Arrhythmia disorders and treatment
There are two types of cardiac rhythm disorders, supraventricular arrhythmia and ventricular arrhythmia:
- Atrial fibrillation, atrial flutter, and atrial tachycardia (rapid heartbeat): arrhythmias caused by atrioventricular (AV) nodal reentry, where two conduction paths—slow and fast—create an abnormal electrical circuit, causing bouts of fast heartbeats
- Arrhythmias: arrhythmias such as Wolff-Parkinson-White (WPW) syndrome, which can cause attacks of tachycardia and, infrequently, can be fatal.
Ablation is the treatment of choice for many patients with AV nodal reentry or WPW. This procedure is very safe and offers a very high success rate. Ablation also has a very high success rate for atrial flutter. Sophisticated ablation techniques are also used for treatment of atrial fibrillation. In many cases this arrhythmia originates in the pulmonary (lung) veins that deliver oxygenated blood from the lungs to the left atrium and ventricle. Ablative treatment that focuses on specific areas at the opening to these veins is highly successful. State-of-the-art imaging and navigation equipment used at the Tel Aviv Sourasky Medical Center, such as NAVx and CARTO, greatly enhance ablation efficacy.
Ventricular arrhythmias are caused by disturbances in the left or right ventricle. These arrhythmias are generally the result of scarring from heart occlusions or heart disease, such as right ventricular dysplasia or dilated cardiomyopathy, but can also occur in hearts without apparent structural disease, as in several genetic diseases. The latter group of diseases includes conditions such as long QT syndrome and Brugada syndrome.
Therapy for ventricular arrhythmias includes medications, ablation procedures and implantation of implantable cardioverter defibrillators (ICD) devices. Life-saving ICDs are implanted in a procedure similar to that of a pacemaker, but in addition to pacing functions, these devices can terminate ventricular arrhythmias by rapid pacing or by electric shock administration. At times, treatment involves the integration of ICD implantation and medications. When these solutions are ineffective, patients can be treated with targeted ablation techniques using potential mapping and three-dimensional imaging and navigation technologies, such as NAVx or CARTO.