedure can be used.
Our cardiac surgeon will most likely recommend you undergo ablation in cases where atrial fibrillation has not improved as expected after other treatments.
Heart ablation can significantly reduce the incidence of atrial fibrillation and the associated symptom of uncontrolled heartbeat. Depending on the type of atrial fibrillation and additional causes, catheter ablation can restore your heart to a normal, constant rhythm.
Modern methods of cardiac ablation in Israel
Israeli doctors have gradually improved methods for mapping cardiac arrhythmias and have come to a greater understanding of complex rhythm disturbances, which allows them to effectively treat it. These types of arrhythmias include atypical atrial flutter, atrial fibrillation and ventricular tachycardia. Those types of arrhythmias that are often associated with significant structural damage to the heart, such as birth defects, conditions after myocardial infarction or after heart surgery.
In some cases, it is a scar area that contributes to the creation of an electrical circuit (Macroreentry). The mapping method Electroanatomical Mapping (EAM) developed by cardiac surgeons helps to “expose” the area of the scar, which is the source of arrhythmia. This method increases the percentage of success and safety of the complex arrhythmias surgeries.
Radiofrequency ablation – RFA CARTO
Radiofrequency ablation CARTO is a high-precision method that uses a low-intensity magnetic field.
A catheter is inserted into the heart cavity, where it records the intensity of local electrical activity, plans it and simultaneously records landmarks in space, creating a three-dimensional geometric structure and determining the exact localization of the arrhythmia focus. The system can accurately indicate important anatomical structures that cannot be damaged during RFA ablation. Through the tip of the catheter, radio waves are fed into the arrhythmia focus.
CARTO Merge is a technology that allows doctors to create images of a three-dimensional structure using CT or MRI images before acting on a three-dimensional structure created by the CARTO system in real time, so that both three-dimensional structures undergo a kind of merging. This allows the cardiac surgeon to better understand complex anatomical cavities.
In addition, Israeli cardiac surgeons also use the most advanced ablation catheter with irrigation system, which allows to treat deeper and larger areas with RFA, showing better results and causing fewer complications associated with catheter overheating.
These two methods allow to increase the energy flow through the tip of the electrode and create deeper and wider areas of exposure to RF waves. In addition, the use of an irrigation catheter for RFA allows ablation in areas with very slow or absent blood flow such as pericardial space.
Ablation for atrial fibrillation treatment
Over the past ten years, significant changes have been made in Israeli cardiac surgery in the treatment of atrial fibrillation by RFA.
Atrial fibrillation is the most common heart rhythm disorder, and the frequency of such cases is constantly increasing.
Ablation of atrial fibrillation is very complex and requires special skill. It should only be performed by an experienced heart surgeon. During RFA ablation, atrial fibrillation isolates four pulmonary veins (PVIs), and additional cauterization is sometimes necessary. Three-dimensional anatomical navigation systems help the doctor understand the complex anatomy and pinpoint areas of catheterization without the use of ionizing radiation. The development and use of intracardiac echocardiography (ICE) has made RFA surgery easier and safer.
Additional CartoSound technology allows to integrate the anatomical information obtained using a real-time ultrasound catheter into the CARTO system for three-dimensional electroanatomical mapping using an accurate transducer on an ultrasonic catheter.
Balloon ablation is a cold ablation technology or cryoablation, in which a sterile liquid balloon is used to isolate the pulmonary veins (PVI). The balloon ablation system adapts to the anatomy of visceral veins. This method makes it easier to achieve electrical isolation of visceral veins compared to standard operating systems. The cryoballon consists of a system of two cylinders – internal and external on a catheter. Cold liquid nitrogen is injected into the inner cylinder and evaporates on contact with heat from the surrounding tissue. An external cylinder ensures safety and prevents nitrogen leakage.
Preparation for Radio Frequency RFA or Cryoablation Procedure in Israel
Before the ablation procedure we will coordinate a consultation with one of the leading cardiac surgeons. At the consultation doctor will consider your test results, he will also give you information about the medicines that you need to take, and about those medicines that you need to stop taking. He will also give special instructions about food before the procedure.
On the day of the procedure, the hospital staff will prepare you for ablation. This preparation includes preparing the area of the skin into which the catheter will be inserted. Local anesthesia will be introduced there. A needle will also be inserted into the vein on your arm so that you can receive medication during the procedure. These medications include sedatives to make you feel relaxed because you will not sleep during the entire procedure. Then you will be placed in an electrophysiological operating room, where the cardiac RFA ablation procedure is performed.
During the procedure, you will be constantly monitored by all systems, including an electrocardiogram (ECG) to record your heartbeat. Then the doctor will insert the catheters, and you can first feel some pressure in the injection area. The procedure itself includes a test called an electrophysiological study, which checks the electrical activity inside the heart and then eliminates the abnormal electrical signals through an ablation catheter. Some patients may experience temporary chest discomfort. The whole procedure usually takes several hours.
Immediately after cardiac radiofrequency ablation, RFA catheters are removed. At this time, it is important to lie still. After the procedure, you need to rest for several hours, many patients have a night of hospitalization in the clinic.
Within a few days after the heart RFA procedure, your actions should be limited, strenuous exercise should be avoided. Particular attention should be paid to the areas through which the catheter was inserted. The formation of a small blood flow or a small swelling is common, but if the place becomes hot, sensitive, sore or swollen, you should inform us immediately. The appearance of atrial fibrillation during a certain period after the heart ablation procedure is quite common. This can be explained by many factors. For example, the healing of an ablation area.
You can return to work a few days after the procedure if there are no problems and your work is not stressful. Driving a car may be limited in some cases, this is discussed individually with the doctor.
Benefits and risks of heart ablation
Ablation is a successful treatment for atrial fibrillation. Most people undergoing this procedure show a prolonged decrease in the number of atrial fibrillation cases and the severity of symptoms, or the heart returns to a normal, constant rhythm.
Heart ablation (radiofrequency RFA and cryoablation) is considered a safe procedure, and the likelihood of serious complications is low (about 2%). However, like any medical procedure, it carries a risk. Our electrophysiologist doctor will discuss with you the unique risks before performing the ablation procedure.