Electrophysiology Study and Catheter Ablation

Atria Flutter

Atrial flutter is another form of a supraventricular tachycardia. It can originate in the right or left atrium.   It is a reticulating or circular arrhythmia, that circles a structure, that resembles a train on a circular track. The difference with this arrhythmia, that it causes your atria to flutter, which can lead to a stroke. Anticoagulation (blood thinners) may be indicted with Atrial Flutter.

The treatment of Atrial flutter is ablation. If the Atrial flutter is typical, it is in the right atrium, if atypical, the left atrium. Both can be treated with a radio frequency ablation. The ablation heats up tissue on the circular tract similar to taking piece out of the train track so the train can no longer run in a circle. The success of this procedure is 80% or greater.

Prior to undergoing an ablation, preoperative instructions will be given to you by our schedulers as well as a post-operative follow up appointment. If you are on blood thinners, you will be given instructions on whether or not to hold them. You will need someone to drive you to the surgical center, wait for you and drive you home. You should not drive for 24 hours after the procedure.

For the procedure, you will be given medication intravenously (IV) to sedate you so that you are comfortable. You may not remember very much about the procedure when it is complete. Your right groin or bilateral groin sites will be numbed, and tubes called sheaths will be inserted so the wires needed for the procedure can be inserted.

After the procedure you will be taken to recovery and when you are awake, and we have made sure there is no bleeding from the sheath sites, you can to home. You may feel some chest discomfort for the first 24-48 hours, but will resolve. Some people feel shoulder pain. This discomfort is referred pain from the ablation, and will also resolve. Anti-inflammatory medication, such as Ibuprofen can used for the discomfort.

SVT

SVT or supraventricular tachycardia (tachycardia is a rapid heartbeat and Supraventricular is a rhythm that originates from above the bottom two chambers of the heart). There are several types of SVT all that will cause rapid heart sensations, or palpitations. The heartbeat can be as rapid at 200 beats per minutes in some instances.

1.  Atrioventricular reentrant tachycardia or AVNRT, is a rhythm that comes from the center of the conductions system in your heart call the atrioventricular node. There is at times two pathways that a signal from the sinus node or pacemaker cells initiates, that can cause a circular rhythm that circles the structure and causes the ventricles to beat rapidly. It is the most common of the supraventricular tachycardias.
2. Atrial tachycardia. This a fast heart rate that originates in the right or left atrium (the top two chambers of the heart). This is the second most common arrhythmia that can cause a fast heartbeat. It originates from a cluster of cells that overtake your pacemaker cells (sinus node) and lasts for a few seconds, and can last for hours.
3. WPW or Wolf-Parkinsons-White. This is an arrhythmia that is caused by a tract that bypasses the regular conduction sytem with a signal that may go to the outside of the ventricle (lower chamber) and cause a rapid heart rate. This can be diagnosed by EKG, as there will be an abnormality in conduction called a Delta Wave.
4. All three of the SVTs can be successfully ablated, by using tiny amount of radio frequency heat to terminate the arrhythmia.

You will be given pre-operative instructions when the procedure is scheduled as well as a post-operative follow up appointment. You will need someone to transport you to the center, stay during the procedure, and take you home. Post-operative instructions will also be given to you at that time. You should not drive for 24 hours after the procedure.

For the procedure, you will be given conscious sedation that will keep you comfortable. Then your groin areas will be numbed and small tubes call sheaths will be inserted into the femoral veins. Wires are inserted into the sheaths to perform the ablation,

After the ablation, you will be in a recovery area. When you are awake, and we are sure there is no bleeding from the sheath removal, you can be discharged home. After returning home, we asked that you do not lift anything heavy for 3 days, and do not swim or sit in a bathtub or hot tub for 5 days. You may feel some discomfort in your chest for 24 to 48 hours, but it will subside. You may also feel palpitations, but they will also resolve.

If there are any questions or concerns, please contact Case Management at 602-867-8644.