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Catheter Ablation for PSVT

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Paroxysmal Supraventricular Tachycardia (PSVT)- RF Ablation: An Overview

Have you experienced a recurring rapid heartbeat that starts and stops abruptly? You could be having episodes of PSVT or Paroxysmal Supraventricular Tachycardia, also known as SVT or Supraventricular Tachycardia.

This common arrhythmia happens when an abnormal electrical circuit develops in the atria or the upper heart chambers. During an episode of PSVT, your heartbeat could rise beyond 100 bpm without any specific reason. PSVT is more common among children and babies and specifically among children with existing heart issues.

Recurring PSVT episodes are not suitable for your heart. This condition calls for immediate diagnosis and treatment, and if left untreated, it can weaken your heart muscles and lead to further complications.

Fortunately, the good news is that most of the time, PSVT can be cured with radiofrequency ablation or RF ablation. There is no one better to perform this procedure than Dr Karthigesan. He is a Cardiac Electrophysiology and Device Specialist, certified by the International Board of Heart Rhythm Examiners, USA. As a Senior Consultant Cardiologist in Chennai, Dr Karthigesan has helped improve the quality of life for thousands of patients with RF ablation.

Furthermore, it is important to note that RF ablation or catheter ablation is the primary therapy for PSVT and is generally considered safe and effective.

A bisection image of the heart illustrating Paroxysmal Supraventricular Tachycardia.
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Image of the His bundle catheter and the Ablation catheter.
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Types of Paroxysmal Supraventricular Tachycardias

PSVT is caused by one or multiple abnormal connections between the top and bottom chambers of your heart, either directly or through the Atrioventricular node. The most common types of PSVT are:

  • Atrioventricular Nodal Re-entrant Tachycardia (AVNRT)
  • Atrioventricular Re-entrant Tachycardia (AVRT)
  • Antidromic Reciprocating Tachycardia.
  • Atrial Tachycardia
  • Atrial flutter

Catheter Ablation for PSVT: Evaluation Tests

Dr. Karthigesan will recommend the following tests before proceeding with catheter ablation.

  • Holter monitor  or ELR in case of suspected but not documented SVT.
  • Electrocardiogram(EKG) to analyse your heart's electrical impulses
  • Echocardiogram to assess the heart size, pumping capacity and strength
  • Chest X-ray to understand the status of your heart and lungs
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The image illustrates the Radio frequency Ablation procedure.
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Radiofrequency Ablation: The Procedure
  • Before the procedure, Dr Karthigesan will administer local anaesthesia to numb the groin area from pain or discomfort.
  • A small needle is used to create puncture sites on your arteries or veins, through which multiple catheters are guided into your heart. X-ray monitors are used to guide the catheters through the right path.
  • The catheters locate the areas in your heart that generate abnormal electrical impulses and mark the affected areas on our 3D mapping system.
  • Once these areas are marked, radiofrequency energy will be delivered through the catheters to ablate the marked tissues and create lesions which will block the abnormal electrical impulses generated in your heart.
RF Ablation: Before, During & After Procedure Care
  • Avoid food consumption for several hours before the procedure.
  • Temporarily discontinue certain routine medications for a few days as instructed.
  • Avoid using perfumes, lotions, and moisturisers.
  • Dr Karthigesan will administer local anaesthesia in your groin. This way, you will not feel any pain when inserting the catheter since the area will be desensitised.
  • Based on the type of arrhythmia, the procedure may last for 90 minutes to 120 minutes.
  • Remain lying flat for 6 hours to ensure that all bleeding is controlled and that your groin area is healing well. Usually, you won’t need stitches (sutures).
  • Expect some soreness or bruise in the procedure area for at least a week. Applying ice packs or cold compresses will help.
  • Take the prescribed blood thinners, which will help mitigate the risk of blood clots while you recover.
  • Avoid lifting heavy objects and engaging in sports activities during your recovery period.
RF Ablation: The Benefits
  • Quality of care: Most cardiac arrhythmias can be treated and cured by catheter ablation, thereby eliminating the need for lifelong medical therapy.
  • Quality of Life: catheter ablation can restore the quality of life of the patient leading to happier family life and improved productivity at the workplace.
  • Save lives: Some life-threatening ventricular arrhythmias can be successfully treated with catheter ablation, thereby providing patients with an option to live.
  • Cost of care: The overall lifecycle cost of care for the patient may be reduced due to the curative nature of catheter ablation therapy.
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More About PSVT- RF Ablation

It is imperative that you consult Dr Karthigesan if you have been experiencing recurring arrhythmia symptoms such as:

  • On and off palpitation
  • Pain in the chest
  • Shortness of breath
  • Dizzy spells
  • Fainting spells

Dr Karthigesan will diagnose your symptoms and start on the right course of treatment to restore your normal heart rate.

Radiofrequency ablation for PSVT is required to avoid long-term medication, repeated hospitalisation, emergency admissions, life-threatening complications, heart failure symptoms or syncope. However, Dr Karthigesan may suggest medication and other non-invasive treatment methods if your symptoms are minimal and rarely occurring.

Not at all. Since this is a minimally invasive procedure, you will be given lidocaine, a local anaesthetic, to numb the area before the procedure begins. At that time, you mainly experience a little pain when the catheter is placed into your vein. Apart from this pain, the rest of the procedure is generally painless.

The success rate of the procedure depends on which type of SVT is present but is usually 98-99% successful.

It may take upto one or two days to recover from a PSVT ablation procedure. You will be discharged after the procedure on the same day or the next day. You will be able to return to your daily routine in a day or two.

The ablated heart tissues need as much time to heal, during which you may experience irregular heartbeats in the first few weeks.

Generally, 99% of people recover well and experience a good improvement in their quality of life post-RF ablation. However, there are chances of arrhythmia recurring even after the treatment is less than 1%. In such instances, you should immediately consult Dr Kathigesan. He may recommend other courses of treatment or repeat the procedure to rectify the condition.

Cryo Mapping followed by Cryo ablation can be performed instead of conventional RF ablation in all PSVTs and certain Ventricular arrhythmias. Cryoablation, commonly used in children and certain arrhythmias, originates close to the natural electrical system to avoid damage with RF ablation.

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