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Ablation Techniques

In medicine, ablation is the removal or excision of any sort of tissue, usually by surgery. In heart disease, ablation techniques have become high-tech and sophisticated with great benefits to patients. The techniques developed use direct current, radiofrequency, cryoenergy (freezing), ultrasound, and rotablation. These procedures are done by cardiac specialists working with imaging specialists. Active devices are inserted into the heart through a catheter.

  1. Direct Current

    • This technique was one of the first used for patients with cardiac tachycardias (rapid heartbeats). Risks of using high-voltage, direct current from a standard external defibrillator in catheter ablation included a high complication rate and the need for general anesthesia. Direct current has been replaced by radiofrequency ablation.

    Radiofrequency Ablation

    • This technique uses low-voltage, high-frequency or radiofrequency alternating current for treatment of heart arrhythmias. The electrode is inserted into the end of a catheter which has been threaded through the femoral vein into the heart. Radio waves generated by the electrode produce heat that destroys the targeted tissue. General anesthesia is not required.

    Cryoenergy Ablation

    • Cryoenergy ablation or cryoablation is not yet widespread. Cold is delivered via an electrode tip using nitrous oxide as a refrigerant fluid, which freezes selected tissue. Successful use on pediatric patients with supraventricular tachycardias in Italy was reported in 2004.

    Ultrasound Ablation

    • Ultrasonic ablation is still being evaluated for cardiac conditions. In 2008, Dr. Mark Groh and associates at the Mission Saint Joseph Hospital in Asheville, North Carolina reported successful ablation of atrial fibrillation with therapeutic ultrasound for 98 patients.

    Rotablation

    • Blockages in heart arteries are removed with the rotablator. Inserted through a catheter, the device has a diamond-tipped burr at its head which rotates 200,000 times per minute. It breaks up accumulated plaque. Some rotablators have small pouches or vacuums to collect the ablated plaque, but most allow the small pieces to go free and be eliminated by the body.

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