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Catheter Ablations Help Hearts Find Their Rhythm

Non-surgical procedure for cardiac arrhythmias helps patients return to normal activities

A team of Scripps heart physicians and experts gather to discuss catheter ablations for superior patient care.

Twenty-four year old Natalie Nelson had been suffering from a heart arrhythmia for more than a month. Her heart rate would suddenly begin to race out of control, often resulting in a trip to the Scripps Memorial Hospital Encinitas emergency room.

Natalie’s rapid heart rate would begin at random and would last for different lengths of time. It was problematic enough to provoke dramatic lifestyle changes. She altered her eating habits, abstained from physical activity and refused to travel by air.

“It was affecting my entire life,” says Natalie. “I couldn’t fly out of town for any reason. I even missed my friend’s wedding because I was scared of having an episode on an airplane.”

In September, Natalie found herself at Scripps Encinitas for the third time in 30 days. She was administered an electrocardiogram (EKG or ECG), an electrical recording of the heart used to investigate arrhythmia and other heart-related issues.

The EKG confirmed that she was experiencing extremely fast rhythms of the heart, or tachycardias. Tachycardias are the result of areas of abnormal tissue in the heart, which cause its electrical system to short circuit.

“After diagnosis, I just wanted to know how to get back to my normal life,” says Natalie. “A nurse practitioner at Encinitas told me about Thomas Ahern, MD, and a procedure he does called catheter ablation."

Understanding catheter ablation treatment options

Catheter ablation is a non-surgical electrophysiology procedure used to treat certain types of tachycardias. By destroying abnormal tissue areas, catheter ablation repairs the heart’s electrical system and returns it to a normal rhythm.

Catheter ablations are performed at Scripps Memorial Hospital La Jolla, Scripps Mercy Hospital and Scripps Encinitas, which began providing the procedure about two years ago. Dr. Ahern works out of Scripps Encinitas and Scripps La Jolla and has performed more than 1,000 catheter procedures.

“When a patient is suffering from tachycardias, they have three options,” says Dr. Ahern. “They can do nothing and live with it, they can take medications for the rest of their lives — or they can have the ablation procedure. If a patient has tried medications and the tachycardias are still provoking the patient to alter their lifestyle, then I usually recommend the procedure.”

Natalie had been taking medication for her tachycardias, but it left her feeling drowsy and unable to get out of bed. Since these symptoms affected her daily activities, Dr. Ahern recommended the catheter ablation.

The procedure is completed in either an electrophysiology (EP) lab or a cardiac catheterization lab. It takes between one and six hours and is successful about 98 percent of the time.

During the procedure, a small incision is made, usually in the groin or neck. An ablating electrode catheter is inserted into a blood vessel and gently moved toward the heart. The physician follows the catheter’s progress on a special monitor connected to a fluoroscope camera, which is like an X-ray video camera.

The catheter can be used to sense electrical activity in various areas of the heart and measure how fast these impulses travel. The catheter can also be used to deliver tiny electrical impulses to stimulate the heart to beat or contract. By doing so, physicians attempt to induce the tachycardia so they can understand more about it and decide how best to treat it.

After a proper diagnosis has been made and the abnormal tissue is located, the physician burns or ablates the area using high-frequency energy. The burning creates a lesion or tiny scar, making the tissue no longer able to sustain the arrhythmia. This usually causes the electrical system to return to a normal rhythm.

After treatment, a return to life's adventures

Except for some mild discomfort at the incision point, Natalie did not encounter any problems during her procedure, as catheter ablation is usually not painful.

“The procedure was a real lifesaver,” says Natalie. “It helped me finally put this problem behind me and get back to doing the things I love.”