Radiofrequency ablation is the treatment of tachyarrhythmia by introducing radiofrequency current (a high-frequency electromagnetic wave) into the heart through a catheter to ablate localized cardiomyocytes in specific areas in order to block the foldback loop or eliminate the lesion. Shanghai Yuanda Cardiothoracic Hospital Cardiac Center adopts radiofrequency ablation: that is, under the monitoring of X-ray angiography machine, the electrode catheter is inserted into the heart through the punctured blood vessel, and the location of the abnormal structure causing tachycardia is examined first, and then high-frequency current is released locally at the location, which generates high temperature in a small area, and through thermal efficiency, water evaporates in the local lesion tissue and dries up the necrosis to achieve the treatment purpose This method is less invasive and has a high cure rate. This method is the best way to treat patients with this type of heart disease because of its small trauma, high cure rate, short hospitalization time and almost no serious complications. Indications for radiofrequency ablation (1) Atrial folding tachycardia, i.e., overt and occult pre-excitation syndrome. There is a congenital “bypass” between the atria and the ventricles, and radiofrequency catheterization “cuts off” the bypass so that the tachycardia or preexcitation wave never occurs again. (2) Atrioventricular node foldback tachycardia atrioventricular node forms the so-called “double pathway”, so that small currents will run fast in the foldback loop formed by the two pathways under suitable conditions, causing tachycardia. This tachycardia will not recur if the slow path is eliminated by RF catheterization and only the fast path is retained. (3) Atrial flutter Atrial flutter is a large loop in the atria (mainly the right atrium), tiny currents keep circling on this loop, and the atria can beat up to 300 beats/min, while the ventricles are usually at 150 beats/min. Catheter radiofrequency can destroy the right atrial slit causing a bidirectional current block in the loop, thus eradicating atrial flutter. (4) Atrial tachycardia (atrial tachycardia) is due to an abnormally fast “excitation point” in the left or right atrium or a small foldback movement in the atrium. The ectopic “excitation point” or the site of the folding loop can be detected by electrophysiological examination and ablation can be performed to cure the problem. (5) Atrial fibrillation (AF) is a very common cardiac arrhythmia. Scientists have recognized that atrial fibrillation is triggered by rapid electrical impulses from the “myocardial sleeve” in the large vein connected to the atria; in addition, the persistence of atrial fibrillation is related to the atrial muscle’s own remodeling. Atrial fibrillation can be cured by ablation with catheter electrodes in the circumferential pulmonary vein to create “electrical isolation” of the large vein from the atrium, or by adding some linear ablation in the atrium. (6) Ventricular premature contractions are mainly used for frequent ventricular premature contractions of monogenic origin with obvious clinical symptoms. It is often caused by a single “focal point of excitation” located in the outflow tract of one ventricle. Immediate ablation of the ectopic foci of excitation is indicated by the disappearance of premature ventricular contractions. (7) Idiopathic ventricular tachycardia This type of ventricular tachycardia is common in people with normal heart structure and function and no evidence of organic heart disease. However, tachycardia committed too frequently can cause tachycardia cardiomyopathy. It occurs when a “focal point of excitation” in the right or left ventricular outflow tract and left ventricular septum of the heart rapidly delivers a small electrical current, resulting in ventricular tachycardia. The catheter radiofrequency can find the location of the “foci of excitation” and eliminate them, so that ventricular tachycardia can no longer occur. (8) Bundle branch folding ventricular tachycardia is seen in patients with organic heart disease. Patients often experience syncope and convulsions during the attack, requiring emergency resuscitation. This type of tachycardia is characterized by tiny currents turning in circles between the left and right bundle branches and the left and right ventricles. When the catheter electrode finds the right bundle branch, the current is issued to block it, this loop is broken, and the tachycardia does not occur. Catheter radiofrequency ablation can cure this tachycardia, but it cannot cure the heart disease. If ablation is unsuccessful or the ventricular tachycardia is life-threatening, a buried defibrillator will be implanted. Preoperative preparation for radiofrequency ablation (1) electrocardiogram; (2) X-ray; (3) echocardiogram; (4) laboratory tests. Radiofrequency ablation operation method (1) Disinfection of the puncture site and cover the operation sheet. (2) Puncture and lower the catheter. (3) Electrophysiological examination – find the “target point”: induce tachycardia with the stimulator, then record the electrocardiographic activity synchronously with electrodes to find out the site where the electrical activity occurs in the tachycardia, which is the origin of the tachycardia and the “target point” of the large head ablation. The “target point” for large head ablation. (4) Discharge until the ECG changes, continue to stimulate with the stimulator, if the tachycardia can be induced, rescale and discharge; otherwise, observe for 15 minutes, the patient has no abnormalities, the procedure is successful, withdraw the catheter and the inner sheath, compress the puncture site for 15-20 minutes, dress the wound, and the procedure is finished. Advantages of radiofrequency ablation Compared with drug treatment, catheter radiofrequency ablation can be a one-time cure, and no longer need to use anti-arrhythmic drugs after the operation; compared with surgery, it does not need open chest and general anesthesia, the patient is painless, and the operation method is simple. It is characterized by small trauma, fast recovery, high cure rate, 24 hours after surgery, short hospitalization time (generally discharged in three days after surgery), and rapid cure. Postoperative attention after radiofrequency ablation (1) Stop moving within 6 hours to prevent bleeding from the puncture site. (2) Proper cardiac monitoring. (3) Quick recovery and discharge the next day. (4) A little rest and you can work immediately.