Arrhythmias: catheter ablation for the treatment of rapid tachycardia

New guidelines for the treatment of rapid cardiac arrhythmias

Supraventricular tachycardia (SVT) is a heart rhythm disorder that is not normally life threatening, but can be very uncomfortable. The European Society of Cardiology (ESC) has now published new guidelines for SVT.

The European Society of Cardiology (ESC) guidelines on supraventricular tachycardia (SVT) were published online in the “European Heart Journal” and on the ESC website on Saturday. The document highlights how catheter ablation is revolutionizing the treatment of this group of common arrhythmias (cardiac arrhythmias).

Women are at twice the risk as men

As the ESC explains in a message, the SVT has a heart rate of more than 100 beats per minute (the normal resting heart rate is 60 to 100). SVTs are common arrhythmias with a prevalence of approximately 0.2% in the general population. Women are at twice the risk of SVT than men, while people aged 65 and over are at more than five times the risk of SVT than younger people.

SVTs usually start and stop suddenly. They arise in the atria of the heart and are rarely life-threatening. Most SVTs, however, if left untreated, are lifelong diseases that affect heart function, increase the risk of stroke, and decrease quality of life. Symptoms include palpitations, rapid heartbeat, tiredness, drowsiness, dizziness, chest pressure, shortness of breath and changes in consciousness.

Further development of catheter ablation

The guidelines contain treatment recommendations for all types of SVT. Drug therapies for SVT have not changed significantly since the previous guidelines were published in 2003. “We have more data on the potential benefits and risks of multiple drugs and we know how to use them more safely. Some new antiarrhythmic drugs are also available, ”said Josep Brugada, professor of medicine at the University of Barcelona, ​​one of the leaders of the guidelines working group.

Antiarrhythmic drugs are said to be suitable for acute episodes. These drugs are of limited value for long-term treatment due to their relatively low effectiveness and the associated side effects.

The most important change in clinical practice over the past 16 years has been due to the availability of more efficient and safe invasive methods to remove arrhythmia through catheter ablation. As explained on the website of the Heart and Diabetes Center North Rhine-Westphalia (HDZ NRW), University Clinic of the Ruhr University Bochum, ablation therapy deliberately damages heart tissue, which is responsible for the development or maintenance of an arrhythmia.

"Different forms of energy and catheters are available for the obliteration of tissue. For example, in the treatment of atrial fibrillation," cold energy "is often used, which is released via a balloon to the inner layer of the heart muscle tissue. In most other ablations, on the other hand, the tissue is heated in order to cause sclerotherapy, ”it continues.

Guideline Working Group member Professor Demosthenes Katritsis from Hygeia Hospital in Athens said: "Catheter ablation techniques and technologies have evolved so that we can now offer this treatment method to most of our patients with SVT."

Specific recommendations for pregnant women

According to the ESC, SVT is associated with a higher risk of complications during pregnancy, which is why specific recommendations are made for pregnant women. All antiarrhythmic drugs should be avoided if possible within the first trimester of pregnancy. However, if necessary, some medications can be used with caution during this time.

“Pregnant women with persistent cardiac arrhythmia, who do not respond to medication, or who are contraindicated or undesirable with drug therapy, can now be treated with catheter ablation using new techniques that avoid exposing the patient or her baby to harmful radiation become, ”says Prof. Katritsis.

Finally, the ESC Communication explains what people should do if they have a fast heartbeat. "Always seek medical help if you have a fast heartbeat," said Prof. Brugada. “If you suspect SVT, you should undergo electrophysiological examinations with regard to catheter ablation, as some of the underlying diseases have serious long-term side effects and can inadvertently affect your well-being. The prevention of recurrences depends on the type of SVT. Ask your doctor for advice. Catheter ablation is safe and heals most SVTs. ”(Ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Video: Ablation: Treatment for Ventricular Tachycardia - Part 1 (January 2022).