Ask the Expert
New Treatment Available for Hearts Aflutter!
With the September 2006 opening of the NIH Heart Center at Suburban Hospital, cardiac surgery and elective angioplasty are new services at Suburban Hospital, which runs the center in conjunction with the National Heart, Lung, and Blood Institute of the National Institutes of Health and Johns Hopkins Medicine. The NIH Heart Center also offers easy access to advanced cardiovascular treatments available in only a handful of medical centers in the region.
One of these treatments is called radiofrequency ablation, and it's now available at Suburban Hospital, thanks to the opening of the Orkand Center for Interventional Cardiology, one of several new facilities of the NIH Heart Center. The Orkand Center includes three all-digital catheterization labs that provide the highest resolution available, film-viewing for doctors via high-security Internet access, and a 12-bed holding and post-recovery area. Cardiologist Dr. Edward Healy talks about radiofrequency ablation and what this procedure means for Suburban Hospital's patients.
What is radiofrequency ablation and for what conditions is it used?
Radiofrequency ablation (RFA) is a minimally invasive procedure that is used to treat some types of arrhythmias. RFA is most often used to treat arrhythmias that originate in the upper chambers of the heart. These arrhythmias are called supraventricular tachycardias, and include atrial fibrillation and atrial flutter.
What is an arrhythmia?
An arrhythmia is an abnormal heart rhythm. When the heart's electrical impulses don't function properly, the heart can beat too fast, too slow, or irregularly. Arrhythmias that occur because the heart is beating too fast may be helped by radiofrequency ablation.
Are arrhythmias dangerous?
Some types of arrhythmias can be life-threatening if not treated properly. Arrhythmias can cause syncope (fainting) or predispose an individual to a heart attack or stroke. Arrhythmias shouldn't be ignored. If you are experiencing heart palpitations or you feel that your heart is racing or skipping beats, you should see your doctor to determine if you have a heart arrhythmia. Other symptoms of arrhythmia include fainting, light-headedness or dizziness, chest pain, and shortness of breath.
What is different about this procedure compared to other treatments for arrhythmias?
Most often, arrhythmias are treated with medication therapy, which is an ongoing, lifelong form of treatment. RFA is the preferred therapy in some cases because it offers patients the potential for a cure. When successful, RFA eliminates the need for lifelong drug therapy or other more invasive procedures used to treat the arrhythmia.
How is the procedure performed?
During the RFA, two to four catheters (narrow, flexible tubes) are inserted into a vein, usually through the leg area. The doctor guides the catheters until they reach the heart. The electrodes at the tips of the catheters are used to map out how electricity is moving through the heart. They relay information to the doctor about the heart's electrical activities and pathways and help determine the area of abnormal activity. This is called electrical mapping.
The doctor then transmits mild, painless radiofrequency energy to the area of heart muscle that has been identified. This causes the heart muscle cells in a very small area to lose electrical activity, which stops the area from conducting the extra impulses that cause the heart to beat too rapidly. After the procedure, the doctor will retest the heart to make sure that the abnormal activity is no longer present.
Where does the procedure take place?
Radiofrequency ablation is performed in one of Suburban Hospital's new state-of-the-art catheterization labs. This procedure has been offered to Suburban Hospital's patients since December 2006, thanks to the opening of the Orkand Center for Interventional Cardiology.
Who performs the procedure?
The procedure is performed by an electrophysiologist, a cardiologist who has undergone specific training in electrophysiology.
Is special equipment used?
The procedure requires the use of catheters; x-ray equipment, which is used to position the catheters; a recording system, which records the heart's electrical activity; and heat equipment, which is used to perform the ablation.
Is radiofrequency ablation safe?
Yes, RFA is generally considered to be a safe treatment option. As with any medical procedure, there is some risk. The risk of complications with RFA is approximately one percent or lower. The most common complications involve bleeding or bruising at the access site.
How do I know if I'm a candidate for radiofrequency ablation?
Any patient who has been diagnosed with a heart arrhythmia is a potential candidate for this procedure. Age is not a factor when evaluating patients. To determine if someone is a good candidate for RFA, a cardiologist will consider the type of abnormal heart rhythm the patient is experiencing, the amount of arrhythmia (the more frequent the episodes, the more likely the procedure will be considered), and the patient's preference.
What is the recovery time for this procedure?
The procedure takes one to four hours; most patients go home later that day or the next day. Patients can expect complete recovery within a few days.
What is the success rate for radiofrequency ablation?
The success rate varies depending on the type of arrhythmia, but RFA is considered an excellent form of treatment for many heart arrhythmias. We have seen a success rate as high as 85 to 90 percent.
About Dr. Edward Healy
Dr. Healy received his medical degree from the Georgetown University School of Medicine and completed his internship and residency in internal medicine at New England Medical Center. He completed his fellowship in cardiology and cardiac electrophysiology at University of Massachusetts Memorial Medical Center.
Dr. Healy is board certified in internal medicine and cardiovascular disease. He has special interests in cardiac electrophysiology, nuclear cardiology, and echocardiography. Dr. Healy is a member of Maryland Heart, a full-service cardiology group located at 6410 Rockledge Drive in Bethesda. Dr. Healy can be reached at (301) 897-5301.