Radiofrequency ablation for tachyarrhythmias

  The normal human heart rhythm is sinus rhythm; the resting state has a frequency of 60 to 100 beats per minute; all rhythms other than sinus rhythm are considered arrhythmias; tachyarrhythmias include sinus node atrial tachycardia, atrial tachycardia, atrial flutter, atrial fibrillation, atrioventricular tachycardia (tachycardia consisting of bypass involvement of the preexcitation syndrome), atrioventricular node tachycardia (also called double pathway tachycardia), ventricular tachycardia, ventricular flutter, and ventricular fibrillation. They are also divided into supraventricular tachycardia and ventricular tachycardia according to the origin of the tachycardia.  These arrhythmias are characterized by: 1. sudden onset; sudden termination, mostly under emotional excitement and fatigue. 2.  2. Patients feel sudden panic, chest tightness, shortness of breath, weakness, some patients may appear sweating profusely, hypotension, so it may cause dizziness or even fainting.  3, Recurrent and frequent episodes with long history are often prone to heart enlargement, called arrhythmogenic cardiomyopathy, but this cardiomyopathy is reversible; that is, the size of the heart can return to normal after the tachycardia is cured.  Radiofrequency ablation technology has revolutionized the treatment of arrhythmias, and more notably, radiofrequency ablation for arrhythmias is the only radical technique in cardiology. This technology has made tremendous progress since it was applied to clinical practice in 1986, enabling thousands of arrhythmia patients to be cured. In China, the technical development of radiofrequency ablation has been synchronized with the international one, and it has become the preferred method to cure tachyarrhythmias after more than 20 years of practice and improvement.  The advantages of radiofrequency ablation technology are: 1. The procedure only requires local anesthesia, and the patient can get out of bed in 4 to 8 hours after the procedure.  The success rate is 95 to 99%; the success rate of certain types of tachyarrhythmias is almost 100% in experienced interventional centers; the recurrence rate is about 1 to 2%; and recurrent cases can be cured by re-operation.  3. The cost is low, and most units and families can afford it. China has reached the level of almost simultaneous development with developed countries in this technology; because the advantage of the total number of patients in China is unparalleled by any other developed countries; therefore, it is still in the world leading position in terms of surgical proficiency and success rate of some diseases.  The principle and procedure of interventional treatment of tachyarrhythmia is: after local anesthesia, the interventional catheter is pushed to a specific part of the heart under X-ray fluoroscopy through vascular puncture; through a series of close intra-cardiac electrophysiological examinations, the mechanism of arrhythmia onset and the key part of maintaining tachycardia are clarified; through the electrode catheter, energy is introduced to the lesion of the heart, and the lesion is ablated by quantitative energy application To achieve the purpose of treatment.  This procedure is often referred to as radiofrequency ablation because the energy used is radiofrequency electrical energy. The frequency of the radiofrequency current is very high, so there is no stimulation to the muscles and nerves; the patient only feels warmth and no pain during the ablation discharge. The catheter is removed at the end of the procedure; pressure is applied for a few minutes to stop the bleeding; the procedure takes about 30 to 90 minutes, and the patient is awake at all times and can communicate with the surgeon about his feelings.  The indications for interventional treatment of tachyarrhythmia are: supraventricular tachycardia and the majority of ventricular tachycardias; in addition, some ventricular premature contractions with frequent episodes and poor drug efficacy can be treated by interventional procedures.  Studies have confirmed that radiofrequency ablation produces less myocardial damage than direct current and does not require general anesthesia, making it very safe, especially for patients with supraventricular and ventricular tachycardia without organic heart disease. It may be higher in patients with organic heart disease than in those without, but the overall incidence is still low. The overall incidence of complications from radiofrequency ablation is only about 5%.