Treatment of Typical Atrial Flutter at Dr. Erfan and Bagedo General Hospital usingRadiofrequency Ablation with a success Rate of 97% at Dr.Erfan & Bagedo General Hospital
Cardiac dysrrhythmias are considered one of the most common cardiac disorders all over the world. Fortunately, most of the etiologies of these dysrrhythmias are benign in naturehowever some of them are considered of high risk for the cardiac patients even in thosewithout structural heart disease and might be disabling for them during their usual daily
During the Operation
Recently we had performed electrophysiological study for a 60 year old gentleman whowas complaining of recurrent irregular heart beats associated with exhaustion despite thepreviously prescribed medications at another medical facility. HIs electrocardiogram
showed evidence of atrial related tachyarrhythmias called atrial flutter. This type oftachyarrhythmia is characterized by abnormal atrial electrical activity with increase of theatrial rate up to 300 beats per minute. It is more common in males having increased risk ofthromboemolism.
Electrophysiological study is a fairly recent method for treatment of tachyarrhythmias. It is
performed under local anesthesia with the introduction of multipolar electrode catheters
into the different cardiac chambers through the peripheral veins and arteries to record theintracardiac signals in contrast to the conventional surface electrocardiogram whichrecords the cardiac signal over the surface of the body. It is more precise in diagnosing thetype of tachyarrhythmias. Induction of the different types of tachyarrhythmias is donethrough pacing stimulation of the heart through the different cardiac chambers by using anexternal device called “the stimulator”. This is done to accurately determine themechanism and type of different tachyarrhythmias. Whenever the tachyarrhythmia is induced and accurately diagnosed, termination of the tachyarrhythmias will be done usingRadiofrequency current generated through a specific device called “the Radiofrequency
Generator”. This current is conveyed to the targeted area through a specialized multipolar
electrode catheter called “the ablation catheter”. This procedure is called “Radiofrequency
Ablation”. After termination of the tachyarrhythmia, trials for induction of arrhythmia is doneagain through giving specific medications and also through pacing stimulation of the heart.
During the procedure the patient will feel rapid heart beats and some chest pain that is dueto radiofrequency current application and this can be controlled by giving analgesics andpain killers during the ablation procedure. The whole procedure would take about 2-4hours and it is variable from one person to another and according the type of tachyarrhythmias.
The success rate of such procedure in termination of the atrial flutter reaches up to 97% with a small rate of recurrence which reaches up to 8% in most of the literature reviews.
The procedure related risk is very small reaching up to 1%.
This case is considered one of the first cases done at a private hospital in the westernarea in the kingdom.
Dr. Hesham Yehia
Director of Cardiac Catheterization LAB
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