Our heart has a system similar to a city's electrical grid. In fact, the signals originating from the main center (sinus node) located in the right atrium pass through an intermediate station (atrioventricular node) located between the atria and ventricles with a short delay, and then spread to the ventricles via specialized conduction pathways. Thus, the electrical stimulus produced in the main center is transmitted to all heart muscle cells, causing the heart to contract.
Disruptions may occur in this normal stimulation and conduction system of the heart for various reasons. Sometimes additional congenital pathways can cause short circuits in conduction, causing rapid heartbeats, which we call tachycardia. In addition, sometimes signals may arise from any part of the heart beyond the control of the main stimulation center of the heart mentioned above and may cause rapid beats.
What is the electrophysiological diagnosis method?
Electrophysiological With the diagnostic method called study, electrical signals received directly from the heart with the help of thin wires called catheters, which are passed through thin sheaths placed into the vein from the groin and / or neck and delivered to the heart, are evaluated through advanced computers and deviations from normal are investigated. In patients who complain of palpitations, often in the form of rapid beating, the rapid beating, which is the cause of the patient's complaint, is created by stimulations given through these wires (2-4 depending on the purpose of the study and the type of arrhythmia) placed in the heart with special methods, and the reasons for their occurrence are investigated. Thus, if the presence of short circuits is detected, palpitations are completely treated by giving point energy with radio waves. Or, if a focus causing the flutter is detected, it is eliminated by applying radio wave energy. This is called catheter ablation therapy (BURNING OR FREEZING). In this way, permanent treatments for most of the palpitations in the form of rapid heartbeat (tachycardia) have become possible today.
You may feel palpitations when test stimuli are given through the heart during the electrophysiological study. Or you may feel a similar feeling when your main complaint, palpitations, is caused by the stimulations given to the heart. Sometimes, after stimulating the rapid-fire rhythm, it goes out to correct it. It may be necessary to give an electric shock. You will not feel any pain as you will be given medication to put you to sleep before the shock procedure.
Electrophysiological examinations performed for diagnostic purposes take about 30-60 minutes. If a therapeutic intervention is required, this is a procedure that may take up to 1-4 hours.
These procedures are basically low-risk applications. However, as with every transaction, it may also bring some problems. The probability of death is very low. Rarely, fluid may leak between the cardiac membranes due to perforation of the heart muscle during the procedure. Rarely, during therapeutic procedures (ablation), blocks may occur in the heart's conduction system during radio wave energy administration, since the short circuit that causes palpitations is very close to the normal stimulation system of the heart. In such cases, a permanent pacemaker may need to be installed.
The data obtained by electrophysiological study cannot be provided by any other diagnostic method. It is often applied when other diagnostic methods are insufficient.
What is catheter ablation, when and how is it applied?
Catheter ablation is an arrhythmia performed by administering radio waves. is the treatment. This method is applied in cases of rhythm disorders that cannot be controlled with medications or if patients do not want to take medication for life. In some cases, the arrhythmia may be so significant that it can be life-threatening. In such cases, direct catheter ablation method may be required. The procedure is basically performed by anesthetizing the needle insertion areas with local anesthesia, and in some cases under general anesthesia. A sedative medication may be administered to make you feel comfortable during the procedure. After the procedure, you need to lie down without moving your legs for a few hours to prevent bleeding.
What are the chances of success of the catheter ablation method?
The probability of success in the treatment of fast-beating rhythm disorders with catheter ablation depends on the type of palpitation targeted for treatment and the location of the short circuit. It varies between 70-95%. Success means treating palpitations so that they don't happen again. The likelihood of recurrence of palpitations after successful application varies depending on the type of arrhythmia. For example, this may occur in palpitations due to short circuits in the heart. hanging percentage is between 5-8%.
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