General knowledge of cardiac catheterization radiofrequency ablation for cardiac arrhythmias

  At one time or another in their lives, people have felt panic and heartbeat, which affects their work and life and can lead to angina, tightness of breath, shock, syncope, and even sudden death in severe cases. Arrhythmia is one of the key causes.  The excitation of the heart originates from the sinus node, which is equivalent to the “command” of the heartbeat, and is transmitted down to the atria, atrioventricular junction, left and right bundle branches, and Pakeno’s fibers and ventricular muscle in order to make the heart excited as a whole. When abnormalities occur in the generation or conduction of excitation, the frequency and rhythm of heart activity are disturbed, which is called arrhythmia. Like a power plant, a generator, an electric wire and a light, if one of the links goes wrong, the light will not shine.  There are four types of treatment for arrhythmias: psychotherapy, medication, surgery and radiofrequency ablation of cardiac catheters. Psychotherapy is the basic treatment, but it is mainly for arrhythmias with milder symptoms and less danger, such as atrial premature beats, ventricular premature beats and sinus tachycardia. Drug therapy is a treatment for the symptoms, which requires long time maintenance and may have side effects and arrhythmogenic effects, and some drugs may reduce the occurrence of arrhythmia but increase the death of patients. Surgical procedures require open-heart surgery, which is very traumatic and rarely used at present. With advances in medical technology, many arrhythmias can now be treated by interventional methods, including radiofrequency ablation, which can cure many tachyarrhythmias.  Radiofrequency ablation is performed by passing an electrode catheter into the heart under the monitoring of an X-ray angiography machine, first examining the location of the abnormal structure causing tachycardia, then releasing a high-frequency current locally at that location, generating high temperature in a small area, and through thermal efficiency, causing water to evaporate from the local tissue, drying and necrosis, and achieving the purpose of treatment. Since the local damage caused by radiofrequency current to the myocardium is very limited, about 3-4 mm in diameter and depth, it will not affect the surrounding normal myocardial tissue, so patients generally have no significant discomfort during the operation. Most of the procedures are completed in about one hour, and patients are usually discharged in two to three days.  Generally speaking, the following arrhythmias can be treated by radiofrequency ablation of cardiac catheters: 1, paroxysmal supraventricular tachycardia, sudden onset of panic, each lasting from a few minutes to a few hours, and the diagnosis can be made clearly by electrocardiogram during the attack; 2, most of the preexcitation syndrome can be clearly diagnosed by ordinary electrocardiogram, but if accompanied by panic or atrial fibrillation, radiofrequency ablation should be performed; 3, atrial flutter and atrial tachycardia, panic is the main manifestation, and the patient can be diagnosed by electrocardiogram during the attack. 4. Idiopathic ventricular tachycardia without other organic heart disease is often accompanied by dizziness and sometimes syncope when panic occurs; 5. Atrial fibrillation includes paroxysmal and persistent, repeated panic, which is easy to produce blood clots and increase the incidence of stroke. At present, the success rate of radiofrequency ablation of atrial fibrillation is not as high as the success rate of other types of tachycardia, but it is still an important treatment for atrial fibrillation; 6, ventricular premature beats with obvious symptoms of frequent ventricular premature beats, which are poorly controlled by drugs.  Radiofrequency ablation is by far the most rapidly developing and widely accepted new technology by both doctors and patients. At present, radiofrequency ablation has developed from the original two-dimensional positioning technology to today’s three-dimensional positioning technology, just like the satellite positioning system, which can more accurately find the root cause of arrhythmia, improve the cure rate and reduce the amount of X-rays the patient receives. It is a kind of radical treatment, so there is no need to take medicine after the operation, and all life and work processes will return to normal, and it is a relatively safe treatment method, the main complications are local bleeding, thrombosis, atrioventricular block, pericardial compression; its complication rate is about 1%.