Catheter ablation

The electrophysiological study (EPU ) is a special cardiac catheterization in patients with cardiac arrhythmias.

The aim of the electrophysiological study is to determine the nature and mechanism of arrhythmias and also to carry out a therapy where possible. A simple test takes about 1-2 hours, in complex cases but also significantly longer. Mostly just local anesthesia at least two, but often three or more thin electrode catheter through the femoral vein under fluoroscopy are introduced into the right heart. This process is barely noticeable. Cardiac arrhythmias that originate in the left half of the heart, you can either go through the femoral artery and the body 's main artery to the heart or via a puncture of the atrial septum.

Of the electrode catheter, the electrical signals at various locations of the heart are recorded and triggered arrhythmia using pace pulses undetectable. In most cases, these cardiac arrhythmias on the inserted catheter with pacing pulses or by fast-acting drugs can be stopped again if symptoms occur. Only rarely termination of arrhythmia with an external electric surge in short anesthesia (defibrillation ) is necessary.

In addition to the classical method of investigation, there is also the possibility of using special computer-based systems to produce a three dimensional image of the heart cavity and the electrical excitation sequence. Advantage of this method is the reduced need for X-rays as well as the understanding of complex arrhythmias, particularly in previously operated heart or congenital heart defects. Following diagnosis of the arrhythmia, the examining physician may be other suggestions for therapy and sclerotherapy of the affected area with high frequency current or cold ( catheter ablation ) can be performed in many cases in the same study.

A new method for the targeted control of the electrode catheter is the magnetic navigation. It was a very soft and flexible catheter is inserted with a small magnet at the top, which is directed from the outside via computer-controlled permanent magnets. The physician controls the catheter via a joystick and can so unerringly drive held for obliteration points on the inner heart wall. This method also regions of the heart can be achieved which were not amenable to catheter ablation before. This is important for example for the treatment of atrial fibrillation. The computer also helps to achieve already covered automatically again when the ablation did not work correctly at the first attempt. The soft catheter also has the advantage that it can not injure the vessels as previously used wire catheter.

• The diagnostic method in cardiology
• Apparative investigation procedure