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World Class, State-of-the-Art Radiofrequency Catheter Ablation w/Lower Costs
Radiofrequency Catheter Ablation
Introduction — Radiofrequency catheter ablation is a procedure that is performed to correct a disturbance in heart rhythm. A brief review of how a normal heart rhythm occurs and a description of some of the rhythm problems that are treated with this procedure will help in the understanding of radiofrequency catheter ablation.
Radiofrequency Catheter Ablation (R F Ablation) $1,980
Package Includes:
- Attending Doctor/Surgeon's fees, nursing, material cost, pre and post procedure consultations, tests and physical examination.
- Medical surgical procedure hospital costs
- All ancillary medical surgical staff
- All medications, medical supplies and drugs used during the in-patient hospital stay.
- Room fees for a private air conditioned room. Notes...Room includes bathroom, TV, telephone. Room includes accommodations for one guest.
- Meals. The type of cuisine will be served as what is available at the hospital.
- Rental of pre-activated cellular phone for use during stay. Note: Phone usage charges are not included in price.
- All diagnostic tests, laboratory, radiology etc. before and after the procedure as required for the procedure and as advised by the attending physician/surgeon.
- More comprehensive quote available in the Medical Travel Packet.
Radiofrequency Catheter Ablation
Radiofrequency catheter ablation is a procedure that is performed to correct a disturbance in heart rhythm. A brief review of how a normal heart rhythm occurs and a description of some of the rhythm problems that are treated with this procedure will help in the understanding of radiofrequency catheter ablation.
Heart muscle cells are stimulated by electrical impulses that cause them to contract in a uniform way and with a regular rate. This contraction produces the heartbeat, which causes blood to be pumped out of the heart into arteries and then to all parts of the body. The flow of blood into arteries can be measured by feeling the pulse, which corresponds to the heartbeat. In the normal heart, electrical impulses arise from an area of specialized cells called the sinus node, which is the heart's normal pacemaker. The sinus node is located in the right atrium, the upper right chamber of the heart. After leaving the sinus node, an impulse spreads across the upper heart chambers (right and left atria) and reaches the atrioventricular (AV) node located near the center of the heart between the atria and the lower chambers, or ventricles, and then to conduction fibers that spread across the ventricles, which are the heart's main pumping chambers. As the impulse moves along the conduction fibers, cardiac muscle cells are stimulated and contract, producing a heartbeat.
Sometimes, the electrical impulses "short circuit" the normal pathway and travel across the heart in an abnormal way. Abnormal pathways, or routes, for the impulses can develop, causing irregularities in the heartbeat, or arrhythmias. In other cases, arrhythmias arise when areas other than the sinus node become active and begin to send out impulses that either compete with or take over the pacemaker function of the sinus node. Typically, the end result of these abnormalities in electrical conduction is a heartbeat that is too fast. This is known as tachycardia, and it may develop in any location within the atria, AV node, or ventricles.
Radiofrequency ablation is a procedure that can cure many types of tachycardia. Using small tubes, or catheters, that are threaded into the heart, radiofrequency energy (low-voltage, high frequency electricity) is targeted toward the area(s) causing the abnormal heart rhythm, permanently damaging small areas of tissue. The damaged tissue is no longer capable of generating or conducting electrical impulses. If the procedure is successful, this prevents the arrhythmia from being generated, curing the patient.
In some patients, implantation of a pacemaker is a planned part of the procedure. In other cases, the need for a pacemaker is an unusual complication of the ablation procedure. When certain critical areas of the heart are being treated with radiofrequency ablation in order to stop a problematic arrhythmia, the normal sequence of impulse conduction is disrupted and a pacemaker is sometimes needed to ensure proper regulation of the heartbeat. A pacemaker is a small electrical device that stays in the body and is connected to the heart with wires that stimulate the heart to contract in a regular way. Your doctor can tell you whether or not you will need a pacemaker after your ablation.
Many different arrhythmias that cause tachycardia are now treated using this technique.
Radiofrequency ablation may be recommended for:
- Wolff-Parkinson-White syndrome, and the associated AV reentrant tachycardia
- AV nodal reentrant tachycardia
- Atrial tachycardia
- Atrial flutter
- Ventricular tachycardia
- Atrial fibrillation
You may be asked to discontinue certain medications in the days before the procedure. Your doctor will advise you as to which, if any, of your medicines should be stopped. some physicians suggest that premenopausal women not have the procedure during the menstrual period, as blood thinning agents may be used and could cause excessive bleeding. Most patients are advised to stop eating and drinking at midnight the night before the procedure. A pregnancy test may be performed immediately prior to the procedure in women of childbearing capacity because of the risk that radiation (x-rays) poses to a developing fetus. Before the procedure begins, you will receive strong sedative medication through an intravenous (IV) line so that you will not be aware of most of what is happening.
Small catheters will be threaded into the heart. Most often these catheters are inserted into the vein or artery in the right and left groin and are positioned within the chambers of the heart using fluoroscopy (low energy x-rays). The precise location for these catheters is determined by measuring the electrical impulses from the heart's muscle. The doctor will test various parts of the heart and usually will attempt to provoke the arrhythmia. By using one of several methods for mapping the electrical system, the sections of the heart that are causing your arrhythmia can be identified. The doctor will then use the radiofrequency energy described above to treat the problem area. All during the procedure, doctors and nurses are continuously monitoring your heart rate and rhythm and your blood pressure. Once the procedure is completed, there is another attempt to provoke the arrhythmia. If it cannot be reinitiated, the procedure is successful. However, if the arrhythmia can still be induced, additional radiofrequency energy is delivered.
The length of the procedure varies from patient to patient depending on the type of arrhythmia being treated and other factors. Typically, the procedure lasts three hours or more.
WHAT WILL HAPPEN AFTER THE PROCEDURE? — You will be taken to a recovery area while the effects of the sedative medication wear off. Nurses and doctors will check the area of catheter insertion for bleeding and will monitor your heart rhythm closely during this period. You will probably be asked to stay in bed for at least several hours. You should feel well.
Some patients are admitted to the hospital after the procedure, others go home later the same day. You will be asked to restrict certain activities for a brief period in order to avoid strain on the area where the catheters were inserted.
You may be asked to take aspirin every day for several weeks in order to help prevent blood clots. Your doctor will give you detailed information about medications you should take after your ablation procedure. Usually pain medication is needed for only a short time, if at all, following the procedure.
Like any invasive procedure, radiofrequency ablation carries some risk. In one study of 1050 patients who underwent the procedure, a major complication occurred in 3 percent, and a minor complication in 8.2 percent. Complications include:
- Problems related to threading the catheters through the blood vessels such as bleeding, infection, blood clots, bruising, and injury to the vessel(s)
- Injury to the heart as a result of the catheters; this includes a perforation through the muscle or damage to one of the valves within the heart
- Blood clots that travel to the lungs (pulmonary embolism) or brain (stroke)
- Heart block, or failure of any electrical impulse to travel from the top parts of the heart to the bottom. This complication, if permanent, requires implantation of a pacemaker.
- New arrhythmias
- Exposure to radiation during the procedure, which can take several hours. This can produce a very small increase in the risk of cancer or genetic defects.
- Death (occurs in approximately 0.1 to 0.3 percent of cases)
The type of alternative treatments that may be available will depend in part on what type of arrhythmia you have. Medication, pacemakers, cardioversion (application of an electrical current to the chest to restore a normal rhythm) and surgery are examples of treatments that may be used for particular arrhythmias. For some types of arrhythmias that are transient and non-life threatening, patients can be taught certain maneuvers (such as coughing or increasing pressure in the abdomen) that may stop the arrhythmia. Your doctor can give you detailed information about available alternative therapies.
Your doctor is the best resource for finding out important information related to your particular case. Not all patients with heart rhythm disturbances are alike, and it is important that your situation is evaluated by someone who knows you as a whole person.
